Olga Herrero

Chaos To Coherence: Psychotherapeutic Integration Of Traumatic Loss

Traumatic life events have the power to disrupt those self-narratives with which people order their life experience, by challenging their organization, promoting the development of problem-dominated identities, and fostering dissociation of aspects of the experience in a way that precludes its integration. We briefly consider these processes at levels ranging from the biogenetic, through the personal-agentic, to the dyadic-relational, and ultimately to cultural-linguistic levels of narrative structure, and then present the results of a grounded theory analysis of psychotherapy to reveal the pragmatic and rhetorical strategies by which it counters such disruption. Results suggest the means by which a client and therapist collaborate to help the former reconstruct the meaning of her mothers suicide, ultimately moving toward greater coherence and hopefulness in the narration of her life.

A relational constructivist approach to narrative therapy

This paper presents our understanding of narrative therapy from a relational constructivist approach, as a way to further develop the dialogue between contemporary constructivist theories and social constructionist approaches. In the first section the ten main assumptions of relational constructivism are discussed. In the second, a case study is presented in order to illustrate our therapeutic use of these assumptions.

Predictors of therapeutic outcome and process

Abstract This article presents an intensive study of the outcome and process of the psychotherapeutic treatments conducted at the Blanquerna Psychotherapy Service in Barcelona. It analyzes in detail the relation between outcome (improvement) and process (therapeutic alliance). Specifically, it discusses (a) the therapeutic process in terms of the relation between therapeutic alliance and psychotherapy outcome and (b) the effects of the temporary weakening of the therapeutic alliance and temporary symptomatic relapse on therapeutic outcome and process. Two hundred thirty-nine clients were included in the study, and the assessment instruments were the CORE Outcome Measure and the short version of the Working Alliance Inventory. In addition to good outcome of psychotherapy and maintenance of therapeutic change after treatment, the results also demonstrated the significance of different aspects of the therapeutic alliance as predictors of the therapeutic outcome and process.

Maintenance of the Effects of Cognitive Behavioral and Relational Constructivist Psychotherapies in the Treatment of Women with Postpartum Depression: A Randomized Clinical Trial

The objective of this study was to evaluate maintenance of the effects of models of manualized cognitive behavioral therapy (CBT) and relational constructivist therapy (RCT) for seven sessions with women with postpartum depression. A total of 320 women from maternity wards in a Brazilian city participated in the study. Evaluations of depression were made at 30 to 60 days after childbirth, at the end of treatment, and 12 months after the end of treatment. To evaluate symptoms of depression, we used the Beck Depression Inventory (BDI) with a cutoff of ≥ 12. Women who showed symptoms of depression were invited to participate in a randomized clinical trial. Of the 320 women evaluated, 115 showed symptoms of depression. Of this group, 60 were eligible for the study. The mean BDI scores at baseline and 12 months following the end of treatment were compared, and a significant reduction was demonstrated for both CBT (p = 0.05) and RCT (p < 0.001). There was no difference between the effectiveness of the interventions (p = 0.139). A reduction in depression was maintained for 12 months for models of manualized CBT and RCT.