Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2015-0039
Trends in Psychiatry and Psychotherapy
Original Article

Development of Brazilian prototypes for short-term psychotherapies

Desenvolvimento de protótipos brasileiros para psicoterapias de curta duração

Fernanda Barcellos Serralta; John Stuart Ablon

http://dx.doi.org/10.1590/2237-6089-2015-0039 Trends Psychiatry Psychother, vol.38, n2, p.71-79, 2016
PDF
SciELO
Downloads: 0
Views: 361

Abstract

Abstract Introduction: The Psychotherapy Process Q-Set (PQS) prototype method is used to measure the extent to which ideal processes of different psychotherapies are present in real cases, allowing researchers to examine how adherence to these models relates to or predicts change. Results from studies of short-term psychotherapies suggest that the original psychodynamic prototype is more suitable for studying psychoanalysis and long-term psychodynamic psychotherapy than its time-limited counterparts. Furthermore, culture probably influences how therapies are typically conducted in a given country. Therefore, it seems appropriate to develop Brazilian prototypes on which to base studies of short-term psychodynamic and cognitive-behavioral processes in this country. Objective: To develop prototypes for studying processes of short-term psychotherapies and to examine the degree of adherence of two real psychotherapy cases to these models. Methods: Expert clinicians used the PQS to rate a hypothetical ideal session of either short-term psychodynamic psychotherapy (STPP) or cognitive-behavioral therapy (CBT). Ratings were submitted to Q-type factor analysis to confirm the two groups. Regressive factor scores were rank ordered to describe the prototypes. These ideal models were correlated with ratings of actual therapy processes in two complete psychotherapy cases, one STPP and the other CBT. Results: Agreement levels between expert ratings were high and the two ideal models were confirmed. As expected, the PQS ratings for actual STPP and CBT cases had significant correlations with their respective ideal models, but the STPP case also adhered to the CBT prototype. Conclusion: Overall, the findings reveal the adequacy of the prototypes for time-limited therapies, providing initial support of their validity.

Keywords

Psychotherapeutic processes, brief psychotherapy, psychodynamic psychotherapy, cognitive behavioral therapy

Resumo

Resumo Introdução: O método dos protótipos derivados do Psychotherapy Process Q-Set (PQS) mensura em que medida processos de diferentes psicoterapias estão presentes em casos reais, permitindo pesquisadores examinarem como a adesão a esses modelos se relaciona com ou prediz a mudança. Resultados de estudos com psicoterapias breves sugerem que o protótipo psicodinâmico original é mais adequado para estudar psicanálise e psicoterapia psicodinâmica de longo prazo do que suas variantes de tempo limitado. Além disso, a cultura provavelmente influencia o modo como as psicoterapias são tipicamente conduzidas em determinado país. Portanto, parece apropriado o desenvolvimento de protótipos brasileiros para subsidiar estudos de processos psicodinâmicos e cognitivo-comportamentais de curto prazo neste país. Objetivo: Desenvolver protótipos para o estudo dos processos de psicoterapias de curta duração e examinar o grau de adesão de dois casos reais de psicoterapia a esses modelos. Métodos: Especialistas brasileiros usaram o PQS para avaliar uma sessão hipotética ideal de psicoterapia psicodinâmica breve (PPB) ou de terapia cognitivo-comportamental (TCC). A análise fatorial do tipo Q foi realizada para confirmar os dois fatores. Os escores fatoriais regressivos foram ordenados para descrever os protótipos. Os protótipos foram correlacionados com as avaliações de processos reais de terapia em dois casos completos, um de PPB e outro de TCC. Resultados: Houve alta concordância entre especialistas, e os dois modelos ideais foram confirmados. Como esperado, os escores do PQS para os casos reais de PPB e TCC apresentaram correção significativa com seus respectivos modelos ideais, mas o caso de PPB aderiu também ao protótipo TCC. Conclusões: No geral, os resultados revelam a adequação dos protótipos para terapias com tempo limitado, fornecendo suporte inicial de sua validade.

Palavras-chave

Processos psicoterapêuticos, psicoterapia breve, psicoterapia psicodinâmica, terapia cognitivo-comportamental

References

Luborsky L, Rosenthal R, Diguer L, Andrusyna TP, Levitt JT, Seligman DA. Are some psychotherapies much more effective than others. J Appl P Psychoanal Stud. 2003;5:455-60.

Wampold BE, Mondin GW, Moody M, Stich F, Benson K, Ahn H. A meta-analysis of outcome studies comparing bona fide psychotherapies empirically, "all must have prizes". Psychol. Bull. 1997;122:203-15.

