Fernanda Barcellos Serralta

Elaboração da versão em português do Psychotherapy Process Q-Set

INTRODUCTION: In Brazil, psychotherapy research is in its early development; there are no systematic studies of the therapeutic process, and there are few available measurement instruments for researchers interested in this field. OBJECTIVE: To develop a Portuguese version of the Psychotherapy Process Q-Set. METHOD: The development of a Portuguese version of the Psychotherapy Process Q-Set involved four stages: translation, back translation, evaluation of semantic equivalence and discussion of the results by the authors. Five raters were trained to apply the instrument. During the training, a field diary was used to record difficulties identified in task execution and to subsidize complementary data. Thereafter, the Psychotherapy Process Q-Set was applied to seven sessions of a short-term psychodynamic psychotherapy to examine agreement between referees. RESULTS: The Portuguese version of the Psychotherapy Process Q-Set presented good semantic equivalence with the original. The assessment of interrater reliability had a satisfactory result. It is worth stressing that applying the Psychotherapy Process Q-Set requires study, time and reflection. The discussion with raters pointed to the need of reviewing the application manual concerning the clinical examples. This will be performed in the near future to minimize the discrepancies observed in the understanding of some concepts and to better adjust them to the Brazilian reality. CONCLUSION: This study provides a Portuguese version of the Psychotherapy Process Q-Set, a versatile instrument that can be used in different contexts to quantitatively describe the therapeutic process of different psychotherapies in clinically significant terms.

The process of change in brief psychotherapy: Effects of psychodynamic and cognitive–behavioral prototypes

Abstract A brief psychodynamic psychotherapy was assessed using the Brazilian Portuguese version of the Psychotherapy Process Q-Set (PQS). Each session was scored for its adherence to expert psychodynamic therapy (PDT) and cognitive–behavioral therapy (CBT) prototypes derived from the PQS. Results revealed that the therapy process adhered more closely to prototypical CBT than prototypical PDT. Bivariate time-series analyses showed that prototype components capturing the clients adherence to ideal CBT behaviors and collaboration between therapist and client on ideal PDT and CBT behaviors predicted therapy progress. In addition, specific client symptoms influenced whether the therapist adhered to prototypical PDT or CBT behaviors.

Beginning and end of treatment of patients who dropped out of psychoanalytic psychotherapy

INTRODUCTION Even though it is expected that patients and therapist will agree on when to terminate psychotherapy, quite often patients discontinue treatment on their own. This study aims to better understand dropout in psychoanalytic psychotherapy (PP). METHOD Baseline and post-treatment interviews were conducted with six adult women classified by their therapists as dropout patients at a PP outpatient clinic. Results were analyzed using Bardins content analysis. RESULTS Content analysis generated five categories (reasons for treatment, goals, readiness to change, previous treatment, transference) for the baseline interviews and three categories (change process, results, interruption) for post-treatment interviews. Unclear treatment goals, low readiness to change, early signs of negative transference and resistance, and absence of recognition of their own participation in problems emerged in baseline interviews. In most cases, the patients evaluation of the therapeutic relationship was not determinant of dropout. Therapeutic gains, dissatisfaction, and resistance during the psychotherapeutic process seemed to be associated with noncompliance. CONCLUSIONS Decisions to initiate, continue, or quit PP depend on multiple factors, such as initial goals, readiness to change, insight capacity, awareness of personal problems, resistance, and transference. However, these factors should be considered in view of the methodological limitations of this study. Further investigation of PP dropout is still necessary.

Momentos distintos no abandono da psicoterapia psicanalítica

Objective To identify characteristics of beginning and end of treatment of patients who dropped out of psychoanalytic psychotherapy (PP) at different times: between 2 and 11 months (middle dropout = MD) or with more than one year (late dropout = LD) from the beginning of psychotherapy. Methods Initial and post-treatment interviews of 14 adults (seven MD and seven LD) considered as dropouts by their therapists were analyzed using Bardin’s content analysis method. Results The analysis of initial interviews generated five categories (reason, goals, willingness to change, previous treatment, transference) and three post-treatment categories (process of change, evaluation of results, termination). Conclusion In comparison with LD patients, MD patients have more resistances, expected more support, showed less positive transferences, more depressive complaints and reported more negative experiences with previous treatments. The majority of MD patients began treatment by indication of others while most LD patients sought psychotherapy by themselves. In post-treatment interview, MD patients revealed more resistance during psychotherapy, showed less capacity for insight and made more negative evaluations of treatment, both in general and in specific ways. The differentiation MD and LD patients is tenuous and there is a need of more research on the subject.