Psicoterapia del oprimido

Revista de Humanidades ◽

10.5944/rdh.39.2020.19776 ◽

2020 ◽

pp. 99

Author(s):

Daniel Rzondzinski

Keyword(s):

Mental Health ◽

Therapeutic Alliance ◽

Therapeutic Relationship ◽

Degree Program ◽

Psychotherapy Process ◽

Complex Thinking ◽

Salud Mental ◽

Cognitive Perspectives ◽

Client Needs

Resumen: Este artículo trata de analizar cómo se puede enseñar y aprender el concepto de relación terapéutica siendo éste término, el contenido central de la asignatura Pre-Práctica, materia previa y obligatoria para los estudiantes que deben realizar su práctica de residencia como psicoterapeutas en la carrera de Maestría en Espiritualidad y Psicoterapia de la Universidad Wilfrid Laurier de la provincia de Ontario, Canadá. El concepto de relación terapéutica es abordado desde las perspectivas teóricas del pensamiento de Piaget, Freire y Morin, siendo dicha relación un elemento esencial que permite la implementación del proceso de psicoterapia y de los cambios que el paciente necesita realizar para mejorar su salud mental. A su vez, se analizan los conceptos de transferencia, contratransferencia y alianza terapéutica desde la perspectiva dinámica y cognitiva. Este artículo está sustentado teórica y conceptualmente en los principios de la transdiciplinariedad y del pensamiento complejo.Abstract: This article describes how to teach and how to learn about the nature of the therapeutic relationship. This concept is the main content of the Pre-Practicum course which is a cumpulsory prerequisite for students before they begin their practicum as psychotherapists in the Master in Spirtuality and Psychotherapy degree program of Wilfrid Laurier University in the province of Ontario, Canada. The concept of therapeutic relationship is analyzed from the perspective of Piaget, Freire and Morin. This article is focused on the importance and the needs of reaching a good therapeutic relationship in order to implement the psychotherapy process and the changes that the client needs to achieve to improve his mental health. This work analyzes the concepts of transference, countertransference and therapeutic alliance from dynamic and cognitive perspectives. This article is supported by the principles of transdisciplinarity and complex thinking.

Download Full-text

¡Son las Formas, Estúpido!: En Busca de las Claves de la Alianza Terapéutica desde la Gestión de la Insatisfacción / The Manners, Stupid! In Search of the Keys of the Therapeutic Alliance from the Management of Dissatisfaction

Revista Internacional de Humanidades Médicas ◽

10.37467/gka-revmedica.v1.1288 ◽

2012 ◽

Vol 1 (1) ◽

Author(s):

Antoni Corominas Díaz

Keyword(s):

Mental Health ◽

Patient Satisfaction ◽

Therapeutic Alliance ◽

Therapeutic Relationship ◽

Communication Skills ◽

Technical Skills ◽

The Core ◽

Salud Mental

ABSTRACTThe aim of this study is to determine the core factors of the therapeutic relationship in mental health, and therefore, the basis of a successful therapeutic alliance. The source of data analyzed includes surveys of patient satisfaction and the study of the main causes of patient’s complaints. Communication skills, attitudes and manners emerge as essentials when it comes to satisfactory relationships. The failure of the therapeutic alliance arises when patients feel that they have been roughly or wrongly treated and, even more, when they perceive a lack of involvement or effort by the therapist. A model of inverted pyramids is postulate in order to describe the apparently divergent values of patients and therapists. These include knowledge-technical skills, attitudes-empathy, and forms-manners. Also, three paradoxes are described that summarize the main challenges in the current framework of the therapeutic relationships.RESUMENSe analizan los elementos que podrían considerarse nucleares en la relación entre profesionales y pacientes en el campo de la salud mental y el diseño de estrategias encaminadas a una exitosa alianza terapéutica. A partir de datos procedentes de encuestas en este ámbito y del estudio de los principales motivos de queja de los pacientes se pone de manifiesto la importancia de los aspectos relacionados con la comunicación y que radican en elementos formales y de actitud. Se condensa el fracaso de la relación terapéutica en un punto de no retorno en que el paciente percibe una suerte de «maltrato» formal con un escaso «esfuerzo» o implicación por parte del profesional. Se construye un posible modelo de pirámides invertidas en las respectivas jerarquías de valores de profesionales y pacientes para ilustrar el peso diferencial que comportan los elementos de la tríada trato-formas, actitudes-habilidades empáticas y conocimientos-técnicas. Se sintetizan tres grandes paradojas que resumen las fisuras actuales en la relación terapéutica: hiperespecialización de Servicios para proporcionar elementos básicos de escucha y calidez; demanda de atención centrada en problemas cotidianos o aparentemente banales (patología «menor» o adaptativa) pero que requieren de mayor tiempo y habilidades que los trastornos graves; establecimiento de un vínculo firme y provisión de sintonía, proximidad y empatía como pilares de una buena relación terapéutica pero que asimismo entrañan el riesgo de dependencia y la dificultad en el establecimiento de límites.

