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Processo de mudança em psicoterapia psicodinâmica: o papel da experiência emocional e da aliança terapêutica ao longo do tempo
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Abstract(s)
A Terapia para as Fobia a Afetos (TFA), preconiza que a maioria dos problemas psicológicos se deve ao uso de defesas desadaptativas a que os clientes recorrem para lidar com as emoções temidas. Nesta terapia, os terapeutas procuram auxiliar os clientes a resolver estas fobias a afetos, abdicando das defesas e experienciando de forma autêntica e adaptativa as emoções num contexto relacional seguro. Assim, a experiência emocional (EE) e uma boa aliança terapêutica (AT) são elementos centrais do processo de mudança na TFA.
A presente investigação visa descrever o processo de mudança na TFA, através da identificação de padrões de relação entre a EE, as dimensões da AT na perspetiva de ambos elementos da díade e os sintomas. Participaram neste estudo oito clientes com idades compreendidas entre os 20 e os 43 anos (M = 26.25; DP = 7.15) acompanhados por dois psicólogos que seguem o modelo TFA. Foram utilizados os seguintes instrumentos: Emotional Experience Self-Report, Inventário de Aliança Terapêutica Revisto e Reduzido e Outcome Questionnaire 10. Os dados recolhidos foram analisados com recurso ao Group Iterative Multiple Model Estimation (GIMME).
Os resultados revelaram associações comuns a toda a amostra e dois subgrupos com padrões de relações distintos. No subgrupo 1, a EE, através das dimensões AT, conduziu à redução sintomática, sendo que este conjunto de caminhos complexo englobou todas as variáveis de processo e a interação entre a díade. No subgrupo 2, apenas se verificaram associações entres as dimensões da AT na perspetiva do cliente e do terapeuta.
As descobertas deste estudo salientam a importância da EE para os resultados terapêuticos e o papel das dimensões da AT como potenciadores desse efeito. Deste modo, sugerimos que os terapeutas sejam mais sensíveis ao modo como os clientes elaboram as emoções no contexto da relação terapêutica e os auxiliem neste processo.
Affect Phobia Therapy (APT) is based on the premise that most psychological problems are due to client’s use of maladaptive defenses to cope with feared emotions. In this therapy, therapists seek to help clients resolve these affect phobias by relinquishing defenses and authentically and adaptively experiencing emotions in a safe relational context. Thus, emotional experience (EE) and a good therapeutic alliance (TA) are central elements of the change process in TFA. The present research aims to describe the process of change in TFA, by identifying patterns of connections between EE, the dimensions of TA from the perspective of both elements of the dyad and symptoms. A total of eight clients aged between 20 and 43 years (M = 26.25; SD = 7.15) accompanied by two psychologists who follow the TFA model participated in this study. The following instruments were used: Emotional Experience Self-Report, Working Alliance Inventory-Short Revised and Outcome Questionnaire 10. Collected data were analyzed using Group Iterative Multiple Model Estimation (GIMME). The results revealed associations shared by the whole sample and two subgroups with distinct patterns of connections. In subgroup 1, EE through TA dimensions resulted in symptom reduction, and this complex set of pathways encompassed all process variables and the interaction between the dyad. In subgroup 2, there were found to be associations only between the dimensions of TA from the perspective of the two elements of the dyad. The findings of this study highlight the importance of EE for therapeutic outcomes and the role of TA dimensions as enhancers of this effect. Therefore, we suggest that therapists be more sensitive to the way clients elaborate emotions in the context of the therapeutic relationship and assist them in this process.
Affect Phobia Therapy (APT) is based on the premise that most psychological problems are due to client’s use of maladaptive defenses to cope with feared emotions. In this therapy, therapists seek to help clients resolve these affect phobias by relinquishing defenses and authentically and adaptively experiencing emotions in a safe relational context. Thus, emotional experience (EE) and a good therapeutic alliance (TA) are central elements of the change process in TFA. The present research aims to describe the process of change in TFA, by identifying patterns of connections between EE, the dimensions of TA from the perspective of both elements of the dyad and symptoms. A total of eight clients aged between 20 and 43 years (M = 26.25; SD = 7.15) accompanied by two psychologists who follow the TFA model participated in this study. The following instruments were used: Emotional Experience Self-Report, Working Alliance Inventory-Short Revised and Outcome Questionnaire 10. Collected data were analyzed using Group Iterative Multiple Model Estimation (GIMME). The results revealed associations shared by the whole sample and two subgroups with distinct patterns of connections. In subgroup 1, EE through TA dimensions resulted in symptom reduction, and this complex set of pathways encompassed all process variables and the interaction between the dyad. In subgroup 2, there were found to be associations only between the dimensions of TA from the perspective of the two elements of the dyad. The findings of this study highlight the importance of EE for therapeutic outcomes and the role of TA dimensions as enhancers of this effect. Therefore, we suggest that therapists be more sensitive to the way clients elaborate emotions in the context of the therapeutic relationship and assist them in this process.
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Keywords
Terapia para as fobias a afetos Experiência emocional Dimensões da aliança terapêutica Resultados terapêuticos