Luísa Soares

Benefits of virtual reality based cognitive rehabilitation through simulated activities of daily living: a randomized controlled trial with stroke patients

BackgroundStroke is one of the most common causes of acquired disability, leaving numerous adults with cognitive and motor impairments, and affecting patients’ capability to live independently. There is substancial evidence on post-stroke cognitive rehabilitation benefits, but its implementation is generally limited by the use of paper-and-pencil methods, insufficient personalization, and suboptimal intensity. Virtual reality tools have shown potential for improving cognitive rehabilitation by supporting carefully personalized, ecologically valid tasks through accessible technologies. Notwithstanding important progress in VR-based cognitive rehabilitation systems, specially with Activities of Daily Living (ADL’s) simulations, there is still a need of more clinical trials for its validation. In this work we present a one-month randomized controlled trial with 18 stroke in and outpatients from two rehabilitation units: 9 performing a VR-based intervention and 9 performing conventional rehabilitation.MethodsThe VR-based intervention involved a virtual simulation of a city – Reh@City - where memory, attention, visuo-spatial abilities and executive functions tasks are integrated in the performance of several daily routines. The intervention had levels of difficulty progression through a method of fading cues. There was a pre and post-intervention assessment in both groups with the Addenbrooke Cognitive Examination (primary outcome) and the Trail Making Test A and B, Picture Arrangement from WAIS III and Stroke Impact Scale 3.0 (secondary outcomes).ResultsA within groups analysis revealed significant improvements in global cognitive functioning, attention, memory, visuo-spatial abilities, executive functions, emotion and overall recovery in the VR group. The control group only improved in self-reported memory and social participation. A between groups analysis, showed significantly greater improvements in global cognitive functioning, attention and executive functions when comparing VR to conventional therapy.ConclusionsOur results suggest that cognitive rehabilitation through the Reh@City, an ecologically valid VR system for the training of ADL’s, has more impact than conventional methods.Trial registrationThis trial was not registered because it is a small sample study that evaluates the clinical validity of a prototype virtual reality system.

The co-constructed therapy alliance and the technical and tactical quality of the therapist interventions in psychotherapy

This study sought to describe a brief review of studies conducted on the therapeutic alliance, taking into consideration therapeutic process and outcomes. We seek to reflect about the need to encourage the communities who engage in and conduct research on clinical practice not only to implement surveys of empirically validated measures of therapeutic outcomes, but also make them a regular practice among all clinical mental health psychotherapists. We therefore suggest the following paradigm – the Practice Based on Evidence of Results (PBER) – as a way to improve the quality of technical and tactical interventions of psychotherapists

Bibliotherapy: A tool to promote children's psychological well-being

The focus of this article is on bibliotherapy and child development. Particular attention is given to collaboration between psychologists and educators. The authors identify and discuss the benefits of bibliotherapy, provide guidelines for practice, and discuss implementation. Cautions, new directions, and particular issues relating to bibliotherapy in Portugal conclude this article.

Pilot project for peer tutoring: a case study in a Portuguese university

Purpose – Tutoring or mentoring is a form of mutual and informal learning which has distant origins. This is a way of sharing knowledge and experience which has been proved to be extremely useful in educational settings, particularly where there is a peer that plays the role of tutor. Despite its informal characteristic, tutoring should be a structured process, with defined goals and clear roles for both: tutors and tutees, those who benefit from tutoring. The paper aims to discuss these issues. Design/methodology/approach – As this paper aims to explore a pilot project, it was used as a reflexive and practical methodology, in a case study, analyzing the number of participants attending the project as well as the contents of the training course. Findings – In this first project in a Portuguese university, 35 students attended as candidates to tutor, participating in the training course, showing interest in helping their colleagues. Originality/value – This proposal for a tutoring program in a public highe...

Being a teen and learning how to surf anxiety: Integrating narrative methods with cognitive–behavioral therapy

Adolescence is a challenging stage due to the multiple and rapid changes that occur. In this paper, we present a clinical case of a teen with anxiety and hypochondriac symptoms. The therapeutic treatment, ongoing, was provided in 16 sessions. The intervention was based on the assumption that health anxiety results from processes that maintain catastrophic interpretations that for itself increases anxiety. The principles of cognitive–behavioral and narrative therapy were applied in the intervention. The therapy involved providing psychoeducation, reducing the excessive focus given to the body, learning and training strategies to cope with anxiety, and constructing a life project. The case study shows the value of using metaphors as tools in the therapeutic process, and when facing lifes challenges. Also, it shows the importance of using reading and writing exercises to promote change and adjustment.

