Nelson Valdés

The evolution of therapeutic change studied through generic change indicators

Abstract Ongoing change and therapeutic outcome were studied in five psychotherapeutic processes: three brief psychodynamic therapies, one social constructionist family therapy, and one group therapy of a comprehensive nature for drug abuse patients. Using qualitative methodology, in-session and extrasession change moments were identified and classified in a hierarchy of generic change indicators. Additionally, all patients were administered Lamberts Outcome Questionnaire. Results show that (a) extrasession change moments are more frequent toward the end of therapy, (b) therapy types differ in the frequency of some change indicators but not others, and (c) change indicators observed at the beginning of therapy are of lower level than those occurring at the end.

Language and therapeutic change: A speech acts analysis

Abstract Drawing on the speech acts theory, a linguistic pattern was identified that could be expected to be associated to therapeutic change, characterized by being uttered in the first person singular and present indicative, and by being self-referential in its propositional content. The frequency of the pattern was examined among verbalizations defined as change moments in three therapies with different theoretical orientation. Results show that the majority of change moments have the specified pattern, and that this pattern is significantly more frequent in change moments than in random non-change-related verbalizations, and so, it does not pertain to therapeutic conversation in general. Implications are discussed concerning the possibility of using the linguistic pattern as an additional and complementary criterion in the identification of moments of change in the therapeutic process.

Maternal stress and perceptions of self-efficacy in socioeconomically disadvantaged mothers: an explicative model.

Studies have demonstrated that maternal stress and perceptions of self-efficacy influence a mothers performance, affecting her ability to interact with her child and to understand and answer his needs. The purpose of this study was to evaluate maternal stress and the perception of self-efficacy in the mothers of infants who are cared for in child-care centers and belong to the poorest segment of the Chilean population. To this end, these aspects were studied in 121 low-income, high-social-risk mothers with children between the ages of 4 and 9 months. The final goal was to generate an explicative model of self-efficacy and maternal stress that considered characteristics of the family and the child. The results revealed that family characteristics - especially household size, per capita incomes and mother age - are more relevant for explaining maternal self-efficacy and stress. The findings and implications for practice are discussed.

Revisión Teórica y Metodológica de las Dificultades en Psicoterapia: Propuesta de un Modelo Ordenador

This article presents a theoretical systematization of concepts regarding psychotherapeutic difficulties, from different perspectives and levels of analysis. It proposes a theoretical structure that allows comparing, differentiating and synthesizing the multiple concepts and empirical findings regarding psychotherapeutic difficulties. Concepts were organized as input, process and output variables along the therapeutic process, finally discussing theoretical, clinical and methodological implications in the study of therapeutic difficulties.

Proceso de Cambio Psicoterapéutico: Análisis de Episodios Relevantes en una Terapia Grupal con Pacientes Adictos

En el presente articulo se presentan los resultados de una investigacion que tuvo como objetivo determinar y describir el tipo de acciones comunicacionales realizadas por terapeutas y pacientes durante las sesiones de una terapia grupal. Para esto se utilizo una metodologia orientada al descubrimiento empleando un analisis cualitativo de contenido. En los resultados se incluye tanto la descripcion de las acciones identificadas de acuerdo al nivel de analisis, asi como los patrones ideales de secuencia de dichos componentes asociados al cambio y propios de esta modalidad terapeutica. Finalmente, los resultados son discutidos considerando los principales antecedentes teoricos y empiricos en materia de investigacion en psicoterapia.

Analysis of verbalized emotions in the psychotherapeutic dialogue during change episodes

Abstract As described by many theorists, emotional expressions contribute to the activation and regulation of personal emotional experiences and communicate something about internal states and intentions. These emotional expressions can be observed in the words used in our speech and nonverbal behaviors, even when nonverbal behaviors are synchronized to ones own speech or to the speech of others. Using a quantitative and qualitative methodology, this article reports a classification of verbal emotional expressions of both psychotherapists and patients in change episodes. Assuming that the emotions loaded in linguistic contents are explicit emotions shown by emotion words, this methodology allows for a complete and differentiating assessment of affective qualities in both patients and psychotherapists during the psychotherapeutic dialogue.

Therapeutic verbal communication in change episodes: a comparative microanalysis of linguistic basic forms / Comunicación verbal terapéutica en episodios de cambio: un microanálisis comparativo de las formas lingüísticas básicas

Abstract This study examines clients’ and therapists’ verbal communication during psychotherapy, in order to determine its relation to ongoing change and outcome. It replicates previous studies showing the specificity of verbalizations depending on the speaker (client or therapist) and the phase of therapy, adding its relation to change measured at the level of process and final outcome. 7,009 speaking turns of clients and therapists, nested in 139 change episodes, were analysed regarding the use of the five Linguistic Basic Forms included in the Therapeutic Activity Coding System (TACS) through Hierarchical Modelling. Results show that three of these Linguistic Basic Forms — Question, Assertion and Agreement — are related to ongoing change as well as to final outcome.

Using decision trees to characterize verbal communication during change and stuck episodes in the therapeutic process

Methods are needed for creating models to characterize verbal communication between therapists and their patients that are suitable for teaching purposes without losing analytical potential. A technique meeting these twin requirements is proposed that uses decision trees to identify both change and stuck episodes in therapist-patient communication. Three decision tree algorithms (C4.5, NBTree, and REPTree) are applied to the problem of characterizing verbal responses into change and stuck episodes in the therapeutic process. The data for the problem is derived from a corpus of 8 successful individual therapy sessions with 1760 speaking turns in a psychodynamic context. The decision tree model that performed best was generated by the C4.5 algorithm. It delivered 15 rules characterizing the verbal communication in the two types of episodes. Decision trees are a promising technique for analyzing verbal communication during significant therapy events and have much potential for use in teaching practice on changes in therapeutic communication. The development of pedagogical methods using decision trees can support the transmission of academic knowledge to therapeutic practice.

Relational offers and demands: analysing the conflictual interactional components of anaclitic and introjective female depressive patients / Ofertas y demandas relacionales: análisis de los componentes interaccionales conflictivos de pacientes mujeres depresivas anaclíticas e introyectivas

Abstract Depressive symptoms are associated with typical ways of relating to and handling conflict with others. This study empirically analysed the most frequent relational ‘demands’ and ‘offers’ identified in the verbal expressions of depressive patients during the first session, comparing them according to their personality organization (anaclitic vs introjective). The CCRT-LU-S Category System was used to analyse the first session of 27 patients with depressive symptomatology. The results showed that the highest percentage of depressive patients’ interactional components identified were relational ‘offers’, whereas the remainder percentage were relational ‘demands’. At the same time, the highest percentage of those interactional components were verbalized as disharmonious (weakness, withdrawing, unpleasant and fighting) by anaclitic patients, while the highest percentage were verbalized as harmonious (loving or having self-determination) by introjective patients. Implications for clinical relevance of these results are discussed.