Resumen:Objetivo: El cáncer infantil es una enfermedad que modifica el estilo y calidad de vida de los niños y sus familias debido al impacto físico, emocional y económico que provoca. Los Cuidados Paliativos Pediátricos tienen entre sus funciones otorgar atención psicológica a los niños y sus familiares desde la etapa prediagnóstica con la finalidad de mejorar el estado anímico del paciente y promover pensamientos y conductas que le permitan adaptarse a su nueva condición y mejoren la adherencia al tratamiento. Se expone el caso de una paciente pediátrica con diagnóstico de Sarcoma Sinovial que presenta sintomatología depresiva y evitación ansiosa a raíz de su padecimiento. Método: La evaluación se realizó mediante entrevista conductual y observación directa de la sintomatología ansiosa y depresiva intrahospitalaria y la Escala Visual Análoga (EVA) para el dolor. El tratamiento se llevó a cabo en siete sesiones en las que se emplearon técnicas de la Terapia Cognitivo-Conductual. Resultados: Entre los resultados se obtuvieron verbalizaciones adaptativas sobre su padecimiento, posibles tratamientos médicos, autoconcepto, una mejora en la expresión emocional y control del dolor. Conclusiones: El presente caso es una muestra de la importancia que tiene la labor del psicólogo en los Cuidados Paliativos Pediátricos, así comoel impacto del trabajo con los niños que padecen enfermedades oncológicas y sus familiares. La Terapia Cognitivo-Conductual ha demostrado ser altamente eficaz en este tipo de pacientes, aún en intervenciones breves. Palabras Clave: Cuidados paliativos pediátricos; terapia cognitivo-conductual; cáncer infantil; ansiedad; depresión y estrés.[en] Cognitive-behavioral intervention in pediatric palliative care: a clinical case Abstract: Objective: Childhood cancer is a disease that modifies the style and quality of life of children and their families due to the physical, emotional and financial impact it has on them. Pediatric Palliative Care has among its functions the granting of psychological attention to children and their families from
IntroductionCountertransference (CT) includes a full range of cognitive, affective and behavioral responses that therapists experiment with their patients. Recent evidence indicates that countertransference can help understand the psychological reality of the patient, and also be a prognostic indicator of treatment.Objectiveto evaluate the relationship between countertransference and the patient´s psychopathology.MethodAn adapted Countertransference Questionnaire (CTQ), made by Betan et al, was applied to a group of psychiatry residents and teaching psychiatrists after observing a first psychodynamic psychotherapy interview through a one way mirror during the year 2013. The patients clinical severity was measured with the Clinical Global Impression Scale (CGI- severity of illness), and then categorized into mild (3), moderate (4) and severe (5).Resultswe found statistically significant difference between the three groups of CGI in the scores of the CTQ factor of Empathic-Involved countertransference (Kruskal-Wallis test X2 = 17.335, p <.000) with mean values of 65, 03 (mild), 124,57 (moderate) and 72,58 (severe) and in the Distant-Rejecting countertransference factor (Kruskal-Wallis test X2 = 29.045, p < .000) with mean values of 82,44 (mild), 39,67 (moderate) and 83,30 (severe).Fig 1Countertransference (CTQ) and Severity of Illness (CGI)ConclusionWe have found controversy in the literature regarding countertransference and the patients severity of illness. Our results suggest that psychiatry residents and faculty react with less Empathic-Involved CT, and more Distant-Rejecting CT in the mild and severe patients (CGI).
Countertransference (CT) includes a full range of cognitive, affective and behavioral responses that therapists experiment with their patients. Countertransference is closely related to Empathy; defined as the ability to understand and share emotional experiences and mental states of others. The Countertransference Questionnaire (CTQ, by Betan et al measures and groups countertransference within seven factors, including an Empathic-Involved CT factor (EICT). Empathic researched has showed that female health professionals present higher scores on empathy scales than men. OBJECTIVE: describe the relationship, if any, between sex and scores in the Empathic-Involved CT factor (EICT), in a group of observers and interviewers during a first psychotherapy interview. METHOD: An adapted version of the Countertransference Questionnaire (CTQ), made by Betan et al, was applied to a group of psychiatry residents and teaching psychiatrists after observing a first psychodynamic psychotherapy interview through a one way mirror room during the year 2013. RESULTS: Women, with a median of 27, scored significantly higher than the group of men, with a median of 25 for EICT (Mann-Whittney, U = 2263, p = 0.038). CONCLUSIONS: Our results show that female residents and psychiatry faculty scored higher for EICT than their male colleagues. These findings suggest and are consistent with lliterature research, where female health professionals present more empathy compared to their male colleagues. A limitation of this study is the homogeneity of the sample, since all interviews were observed and / or performed by the same professional.
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