A triagem psicológica é uma prática geralmente utilizada em instituições públicas de saúde psicológica, a fim de selecionar a parcela da população interessada que pode ser abarcada pelos serviços oferecidos e encaminhar o interessado para um atendimento adequado à sua demanda. Por se tratar de uma avaliação psicológica, embora de caráter inicial e breve, abrange funções e características complexas, que devem ser constantemente estudadas, e não é isenta de referenciais teórico-clínicos. É, entretanto, realizada geralmente de modo breve e apenas como uma coleta de dados pessoais dos clientes, o que pode agravar problemas freqüentes em clínicas, tais como o desperdício do momento precioso para um atendimento imediato (o momento em que o cliente procura ajuda), bem como o abandono precoce de terapia, quando decorrente de encaminhamento pouco adequado à demanda. Modelos de triagens interventivas, cada qual com especificidades teóricas e técnicas, são propostos como uma alternativa para lidar com alguns destes problemas. Realizam avaliação e assistência. O objetivo da presente pesquisa foi o de analisar alguns alcances da experiência da realização de atendimentos em uma modalidade de triagem interventiva. Esta pesquisa deu continuidade a um projeto anterior, 2004, inicialmente denominado Consultas Psicológicas, que estudou um atendimento de recepção com retornos, oferecido a pessoas que não haviam conseguido uma das seis vagas semanais para a triagem de uma clínica-escola universitária paulistana. Em 2006, passou a ser denominado Triagem Estendida. A proposta do atendimento consistia em realizar triagem com até seis encontros, uso entrevistas-clínicas semi-abertas e sob referencial psicanalítico. O atendimento tinha dois objetivos centrais: por um lado realizar de modo mais detalhado a tradicional coleta dos dados do cliente, com elaborações sobre a queixa, necessidade e interesses dos clientes, visando ofertar encaminhamento adequado; por outro, oferecer acolhimento psicológico no momento da procura, promovendo alívio terapêutico se possível, a fim de lidar com algumas das demandas pontuais dos clientes. Tratou-se de uma pesquisa clínico-qualitativa, com o estudo de 10 casos, com a finalidade de avaliar os alcances da modalidade aplicada. Discutiu-se se os objetivos planejados puderam ser atingidos e os benefícios da modalidade para o cliente e para a organização do fluxo institucional da clientela. Em consonância com outros estudos, verificou-se o potencial atingido da triagem como espaço terapêutico significativo ao oferecer acolhimento e aprofundamento da compreensão do conflito. Verificou-se que os encaminhamentos ocorreram após o cliente ter obtido informações sobre psicoterapia e havendo maior participação do mesmo nesta escolha. A opinião dos participantes em relação ao atendimento recebido (obtida através de um follow up) foi positiva para a maioria. Após um ano do término da triagem, alguns haviam seguido o encaminhamento proposto, outros haviam achado o atendimento em Triagem Estendida suficiente. Esta divisão sugeriu existirem os dois tipos de demandas, por atendimento focal e prolongado, cada qual diferentemente contemplado e elaborado em uma recepção estendida. Embora existam dificuldades para a implementação deste tipo de atendimento em função da necessidade da articulação com os outros serviços, uma escuta inicial prolongada mostrou-se efetiva como recurso para lidar com problemas institucionais. / The psychological screening is a practice commonly used in public mental health institutions in order to select the portion of the population interested in psychotherapy that can be encompassed by the services offered and to refer the user (patient) to an appropriate service to their demand. Because it is a psychological evaluation, although initial and brief, comprises functions and complex technical features, which must be studied, and also is not exempt from theoretical-clinical references. It is, however, generally carried out in a brief way (simplistic way), and just as the collection of personal data of the patient, what can aggravate frequent problems in clinics such as the wastefulness of the precious moment for an immediate psychological assistance (the one in which the client seeks help), as well as the premature discontinuation of therapy (dropout), when it is a result from an inadequate referral, with regard to the client\'s request and necessity. Models of psychological interventional trials, each one with its specific technical and theory, are proposed as an alternative to deal with some of these problems. They perform both, evaluation and assistance. The objective of this research was to analyze some of the reaches of an accomplishment experience of consultations in an interventional screening modality. This study gave continuity to a previous project, 2004, initially called the Psychological Consultations, that studied a reception with the returns, offered to those who had not had one of six vacant per week for the psychological screening in a school-clinic of São Paulo. In 2006, came to be called Screening Extended. The proposed service was to perform screening of up to six meetings, with semi-structured clinical interviews and under psychoanalytic point of view. The service had two main objectives: firstly perform on detail the traditional gathering of user data, with specific details of customer\'s needs, requests and interests, in order to offer appropriate referral; secondly, offers care at the moment in which there was a request for help promoting therapeutic relief if possible, in order to deal with specific demands. This was a clinical-qualitative research, with the study of 10 cases, with the aim of assessing the scope of the modality when it is applied. It was discussed if the planned objectives were achieved and what were the benefits of the modality for the patient and for the way of organizing the flow routine of institutional users. In line with other studies, there was a screening as a significant therapeutic space as it hosted the patient and provided a better understanding of the conflict. It was observed that the referral for an therapy occurred after the client have obtained information about psychotherapy and that there was a greater involvement of it at that choice. The participants\' opinions regarding the care received (obtained through a follow up) were positive for most. One year after the completion of the assistance, some had followed the referral to therapy; others thought that the received care was already enough. This bifurcation has suggested that there are two types of demands, for focal and prolonged care, each one differently embraced and elaborated in an extended reception. Although there are difficulties in implementing this type of service due to the need for coordination with other services, an initial prolonged listening proved to be effective as a resource for dealing with some institutional problems.

