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- Psychometric properties of a portuguese version of the SOCRATES 8D: a study with a sample of heroin addicts in treatmentPublication . Janeiro, Luís; Faísca, Luís; Lopez Miguel, Maria JoséIn the present study, we adapted the Stage of Change Readiness and Treatment Eagerness Scale (SOCRATES, version 8D) to the European Portuguese and we examined its factor structure and psychometric properties. The scale was applied to a sample of 100 adults, mostly heroin addicts, in outpatient or inpatient treatment. A Principal Component Analysis applied to the data revealed three dimensions - Problem Recognition, Taking Steps and Ambivalence -, corresponding almost exactly to the factor structure originally proposed by Miller and Tonigan (1996). The reliability indices for SOCRATES three subscales (internal consistency and temporal stability) were adequate. External validity study showed that the subscales differentiated treatment contexts and were associated to the participants' evaluation regarding the treatment expectations and the technical team. Thus, the Portuguese version of SOCRATES 8D seems to possess the proper psychometric properties to evaluate drug addicts' treatment motivation.
- Reasons for Living Inventory for Young Adults: Psychometric Properties Among Portuguese SamplePublication . Madeira, Ana Rita Salve-Rainha; Janeiro, Luís; Carmo, Claudia; Brás, MartaA main protective factor against suicide in young adults is their reasons for living; therefore, suicide risk screening should consider these reasons. However, few psychometric instruments assess reasons for living, and none have been adapted for young adults in Portugal. Thus, we assess the psychometric characteristics of the Reasons for Living Inventory for Young Adults-II (RFL-YA-II) in participants (n = 936; Mage = 21.77; SD = 2.88) from Portugal. Participants answered measures concerning suicidal ideation, depression, hopelessness, and positive and negative affect. The results of an exploratory factorial analysis replicated the original 4-factor model of the RFL-YA-II, and a confirmatory factorial analysis indicated satisfactory indices. In terms of reliability and convergent, discriminant, and concurrent validity, our results are consistent with previous research. Moreover, our results indicate that the RFL-YA-II is a valid and reliable instrument to study the protective factors against suicidal behavior in Portuguese young adults, and should thus be integrated into preventive strategies.
- Treating affect phobias: Therapeutic alliance as a moderator of the emotional experience effect on outcomesPublication . Ferreira, Laura Inês; Janeiro, LuísPsychodynamic-oriented psychotherapies have demonstrated their efficacy in emotional disorders' treatment. However, it remains unclear what are the specific mechanisms accounting for change. In psychodynamic psychotherapeutic models as the Affect Phobia Therapy (APT), emphasis is placed on therapeutic relationship and the ability of clients to regain adaptive contact with their emotions. Specifically, it is argued that there must be a high therapeutic alliance for the emotions' exposure to lead to positive outcomes. This exploratory study aimed to examine whether the level of therapeutic alliance (high vs. low) moderates the contribution of emotional experience to outcomes. Twenty-six clients (65% females; Mage= 25; SD= 7.26) with depressive and/or anxiety symptoms undergoing a psychodynamic psychotherapy on a university counselling centre were included. After each weekly session, clients answered measures of therapeutic alliance, emotional experience, and outcomes (Psychological Well-Being and Subjective Discomfort). Data were analysed using Hierarchical Linear Models for longitudinal data. Results indicated that effect of emotional experience on outcomes depends on levels of therapeutic alliance. In clients with low therapeutic alliance, higher levels of emotional experience contributed to a decrease in Psychological Well-Being and an increase in Subjective Discomfort across sessions. In clients with higher levels of alliance, both outcomes decreased significantly between sessions, regardless of the emotional experience effect. Our findings highlight that it is important to consider that exposure to adaptive emotions may have adverse effects when a strong alliance is not established.
