Resumen en este artículo se presenta el concepto resiliencia familiar, revisando sus antecedentes históricos, desarrollos actuales y posibles aplicaciones en el campo de la intervención clínica, psicosocial y de salud con familias altamente vulnerables. este enfoque permite articular los aportes teóricos y empíricos de campos hasta ahora inconexos, como las ciencias del desarrollo, la terapia familiar y la intervención biopsicosocial con familias y niños vulnerables. Se distingue entre el riesgo crónico, la crisis significativa o la tensión familiar, en cuya presencia se activan procesos de resiliencia diferentes. la resiliencia familiar se define como el conjunto de procesos de reorganización de significados y comportamientos que activa una familia sometida a estrés para recuperar y mantener niveles óptimos de funcionamiento y bienestar, equilibrando sus recursos y necesidades familiares. Quedan numerosos aspectos metodológicos que resolver, como evaluar familias integralmente, la necesidad de estudios longitudinales y de investigación especialmente diseñada a partir de este enfoque.Palabras Clave: resiliencia familiar, estrés familiar, crisis familiar, familias multiproblemáticas, intervención.
The authors reviewed papers published between 1999 and 2009 in journals indexed in PsycInfo, PubMED, EBSCO and ProQuest concerning the characteristics, effectiveness and challenges of home visit programmes orientated towards early childhood intervention, clarifying the research's scope and limitations and its applications. Home visiting has been shown to be effective for a variety of relevant areas, especially for developing parent skills and child-caregiver relationships. The most effective programmes have started at pregnancy, lasted more than a year, had specially trained staff and have focused on building a trustworthy relationship and on modelling the infant-caregiver interaction. The importance of considering target population characteristics, the visiting model used and the visitor agent was identified in designing these programmes. In spite of the evidence accumulated in Anglo-Saxon studies, the costs associated with these programmes can be very high, thereby implying barriers which can make their dissemination difficult in Latin-American countries. The authors discuss the need for developing and evaluating other variants (i.e. including community agents), considering their cost/effectiveness ratio for treating early childhood problems, needs and characteristics in Latin-America.
ResumenSe presenta los resultados obtenidos por los Centros de Desarrollo Infantil Temprano (DIT) en familias con vulnerabilidad psicosocial. Mediante un estudio longitudinal no experimental, se observó una mejoría estadísticamente signifi cativa en el desarrollo psicomotor infantil, identifi cándose en el EEDP un efecto preventivo para casos con normalidad inicial y un efecto nivelador para casos en riesgo inicial (n=166, p<0.05). Asimismo, se observó un aumento en la proporción de casos clasifi cados con apego seguro en el ADS y de disminución de aquellos con apego evitativo (n=49, p<0.01). Si bien no pueden atribuirse vínculos causales con la intervención, los datos aportan evidencia que respalda la labor realizada por losCentros DIT e incentivan a desarrollar nuevas investigaciones en programas de intervención temprana en la realidad latinoamericana. Palabras Clave: Intervención Temprana, Desarrollo Infantil, CEANIM, Evaluación de Resultados AbstractThe outcomes achieved by the Centers of Early Child Development (DIT) in families with psychosocial vulnerability are presented. By means of a non experimental longitudinal study, a statistical signifi cant improvement in infant psychomotor development was observed, identifying in the EEDP a preventive effect for the cases with initial normality and a leveling effect for the cases with initial risk (n=166, p<0.05).Likewise, it was observed an increase in the proportion of cases classifi ed with a secure attachment in the ADS, and a decreased of those cases classifi ed with evitative attachment (n=49, p<0.01). Although causal links with the intervention cannot be established, data gives evidence that support the work of DIT Centers, and incentive to develop new research with early intervention programs in Latin-American reality.
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