Download Full-text

TEORIA DAS RELAÇÕES INTERPESSOAIS: REFLEXÕES ACERCA DA FUNÇÃO TERAPÊUTICA DO ENFERMEIRO EM SAÚDE MENTAL

Enfermagem em Foco ◽

10.21675/2357-707x.2019.v10.n3.2291 ◽

2019 ◽

Vol 10 (3) ◽

Author(s):

Carlon Washington Pinheiro ◽

Michell Ângelo Marques Araújo ◽

Karla Maria Carneiro Rolim ◽

Camila Moreira De Oliveira ◽

Alexsandro Batista De Alencar

Keyword(s):

Mental Health ◽

Therapeutic Relationship ◽

Interpersonal Relations ◽

Theoretical Framework ◽

Psychiatric Nursing ◽

Nursing Theory ◽

Therapeutic Function ◽

Salud Mental

Objetivo: Refletir teoricamente sobre a importância da Teoria das Relações Interpessoais de Peplau, contextualizada com o processo de formação da identidade do enfermeiro como terapeuta em saúde mental e psiquiatria. Metodologia: A partir do estudo da obra sobre Relações Interpessoais em Enfermagem de Peplau e demais textos, a reflexão organizou-se em três eixos: a teoria das relações interpessoais, a relação terapêutica na teoria de Peplau e o subpapel de assessor/counseling. Resultados: Os três eixos foram detalhados, aliando as contribuições da literatura, com novas possibilidades de aplicação do arcabouço teórico. Conclusão: A Teoria das Relações Interpessoais com foco no conceito de counseling possibilita reflexões sobre a representação do enfermeiro como terapeuta e fortalece ações de enfermagem no contexto do cuidado em saúde mental.Descritores: Enfermagem; Enfermagem Psiquiátrica; Teoria de Enfermagem; Saúde Mental.THEORY OF INTERPERSONAL RELATIONS: REFLECTIONS ON THE THERAPEUTIC FUNCTION OF THE NURSE IN MENTAL HEALTHObjective: To reflect theoretically on the importance of Peplau's Theory of Interpersonal Relations, contextualized with the process of formation of the nurse's identity as a therapist in mental health and psychiatry. Methodology: From the study of Peplau's work on Interpersonal Relations in Nursing and other texts, the reflection was organized in three axes: the theory of interpersonal relations, the therapeutic relationship in Peplau's theory and the counseling sub-role. Results: The three axes were detailed, combining the contributions of the literature, with new possibilities of application of the theoretical framework. Conclusion: The Theory of Interpersonal Relations focusing on the concept of counseling enables reflections on the representation of nurses as therapists and strengthens nursing actions in the context of mental health care.Descriptors: Nursing; Psychiatric Nursing; Nursing theory; Mental Health.TEORÍA DE LAS RELACIONES INTERPERSONALES: REFLEXIONES ACERCA DE LA FUNCIÓN TERAPÉUTICA DEL ENFERMERO EN SALUD MENTALObjetivo: Reflexionar teóricamente sobre la importancia de la Teoría de las Relaciones Interpersonales de Peplau, contextualizada con el proceso de formación de la identidad del enfermero como terapeuta en salud mental y psiquiatría. Metodología: A partir del estudio del trabajo de Peplau sobre las relaciones interpersonales en enfermería y otros textos, la reflexión se organizó en tres ejes: la teoría de las relaciones interpersonales, la relación terapéutica en la teoría de Peplau y el sub-rol de asesor/consejero. Resultados: Los tres ejes fueron detallados, combinando las contribuciones de la literatura, con nuevas posibilidades de aplicación del marco teórico. Conclusión: La teoría de las relaciones interpersonales, centrada en el concepto de asesoramiento, permite reflexionar sobre la representación de las enfermeras como terapeutas y fortalece las acciones de enfermería en el contexto de la atención de la salud mental.Descriptores: Enfermería, Enfermería Psiquiátrica, Teoría de Enfermería, Salud Mental.