- Paradoxical effects of Worrisome Thoughts Suppression: the influence of depressive moodPublication . Silva, Sónia; Janeiro, Luís; Brás, Marta; Carmo, Cláudia; Martins, Ana Teresa; Jiménez-Ros, Antonia MaríaThought suppression increases the persistence of unwanted idiosyncratic worries thoughts when individuals try to suppress them. The failure of suppression may contribute to the development and maintenance of emotional disorders. Depressive people seem particulary prone to engage in unsuccessful mental control strategies such as thought suppression. Worry has been reported to be elevated in depressed individuals and a dysphoric mood may also contribute for the failure of suppression. No studies examine, however, the suppression of worisome thoughts in individuals with depressive symptoms. To investigate the suppression effects of worrisome thoughts, 46 participants were selected according to the cut-off score of a depressive symptomatology scale and they were divided in two groups (subclinical and nonclinical group). All the individuals took part in an experimental paradigm of thought suppression. The results of the mixed factorial analysis of variance revealed an increased frequency of worrisome thoughts during the suppression phase on depending of the depressive symptoms. These findings confirm that depressive mood can reduce the success of suppression.
- The therapist, the group and I: how therapeutic alliance moderates the effect of group cohesion on outcomesPublication . Vicente, Sofia; Ferreira, Laura Inês; Jiménez-Ros, Antónia Maria; Carmo, Claudia; Janeiro, LuísPurpose This study aims to investigate whether the influence of group cohesion on the outcomes depended on the levels of the therapeutic alliance. Design/methodology/approach Sixteen individuals with a substance use disorder who were undergoing treatment in a therapeutic community responded to therapeutic alliance, group cohesion, craving and outcomes measures after every therapeutic small group session for a period of six weeks. Data analysis was performed using hierarchical linear modeling. Findings Results indicate that the effect of group cohesion is stronger when there is a high therapeutic alliance between resident and therapist. Originality/value Even on group interventions, to enhance group cohesion effects on outcomes, therapists must foster higher therapeutic alliance levels. The findings point out the importance of studying the effect of common factors on outcomes.
- Motivacao para o tratamento. Dados psicometricos da escala SOCRATES 8D e estrategias psicoterapeuticas para motivar para o tratamentoPublication . Janeiro, Luís; Faísca, LuísA motivação para o tratamento é considerada um factor fundamental para o processo de mudança e tratamento do toxicodependente. Prochaska, Diclemente, e Norcross (1992) consideram que a motivação que o sujeito possui no início do tratamento determina directamente os resultados alcançados no mesmo. Diclemente, Bellino, e Neavins (1999) acrescentam, ainda, que a estreita relação entre os resultados obtidos no tratamento e a motivação aquando do seu início pode ser medida pela formação precoce de uma aliança terapêutica por parte dos utentes mais motivados. Isto é, a motivação no início de tratamento pode potenciar a aliança terapêutica e estes dois factores, em conjunto, conduzem a melhores resultados.
- The sister concepts of working alliance and real relationship: A meta-analysisPublication . Vaz, Ana Marta; Ferreira, Laura Inês; Gelso, Charles; Janeiro, LuísThe real relationship and working alliance are considered sister concepts, because, even though they are distinct elements of the therapeutic relationship, they seem to be highly interrelated, especially regarding the bond element of the relationship. Both concepts are considered to contribute significantly to the therapy outcomes, but some questions remain regarding their relationship, similarities, and conceptual differences. The present study aimed to examine the association of real relationship and working alliance across studies and analyze their contribution to treatment success. For this purpose, we conducted a meta-analysis on these two constructs and performed a quantitative analysis to differentiate the contribution of real relationship and working alliance for psychotherapy outcomes. Results from the meta-analysis confirmed the theorized association between real relationship and working alliance, revealing an overall correlation of r = .66. Based on our quantitative analysis, real relationship seems to be as good a predictor as the working alliance, although both benefit from each other. The research findings underline the importance of considering the contribution of these two concepts for therapeutic outcomes. Therapists should pay attention to both real relationship and the working alliance as key factors that improve therapy success.