Baardseth TP, Goldberg SB, Pace BT, Wislocki AP, Frost ND, Siddiqui JR. Cognitive-behavioral therapy versus other therapies redux. Clin Psychol Rev. 2013;33:395-405.

Lambert MJ. Early response in psychotherapy Further evidence for the importance of common factors rather than "placebo effects". J Clin. Psychol. 2005;61:855-69.

Wampold BE. The research evidence in common factor models: a historically situated perspective. The heart and soul of change: Delivering what works in therapy. 2010:49-83.

Norcross JC. Psychotherapy relationships that work. 2011.

Shedler J. The efficacy of psychodynamic psychotherapy. Am Psychol. 2010;65:98-109.

DeRubeis RJ, Brotman MA, Gibbons CJ. A conceptual and methodological analysis of the nonspecifics argument. Clin Psychol Sci Pract. 2005;12:174-83.

Jones EE. Therapeutic action: a guide to psychoanalytic therapy. 2000.

Kazdin AE. Treatment outcomes, common factors and continued neglect of mechanisms of change. Clin Psychol Sci Pract. 2005;12:184-8.

McAleavey AA, Castonguay LG. The process of change in psychotherapy: common and unique factors. Psychotherapy research: foundations, process and outcome. 2015:293-310.

Beutler LE, Forrester B, Gallagher-Thompson D, Thompson L, Tomlins JB. Common, specific, and treatment fit variables in psychotherapy outcome. J Psychother Integr. 2012;22:255-81.

Ablon J, Jones E. How expert clinicians' prototypes of an ideal treatment correlate with outcome in psychodynamic and cognitive-behavioral therapy. Psychother Res. 1998;8:71-83.

Ablon JS, Jones EE. Validity of controlled clinical trials of psychotherapy Findings from the NIMH treatment of depression collaborative research program. Am J Psychiatry. 2002;159:775-83.

Jones EE, Pulos SM. Comparing the process in psychodynamic and cognitive-behavioral therapies. J Consult Clin Psychol. 1993;61:306-16.

Ablon JS, Levy RA, Smith-Hansen L. The contributions of the Psychotherapy Process Q-set to psychotherapy research. Res Psychother. 2011;14:14-48.

Ablon JS, Levy RA, Kazenstein T. Beyond brand names of psychotherapy identifying empirically supported change processes. Psychotherapy. 2006;43:216-31.

Serralta FB, Pole N, Tiellet Nunes ML, Eizirik CL, Olsen C. The process of change in brief psychotherapy effects of psychodynamic and cognitive-behavioral prototypes. Psychother Res. 2010;20:564-75.

Jones EE, Cumming JD, Horowitz MJ. Another look at the nonspecific hypothesis of therapeutic effectiveness. J Consult Clin Psychol. 1988;56:48-55.

Serralta FB, Nunes MLT, Eizirik CL. Elaboração da versão em português do Psychotherapy Process Q-Set. Rev Psiquiatr Rio Gd Sul. 2007;29:44-55.

Van Exel J, de Graaf G. Q methodology: A sneak preview. 2005.

Brown SR. Q technique and method: principles and procedures. New tools for social scientists: advances and applications in research methods. 1986:57-76.

Blagys MD, Hilsenroth MJ. Distinctive features of short-term psychodynamic-interpersonal psychotherapy a review of the comparative psychotherapy process literature. Clin Psychol Sci Pract. 2000;7:167-88.

Enéas MLE, Yoshida EMP. Psicoterapia breve psicodinâmica com adultos. Psicoterapias breves nos diferentes estágios evolutivos. 2012:154-76.

Lemgruber VB. Terapia focal: psicoterapia breve psicodinâmica. Psicoterapias: abordagens atuais. 2008:167-87.

Yoshida EMP. Evolução das psicoterapias breves psicodinâmicas. Psicoterapias psicodinâmicas breves: propostas atuais. 2004:13-36.

Barth J, Michlig N, Munder T. Unique and shared techniques in cognitive-behavioural and short-term psychodynamic psychotherapy a content analysis of randomised trials on depression. Health Psychol Behav Med. 2014;2:929-50.

Brown LA, Gaudiano BA, Miller IW. Investigating the similarities and differences between practitioners of second-and third-wave cognitive-behavioral therapies. Behav Modif. 2011;35:187-200.

6169e2f0a953955c323e5877 trends Articles
Links & Downloads
2238-0019 (Electronic)
Trends Psychiatry Psychother ©2024 All rights reserved.

Trends Psychiatry Psychother

Share this page
Page Sections