Maria Lucia Tiellet Nunes

Caracterização da clientela das clínicas-escola de cursos de Psicologia da região metropolitana de Porto Alegre

Although many studies about Psychology School-Clinics have been conducted in Brazil, there are few in Rio Grande do Sul. So that, this paper is a surveys research about sociodemographic and clinical characteristics of people who reached out for psychological service in 2004 at 10 Psychology School-Clinics in metropolitan area of Porto Alegre. The results showed similarity between most of other studies that had been previously conducted in Brazil and the present one, allowing the inference of two typical profiles in Psychology School-Clinics in Brazil: children, male, referred by schools because of learning or behavior problems and young women, who sought, on their own initiative, psychological consultation due to affective problems. It is also important to mention how difficult it is to research about this topic, because theres no standardized, adequate and well-filled out inpatient registration in Psychology School-Clinics.

Salivary cortisol and dehydroepiandrosterone (DHEA) levels, psychological factors in patients with oral lichen planus.

OBJECTIVE The aim of this study was to determine the salivary levels of dehydroepiandrosterone (DHEA) and cortisol and scores of depression, anxiety and stress in patients with oral lichen planus (OLP). STUDY DESIGN Thirty-one patients with a diagnosis of OLP were selected; they were matched by sex and age with 31 control patients. Symptoms of depression, anxiety and stress were investigated by the instruments Beck Depression Inventory, Beck Anxiety Inventory and Lipps Inventory of Stress Symptoms for Adults, respectively. Saliva was collected in the morning and at night for the determination of DHEA and cortisol levels by radioimmunoassay. RESULTS There was no significant difference between the groups with respect to depression (P=0.832), anxiety (P=0.061) or stress (P=0.611), or with respect to morning and night salivary levels of DHEA (P=0.888, P=0.297) and cortisol (P=0.443, P=0.983). CONCLUSIONS The results suggest an association of OLP with anxiety. However, DHEA and cortisol levels did not differ between groups, which does not support any neuroendocrine aetiology for OLP.

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.

Psicologia da Saúde e Psicologia Positiva: Perspectivas e Desafios

This study aims to discuss the aspects related to spirituality and quality of life in the health context. It encloses a discussion around the interface between Health Psychology and Positive Psychology, standing out the importance of positive variables as research and intervention focus in health. It is important to point out the necessity of advances in studies related to protection factors and the healthy human development maintenance. In the focused discussion, Health Psychology and Positive Psychology have an important role for the comprehension of the aspects involved in sickness confrontation as well as for peoples health maintenance.

Approaching countertransference in psychoanalytical supervision: a qualitative investigation.

A recent examination of the literature concerning countertransference and its developments reveals its clinical usefulness in different psychoanalytical cultures. Nevertheless, a shortage of publications is apparent with respect to its approach in supervision. The authors aim in this study was to examine the concepts of transference and countertransference and how countertransference is approached in supervision, in the training of candidates, at an institute of psychoanalysis belonging to a society affiliated to the International Psychoanalytical Association (IPA). Qualitative research was carried out, interviewing supervisors and supervisees. Through analysis of the material acquired, the authors classifi ed the data into initial, intermediate and fi nal categories. The principal fi ndings were subdivided into three categories: the concepts of transference and countertransference, psychoanalytical listening and the complementarity of the phenomena, and the approach to countertransference. The concepts of transference and countertransference predominantly used by those interviewed are based on the totalistic outlook. Countertransference in supervision has been approached in a more direct and objective way when compared with the previous period, although great care is taken to delimit the boundaries between supervision and personal analysis. The main aim of supervision is to broaden comprehension and to deepen the interpretations directed towards the patient. These fi ndings suggest that the evolution of the concept of countertransference in different psychoanalytical cultures and developments in the analytical fi eld are contributing to this change.

Considerações metodológicas sobre o estudo de caso na pesquisa em psicoterapia

The article reviews the literature concerning the applicability of case studies in psychotherapy research: a) it presents the characteristics of case studies as a research strategy, b) addresses the importance of single-case designs in the study of the therapeutic process, c) discusses strategies to increase the reliability and validity of case studies, and d) provides examples of case studies from the current generation of empirical research in psychotherapy and psychoanalysis. In general, the article highlights the potential of single-case intensive and systematic delineations for research into the subjective and complex processes inherent to therapeutic encounters.