Raising cervical cancer awareness: Analysing the incremental efficacy of Short Message Service:

Objective: To evaluate the incremental efficacy of a Short Message Service (SMS) combined with a brief video intervention in increasing the effects of a health education intervention for cervical cancer prevention, over and beyond a video-alone intervention, with respect to key determinants of health behaviour change – knowledge, motivation and intention. Methodology: Quasi-experimental study design, comparing three conditions – control group, video intervention group and SMS + video intervention group. Participants were 144 Portuguese female college students allocated into one of the three experimental conditions. The effects of the health education interventions were assessed using a theoretically based multidimensional cancer prevention questionnaire. Data were collected at baseline and post-test. Results: Interventions significantly increased the key predictors of adhesion to cancer preventive behaviours. SMS contributed to increases in the expected directions. Evidence of the superiority in efficacy of the combined intervention (SMS + video) over the video-alone intervention was found for cervical cancer screening. Interventions were not as effective in improving intentions and more complex preventive practices such as sexual behaviour as they were in improving knowledge. Conclusion: Results are encouraging in that cervical cancer prevention knowledge and motivation appear modifiable via a one-session video preventive intervention. If, however, the development of intentions is an important predictor of effective behaviour change, study findings point to the added importance of an SMS-based strategy for improving specific cancer preventive behaviours. Findings reinforce the need for specific and tailored health education interventions according to the various determinants of behaviour change, as well as to the particular target behaviour with respect to cervical cancer prevention.

Stories about transition to higher education: Empirical narrative organization of freshman-year students from south Europe

This study focuses on the transition to higher education experienced by Portuguese freshman-year students, displaced and nondisplaced from their parents homes, residents on a peripheral island located in the south of Europe called Madeira island. To understand better how students perceive this transition, we collected their narratives and analyzed them with three instruments of analysis of narratives: Structure, Process and Content narrative manuals. The results were an indicator of the narrative enrichment of the students in this transition period. The findings indicate that there is no significant differences between the two groups of students in terms of narrative elaboration. The two groups scored low on narrative richness: in terms of content, structure and narrative process. This might be explained by the changes and reorganizations that the transition to higher education system implies, causing stress and confusion on students, that evolve into an impoverishment of their narratives about that transition life task.

Changing the clinical narratives patients live by: A cognitive behavioral approach of a clinical case of paruresis

This is a psychological clinical case study of a young male, who suffered from paruresis. His problematic narrative is about the fear of not being able to urinate in public toilets or in situations where others may be present or entered in the facility. This problem prevents him from living a normal life and affects his self-confidence. We present a comprehensive cognitive behavioral conceptualization of the problematic narrative and also we reflected on the therapeutic intervention process, its challenges and cognitive strategies. To date, he has progressively adopted more constructive alternative explanations around the problem and is changing the narrative he lives by. Additionally, he has felt more confident, partly due to the fact he can urinate outside the home more often and in different places, yet not all.

Emotions: the implementation and evaluation of an intervention program

Procura-se explorar a importância do conhecimento emocional, atraves da avaliacao de um Programa de Desenvolvimento do Conhecimento Emocional, a partir de um design experimental de pre e pos-teste. Participaram 25 criancas de educacao pre-escolar entre cinco e seis anos e foi utilizada a Escala de Avaliacao do Conhecimento Emocional (EACE), que permite obter uma nota total da Percepcao Emocional Correta (PEC) e foi utilizada em pre e pos-teste. Os resultados evidenciam um aumento significativo do conhecimento emocional entre o pre-teste e o pos-teste, ocorrendo os progressos mais significativos nas dimensoes comportamentos emocionais e situacoes emocionais.

Conocé las emociones: la implementación y evaluación de un programa de intervención

Procura-se explorar a importância do conhecimento emocional, atraves da avaliacao de um Programa de Desenvolvimento do Conhecimento Emocional, a partir de um design experimental de pre e pos-teste. Participaram 25 criancas de educacao pre-escolar entre cinco e seis anos e foi utilizada a Escala de Avaliacao do Conhecimento Emocional (EACE), que permite obter uma nota total da Percepcao Emocional Correta (PEC) e foi utilizada em pre e pos-teste. Os resultados evidenciam um aumento significativo do conhecimento emocional entre o pre-teste e o pos-teste, ocorrendo os progressos mais significativos nas dimensoes comportamentos emocionais e situacoes emocionais.