Download Full-text

A clínica do cuidado e a internação involuntária ― uma reflexão para a enfermagem psiquiátrica

Revista de Enfermagem UFPE on line ◽

10.5205/reuol.211-1351-5-rv.0301200926 ◽

2008 ◽

Vol 3 (1) ◽

pp. 181

Author(s):

Lilian Hortale Oliveira Moreira ◽

Cristina Maria Douat Loyola

Keyword(s):

Mental Health ◽

Therapeutic Relationship ◽

Daily Practice ◽

Psychiatric Nursing ◽

Psychiatric Reform ◽

Nursing Team ◽

Salud Mental ◽

Sobre Todo

ABSTRACTObjectives: to describe the main bases of the therapeutic relationship according to Hildegard Peplau and to discuss on the Brazilian Psychiatric Reform, with emphasis in the Psychiatric Internment and especially the Involuntary Internment and your implications in the care rendered by the nursing team. Methodology: a bibliographical research was accomplished on the principal constructors of these practices medicine from the care of psychiatric nursing referring to the Psychiatric Reform and the involuntary internment. Results: the nursing team sees the patient as the protagonist of your daily practice and he takes care of this person in psychic suffering, although he makes it, most of the team, in an instinctive way. Special manifestation of that team is not observed in relation to the patient of involuntary internment. There is not registration or any action that point there to be a specific glance on that type of patient. Conclusion: the nursing team doesn't get to identify that patient one clearly in the unit of internment, addressing the care for the demand or the patient's solicitation. Like this, it is evidenced that that care is not visible or constant in the daily of the practice of the nursing team. Descriptors: mental health; psychiatric nursing; involuntary internment; patient.RESUMOObjetivos: descrever as principais bases do Relacionamento Terapêutico segundo Hildegard Peplau e discutir sobre a Reforma Psiquiátrica Brasileira, com ênfase na Internação Psiquiátrica e em especial a Internação Involuntária e suas implicações no cuidado prestado pela equipe de enfermagem. Metodologia: foi realizada uma pesquisa bibliográfica sobre os principais construtos da clinica do cuidado de enfermagem psiquiatrica referentes à Reforma Psiquiátrica e a internação involuntária. Resultados: a equipe de enfermagem vê o paciente como o protagonista da sua prática cotidiana e cuida desta pessoa em sofrimento psíquico, embora o faça, na maioria das vezes, de maneira instintiva. Não é observada especial manifestação dessa equipe em relação ao paciente de internação involuntária. Não há registro, nem qualquer ação que aponte haver um olhar específico sobre esse tipo de paciente. Conclusão: a enfermagem não consegue identificar claramente esse paciente na unidade de internação, direcionando o cuidado pela demanda ou solicitação do paciente. Assim, fica evidenciado que esse cuidado não é visível ou constante no cotidiano da prática da equipe de enfermagem. Descritores: saúde mental; enfermagem psiquiátrica; internação involuntária; paciente.RESUMENObjetivos: describir las bases principales de la relación terapéutica según Hildegard Peplau y discutir en la Reforma Psiquiátrica brasileña, con el énfasis en la Internación Psiquiátrica y sobre todo la Internación Involuntaria y sus implicaciones en el cuidado dado por el equipo de enfermería. Metodología: una investigación bibliográfica era cumplida en el construtos principal de la práctica la medicina del cuidado de enfermeria psiquiátrica que se refiere a la Reforma Psiquiátrica y la internación involuntaria. Resultados: el equipo de enfermeria ve al paciente como el protagonista de su práctica diaria y él cuida de esta persona en el sufrimiento psíquico, aunque él lo hace, la mayoría del equipo, de una manera instintiva. La manifestación especial de ese equipo no se observa el paciente de internación involuntaria respecto a. No hay ningún registro, ni cualquier acción que apunta para haber una mirada específica en ese tipo de paciente. Conclusión: el equipo de enfermeria no consigue identificar ese paciente claramente en la unidad de internación, mientras dirigiéndose el cuidado para la demanda o la solicitación del paciente. Así, se evidencia que ese cuidado no es visible o constante en el periódico de la práctica del equipo de enfermeria. Descriptores: salud mental; enfermería psiquiátrica; internación involuntaria; paciente.