Qualidade de vida e bem-estar espiritual em pessoas vivendo com HIV/AIDS

Current study evaluates the quality of life and spi ritual well-being in HIV/Aids people. Two hundred HIV individuals were taken as samples (111 women and 89 men), aged between 19 to 67 years old, 143 symptomati c/Aids and 57 asymptomatic, 62.5% had taken anti-retroviral thera py. Results point to a significant correlation betwe en the quality of life (WHOQOL-HIV bref) and spiritual well being (SWB). The spiritual, religiosity and personal beliefs and the sub scale religious well being had the highest scores. Signifi cant correlations were obtained in symptomatic/Aids g roup between quality of life concerning physical, social relationship an d spiritual, religiosity and personal beliefs with t he religious well-being, the existential well being and the spiritual well-being. The importance of the variables religiosity and spi rituality within the resilience and health protection process was also di scussed. Discussing health protection in research, i n psychologists interventions and in health public policies should be enhanced.Current study evaluates the quality of life and spiritual well-being in HIV/Aids people. Two hundred HIV individuals were taken as samples (111 women and 89 men), aged between 19 to 67 years old, 143 symptomatic/Aids and 57 asymptomatic, 62.5% had taken anti-retroviral therapy. Results point to a significant correlation between the quality of life (WHOQOL-HIV bref) and spiritual well being (SWB). The spiritual, religiosity and personal beliefs and the subscale religious well being had the highest scores. Significant correlations were obtained in symptomatic/Aids group between quality of life concerning physical, social relationship and spiritual, religiosity and personal beliefs with the religious well-being, the existential well being and the spiritual well-being. The importance of the variables religiosity and spirituality within the resilience and health protection process was also discussed. Discussing health protection in research, in psychologist’s interventions and in health public policies should be enhanced.

Preditores de abandono de tratamento na psicoterapia psicanalítica de crianças

INTRODUCTION: The high rates of dropout in psychotherapy and the shortage of studies on treatment dropout in child psychotherapy are strong reasons for further research on this topic. The literature suggests that some sociodemographic and clinical variables could predict psychotherapy outcome. The objective of the present study was to identify predictors of treatment dropout in child psychotherapy. METHODS: This is a retrospective study involving the analysis of medical records of two institutions that provide psychological care to children in Porto Alegre, RS, Brazil. RESULTS: We analyzed the medical records of 2,106 children. Of these, 200 children were discharged from treatment and 793 dropped out. The two groups were compared, and the results suggest that boys have higher risk of dropping out, while children referred by neurologists or psychologists are at a lower risk of dropping out. After six months of treatment, the dropout risk is considerably reduced. DISCUSSION: The results are discussed based on the literature on gender, treatment dropout and child psychotherapy. Some hypotheses were proposed to explain the associations and lack of associations found in the present study. CONCLUSIONS: Knowing predictors of dropout from psychotherapy makes it possible for therapists to identify patients belonging to the risk group in the beginning of treatment. Therefore, they can try to directly prevent aspects related to resistance and negative transference of these patients and their relatives, mainly during the first 6 months of treatment. Implementing early intervention techniques with the parents and delivering transdisciplinary therapies are possible solutions to avoid dropout.

Effectiveness of child psychoanalytic psychotherapy in a clinical outpatient setting

The objective of this study was to evaluate the outcome of child psychoanalytic psychotherapy in a clinical outpatient setting in a city in southern Brazil. Three psychological tests (Rorschach, Bender and WISC III) were administered to 23 children, aged 6–11 years old, and the Child Behaviour Check List (CBCL) was completed by the parents. All testing was completed before the beginning of the individual psychoanalytic psychotherapy. The same measures were repeated after 12 months of intervention. The 23 children who received individual psychoanalytic psychotherapy were compared with a control group who did not receive any kind of intervention. In the clinical group, the results indicated a statistically significant reduction of anxiety symptoms (0.002) and school problems (0.031), improvement in interpersonal relationships (0.022), and positive change in the following CBCL scales: withdrawn (0.010), thought problems (0.022), anxiety and depression (0.017), internalising (0.008) and total (0.003). An effect size of 0.696 was calculated based on the CBCL total scale before and after the intervention. The results revealed that child psychoanalytical psychotherapy is mostly effective in the treatment of female children who present internalising disorders.