- Viés de manutenção da atenção na ansiedade socialPublication . Fernandes, Catarina; Silva, Susana; Pires, Joana; Reis, Alexandra; Jiménez-Ros, Antonia María; Janeiro, Luís; Faisca, Luis; Martins, A.The role of attentional bias in social anxiety is not yet fully understood. Social anxiety individuals can show deliberate avoidance of socially threatening stimuli or, on the contrary, be hypervigilant, persistently allocating attention to those stimuli. Our main purpose was to test whether social anxiety is preferably associated with mechanisms of hypervigilance, avoidance, vigilance-avoidance or maintenance of attention towards socially relevant stimuli. Our secondary goal was to explore the modulating role of personality traits in these attention bias mechanisms. Participants with high vs low social anxiety and different personality structures were exposed to pairs of faces representing different emotions (anger, happiness and neutrality) while their eye movements were continuously recorded. Comparisons between participants with high and low levels of social anxiety showed that participants with high social anxiety were slower in disengaging their attention from happy faces, suggesting that positive emotions can be perceived as a threatening stimuli for social anxious individuals. Preliminary results indicated that depressive personality structure may favour manifestations of hypervigilance bias toward threat faces.
- Experimental manipulation of beliefs about the importance of thoughts and the effect on an aggressive impulsePublication . Ros, Antónia; Faisca, Luis; Martins, T.; Janeiro, Luís; Martins, A.T.Background: Cognitive models of obsessive-compulsive disorder attribute a causal role to maladaptive beliefs. Aims: To test this hypothesis, we manipulated Overimportance of Thoughts (OT) beliefs and experimentally evaluated their effect on the response to an induced aggressive impulse. Method: Eighty-five participants completed a battery of self-report instruments assessing obsession symptoms, thought control, affectivity and obsessive beliefs, and were then randomly assigned to two conditions. In the experimental condition participants read a scientific abstract on the importance of thought control whilst those in the control condition read a neutral abstract. All participants identified a loved person and imagined feeling the impulse to stab this person, then completed again OT beliefs measures (Overimportance of Thought, Moral-Thought Action Fusion and Thought Action Fusion Likelihood). Results: The Moral component of the Thought Action Fusion was reduced by reading a brief text about the possibility and desirability of thought control. However, experimentally induced changes in beliefs did not yield differences in the intrusiveness of the aggressive impulse. Conclusions: Some beliefs can be modified through a single session in which information similar to what could be obtained in quotidian life is provided.
- Developing a european psychotherapy consortium (EPoC): towards adopting a single-item self-report outcome measure across European countriesPublication . Gonçalves, Miguel M.; Lutz, Wolfgang; Schwartz, Brian; Oliveira, João Tiago; Saarni, Suoma E.; Tishby, Orya; Rubel, Julian A.; Boehnke, Jan R.; Montesano, Adrian; Paiva, Dario; Ceridono, Davide; Zech, Emmanuelle; Willemsen, Jochem; Saarni, Samuli I.; Erzar, Katarina Kompan; Janeiro, Luís; Gelo, Omar C. G.; Errázuriz, Paula; Holas, Pawel; Styła, Rafał; Rožič, Tatjana; Rosenström, Tom; Békés, Vera; Unoka, Zsolt; Barkham, MichaelBackground: Complementing the development of evidence-based psychological therapies, practice-based evidence has developed from patient samples collected in routine care, addressing questions relevant to patients and practitioners, and thereby expanding our knowledge of psychological therapies and their impact. Implementation of assessments in routine care allows for timely clinical decision support and the collection of multiple practice-based data sets by addressing the needs of patients and clinicians (e.g., routine outcome monitoring) and the needs of researchers (e.g., identifying the impact of therapist variables on outcomes). Method: In this article we describe an initiative developed in Europe, through the European Chapter of the Society for Psychotherapy Research, aimed at creating a consortium that has the potential for collecting data on tens of thousands of patients per year. Results: A survey identified one of the main problems in the development of a common data set to be the heterogeneity of measures used by members (e.g., 87 different pre-post outcomes). We report on the results of the survey and the initial stage of identifying a single-item - the Emotional and Psychological Outcome (EPO-1) - measure and the process of its translation into multiple European languages. Conclusions: We conclude this first stage of the overall project by discussing the future potential of the Consortium in relation to the development of procedures that allow crosswalks of outcome measures and the creation of a task force that may be consulted when new data sets are collected, aiming for new common measures to be implemented and shared.