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A interação entre terapeuta e cliente nas sessões iniciais da terapia para as fobias a afetos
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Abstract(s)
A Terapia para as Fobias a Afetos (TFA) preconiza que o caminho para o sucesso terapêutico passa por dois objetivos principais: a Reestruturação das Defesas e a Reestruturação dos Afetos. Apesar desta expetativa teórica, escassas investigações têm procurado analisar como decorre o processo de mudança na TFA, particularmente na fase inicial dos tratamentos.
O presente estudo pretendeu avaliar o tipo de intervenções terapêuticas e respostas do cliente mais salientes no início da terapia e examinar a associação entre a intervenção do terapeuta e a categoria proporcionada pelo cliente no momento imediatamente a seguir, com o objetivo de validar empiricamente o decurso da fase inicial da TFA. Para o efeito, foram visualizadas e codificadas as sessões 2, 5 e 10 de cinco clientes em psicoterapia de acordo com o modelo TFA (Midade = 24,6 anos; 60% do sexo feminino). Cada fala dos elementos da díade terapêutica foi categorizada de acordo com a ATOS, um sistema de codificação das sessões gravadas, cujas subescalas correspondem aos objetivos de tratamento do modelo em estudo.
As análises feitas através do teste do Qui-Quadrado revelaram que as intervenções de Motivação, Experiência e Insight são as mais predominantes nos terapeutas, ao passo que os clientes proporcionam mais respostas relacionadas com os Afetos Inibitórios, a Perceção do Self e dos Outros. De modo geral, verificou-se uma associação significativa entre as intervenções terapêuticas e as respostas imediatas dos clientes, com semelhanças entre a díade no que diz respeito ao tipo de categoria proporcionada. Os dados encontrados possibilitam uma maior compreensão face ao processo de mudança dentro das sessões terapêuticas da TFA, corroborando a ocorrência de um trabalho de Reestruturação das Defesas e dos Afetos nas primeiras sessões. As principais descobertas deste estudo são discutidas com base na literatura atual acerca do estudo do processo de mudança em psicoterapia psicodinâmica.
Affect Phobias Therapy (APT) advocates that the path to therapeutic success involves two main objectives: the Restructuring of Defenses and the Restructuring of Affects. Despite this expectation theory, few research have looked at how to study the process of change in APT, particularly at the beginning of treatments. The present study aimed to assess the type of therapeutic interventions and client responses that were most salient at the beginning of therapy and to examine the association between the therapist's intervention and the category provided by the client at the moment immediately after, with the aim of empirically validating the course of the initial phase of APT. For this purpose, sessions 2, 5 and 10 of five clients on undergoing psychotherapy, were visualized and coded according to the APT model (Mage = 24,6 years; 60% were female). Each speech of the therapeutic dyad elements was categorized according to the ATOS, a coding system of recorded sessions, whose subscales correspond to the treatment objectives of the model under study. The analyzes carried out using the Chi-Square test revealed that the interventions of Motivation, Experience and Insight are the most prevalent in therapists, while clients provide more responses related to Inhibitory Affects, Perception of Self and Others. Overall, there was a significant association between therapeutic interventions and immediate client responses, with similarities between the dyad in terms of the type of category provided. The data found allow a greater understanding of the process of change within the therapeutic sessions of APT, corroborating the occurrence of Restructuring ofDefenses and Affections in the first sessions. The main findings of this study are discussed based on the current literature on the study of the process of change in psychodynamic psychotherapy.
Affect Phobias Therapy (APT) advocates that the path to therapeutic success involves two main objectives: the Restructuring of Defenses and the Restructuring of Affects. Despite this expectation theory, few research have looked at how to study the process of change in APT, particularly at the beginning of treatments. The present study aimed to assess the type of therapeutic interventions and client responses that were most salient at the beginning of therapy and to examine the association between the therapist's intervention and the category provided by the client at the moment immediately after, with the aim of empirically validating the course of the initial phase of APT. For this purpose, sessions 2, 5 and 10 of five clients on undergoing psychotherapy, were visualized and coded according to the APT model (Mage = 24,6 years; 60% were female). Each speech of the therapeutic dyad elements was categorized according to the ATOS, a coding system of recorded sessions, whose subscales correspond to the treatment objectives of the model under study. The analyzes carried out using the Chi-Square test revealed that the interventions of Motivation, Experience and Insight are the most prevalent in therapists, while clients provide more responses related to Inhibitory Affects, Perception of Self and Others. Overall, there was a significant association between therapeutic interventions and immediate client responses, with similarities between the dyad in terms of the type of category provided. The data found allow a greater understanding of the process of change within the therapeutic sessions of APT, corroborating the occurrence of Restructuring ofDefenses and Affections in the first sessions. The main findings of this study are discussed based on the current literature on the study of the process of change in psychodynamic psychotherapy.
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Keywords
Psicoterapia Fase inicial Terapia para as fobias de afetos Reestruturação das defesas Reestruturação dos afetos Processo de mudança