Download Full-text

The Therapeutic Alliance: The Key to Effective Patient Outcome? A Descriptive Review of the Evidence in Community Mental Health Case Management

Australian & New Zealand Journal of Psychiatry ◽

10.1046/j.1440-1614.2003.01131.x ◽

2003 ◽

Vol 37 (2) ◽

pp. 169-183 ◽

Cited By ~ 132

Author(s):

Irene M. Howgego ◽

Peter Yellowlees ◽

Cathy Owen ◽

Lenore Meldrum ◽

Frances Dark

Keyword(s):

Mental Health ◽

Mental Illness ◽

Community Mental Health ◽

Case Management ◽

Therapeutic Alliance ◽

Therapeutic Relationship ◽

Current Trend ◽

Case Managers ◽

Level Of Evidence ◽

Improved Outcomes

Objective: The aim of this review was to examine the level of evidence supporting the assumed link between a positive therapeutic alliance among patients and case managers and effective outcome for patients with a mental illness who are managed in community mental health services. Method: MedLine, PsychINFO and Social Sciences Index search of articles from 1986 to 2001 returned 84 articles and two texts. Inclusion criteria were the use of validated measures and relevance to psychiatry and community case management. Results: A definite correlation exists in the psychotherapy literature between the therapeutic relationship and improved outcomes, with its potential as a prognostic indicator acknowledged. Attempts to apply the concept to patients outside the field of psychotherapy have been slow, although expansion of the concept to other forms of change-inducing therapy was a current trend. Issues of definition, quantification and measurement of the relationship caused rigorous debate in the literature. Case management research demonstrating the importance of the therapeutic relationship and ‘goodness-of-fit’ between patients and case managers was sparse with no published Australian studies. Conclusions: The level of evidence supporting the link between the therapeutic alliance of patients with mental illness and improved outcomes although sparse is encouraging. It indicates the potential of the alliance as a predictor of outcome for patients engaged in case management services in community mental health. Research to determine the role and effectiveness of the alliance in the patient/case manager dyad is needed to define this potential. Effectiveness of clinical practice in the case management field could be enhanced if research findings confirmed the genesis and value of the alliance in case management. Focus on relationship strategies as a clinical tool gives the clinician and service provider a potential vehicle for promoting partnerships with the seriously mentally ill person in managing their illness and optimizing their strengths in the community.

Download Full-text

Psychometric Properties of the German Version of the Scale to Assess the Therapeutic Relationship in Community Mental Health Care (D-STAR)

European Journal of Psychological Assessment ◽

10.1027/1015-5759/a000105 ◽

2012 ◽

Vol 28 (4) ◽

pp. 255-261 ◽

Cited By ~ 5

Author(s):

Sabine Loos ◽

Reinhold Kilian ◽

Thomas Becker ◽

Birgit Janssen ◽

Harald Freyberger ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Community Mental Health ◽

Mental Health Care ◽

Psychometric Properties ◽

Therapeutic Relationship ◽

Internal Consistency ◽

Convergent Validity ◽

Community Mental Health Care ◽

German Version

Objective: There are presently no instruments available in German language to assess the therapeutic relationship in psychiatric care. This study validates the German version of the Scale to Assess the Therapeutic Relationship in Community Mental Health Care (D-STAR). Method: 460 persons with severe mental illness and 154 clinicians who had participated in a multicenter RCT testing a discharge planning intervention completed the D-STAR. Psychometric properties were established via item analysis, analyses of missing values, internal consistency, and confirmatory factor analysis. Furthermore, convergent validity was scrutinized via calculating correlations of the D-STAR scales with two measures of treatment satisfaction. Results: As in the original English version, fit indices of a 3-factor model of the therapeutic relationship were only moderate. However, the feasibility and internal consistency of the D-STAR was good, and correlations with other measures suggested reasonable convergent validity. Conclusions: The psychometric properties of the D-STAR are acceptable. Its use can be recommended in German-speaking countries to assess the therapeutic relationship in both routine care and research.

Download Full-text