Made available in DSpace on 2015-04-14T13:22:17Z (GMT). No. of bitstreams: 1 453433.pdf: 3650080 bytes, checksum: c204c042465350ee80f6b74d4fc6e3e6 (MD5) Previous issue date: 2013-12-12 / This doctoral thesis is about psychological treatments for cocaine/crack users, and has 4 articles, structured in the form of sessions. Session 1 is the theoretical chapter, which aimed to present a literature review of treatments offered for crack users, through a systematic review of international and national literature indexed in Medline, SciELO, LILACS, and Web of Science using the descriptors crack or cocaine or cocaine smokers (crack) and psychosocial treatment or psychotherapy or psychological treatment (psychological treatment) including articles published in the period of 2001-2011. The results show that there is no consensus on the effectiveness of crack users treatment, the few efforts to compare techniques resulted in evidence of little or no difference, although there are registered benefits in the application of any those. In session II, a randomized clinical trial is presented in order to evaluate the effectiveness of a group intervention program for cocaine/crack users. The findings of this study suggest that the intervention was effective for readiness for behavior change and for the maintenance of abstinence in the first two weeks post-treatment. Session III, aimed to evaluate and compare therapists skills for using the principles of motivational interviewing through Motivational Interviewing Treatment Integrity (MITI) scale. As a result it was found that the therapists from the group (TTM + MI) were competent in the overall score of the MI spirit, in the percentage of complex reflections and in the percentage of MI adherent; when compared to the control group (Psychoeducation), there was significant difference in all MITI scale scores. The purpose of the session IV, was to verify possible associations and cognitive performance influence in readiness for change in cocaine/crack users. The WCST, WAIS-III subtests, the URICA, and the readiness to change scale were applied in a 113 users sample. The results showed significant correlations between the presence of cognitive deficits and lower degrees of motivation. Multiple regression analyzes showed levels of influence of cognitive tests performance increasing the subject s readiness to change. Thus, it can be inferred that cognitive performance correlates to readiness for behavior change in cocaine/crack users. / A presente tese de doutorado ? sobre tratamentos psicol?gicos para usu?rios de coca?na/crack, e possui quatro artigos, que foram estruturados sob a forma de se??es. A se??o I ? o cap?tulo te?rico, que teve como objetivo apresentar uma revis?o da literatura sobre tratamentos oferecidos para usu?rios de crack, atrav?s de uma revis?o sistem?tica de literatura internacional e nacional, indexada nas bases de dados Medline, Scielo, Lilacs e Web of Science, utilizando os descritores crack or crack cocaine or cocaine smokers (crack) and psychosocial treatment or psycotherapy or psychological treatment (tratamento psicol?gico), incluindo artigos publicados no per?odo de 2001 a 2011. Os resultados apontam que n?o existe consenso acerca da efetividade no tratamento de usu?rios de crack; os poucos esfor?os de compara??o entre t?cnicas resultaram em evid?ncias de pouca ou nenhuma diferen?a, ainda que se registre o benef?cio para os usu?rios na aplica??o de qualquer uma delas. Na se??o II, ? apresentado um ensaio cl?nico randomizado para avaliar a efetividade de um programa de interven??o em grupo para usu?rios de coca?na/crack. Os achados deste estudo sugerem que a interven??o foi efetiva quanto ? prontid?o para mudan?a de comportamento e quanto ? manuten??o da abstin?ncia nos primeiros 15 dias p?s-tratamento. A se??o III teve como objetivo avaliar e comparar as compet?ncias dos terapeutas para a utiliza??o dos princ?pios da entrevista motivacional atrav?s da escala Motivational Interviewing Treatment Integrity (MITI). Como resultados, foi poss?vel constatar que os terapeutas do grupo MTT+EM foram competentes tanto no escore global do esp?rito da EM, quanto no percentual de reflex?es complexas e no percentual de EM aderente; quando comparado com o grupo controle Psicoeduca??o, houve diferen?a significativa em todos os escores da escala MITI. O objetivo do artigo da se??o IV foi verificar as poss?veis associa??es e a influ?ncia do desempenho cognitivo na prontid?o para mudan?a em usu?rios de coca?na/crack. Em uma amostra de 113 usu?rios, foram aplicados o WCST, subtestes do WAIS-III, a URICA e a R?gua de Prontid?o para a Mudan?a. Os resultados apontaram correla??es significativas entre presen?a de d?ficits cognitivos e menores graus de motiva??o. An?lises de regress?o m?ltipla apontaram os n?veis de influ?ncia da performance nos testes cognitivos no aumento da prontid?o do sujeito para a mudan?a. Assim, pode-se inferir que o desempenho cognitivo correlaciona-se ? prontid?o para a mudan?a de comportamento em usu?rios de coca?na/crack.