O presente estudo investigou as mudanças na leitura materna sobre seus sintomas depressivos e sobre os sintomas psicofuncionais do bebê em um contexto de Psicoterapia Mãe-Bebê em Grupo. Participaram deste estudo uma díade mãe-bebê em que a mãe apresentava depressão pós-parto, de acordo com a Escala de Depressão Pós-Parto de Edimburgo (EPDS) e pela Entrevista MINI e confirmados através da Entrevista sobre a Gestação e Parto e também pela Entrevista sobre a Experiência da Maternidade. Já o bebê tinha sintomas psicofuncionais detectados através do Questionário Symptom Check List (SCL). Essa dupla participou de uma Psicoterapia Mãe-bebê em Grupo no período de maio a agosto de 2015. Foi utilizado o delineamento de estudo de caso único, a fim de analisar as mudanças na leitura materna sobre seus sintomas depressivos e sobre os sintomas psicofuncionais do bebê ao longo das sessões de psicoterapia. Para tanto, foi realizada uma análise qualitativa, relacionando os materiais clínicos provenientes das 11 sessões de psicoterapia com os conhecimentos teóricos existentes na literatura, a partir de uma compreensão psicanalítica. Os sintomas depressivos maternos considerados nessa análise foram tristeza, labilidade emocional e irritabilidade e os sintomas psicofuncionais do bebê foram sono, alimentação e comportamento, em especial os que envolvem separação. Os resultados revelaram mudanças na leitura da mãe acerca dos seus sintomas depressivos e sobre os sintomas psicofuncionais do bebê ao longo das sessões da Psicoterapia Mãe-Bebê em Grupo. Além disso, verificou-se que os sintomas depressivos maternos e os sintomas psicofuncionais do bebê estavam mutuamente associados e que a partir da intervenção utilizada houve uma melhora dos sintomas tanto da mãe quanto do bebê. Palavras-chave: leitura materna, depressão pós-parto, sintomas psicofuncionais do bebê, psicoterapia mãe-bebê em grupo. / The present study investigated the changes in maternal read about their depressive symptoms and on psychofunctional symptoms baby in a context Psychotherapy Brief Mother-Baby Group. The study included a mother-baby dyad in which the mother had postpartum depression, according to Depression Scale Postpartum Edinburgh (EPDS) and Interview MINI and confirmed through the interview about Pregnancy and Childbirth and also the interview on the Maternity Experience. But the baby had psychofunctional symptoms detected by the Symptom Check List Questionnaire (SCL). This double attended a Mother-Baby Group Brief Psychotherapy in the period May-August 2015. We used a single case study design in order to analyze the changes in the mother reading about her depressive symptoms and about the baby psychofunctional symptoms along the psychotherapy sessions. For this, a qualitative analysis was conducted, linking clinical materials from 11 psychotherapy sessions with existing theoretical knowledge in literature, from a psychoanalytic understanding. Maternal depressive symptoms were considered in this analysis sadness, emotional lability and irritability and the baby’s psychofunctional symptoms were sleeping, feeding and behavior, in particular those involving separation). The results revealed changes in the mother's reading about their depressive symptoms and about the baby-s symptoms psychofunctional during the sessions of brief mother-infant psychotherapy group. In addition, it was found that maternal depressive symptoms and the baby psychofunctional symptoms were mutually associated and was a improvement in symptoms of both mother and baby with the intervencion.

Introdução: Eventos traumáticos em nossa sociedade, a gravidade dos quadros psicopatológicos que podem advir desses eventos e a dificuldade terapêutica que podem significar levam à necessidade de embasar solidamente as medidas terapêuticas e de prevenção nas características individuais das vítimas de trauma, sendo o Transtorno de Estresse Pós- Traumático (TEPT) o principal transtorno psiquiátrico associado aos acidentes e a violência. Objetivo: Avaliar os efeitos da psicoterapia ultra-breve psicodinamicamente orientada no TEPT e TEA. Método: A amostra foi composta por 27 mulheres que foram atendidas no período de maio de 2008 e novembro de 2009 que completaram pelo menos quatro semanas de tratamento no Núcleo de Estudos e Tratamento do Trauma Psíquico (NET-TRAUMA) do Hospital de Clínicas de Porto Alegre (HCPA), Brasil. 85,2%(23) das pacientes preencheram os critérios para TEPT e 14,8%(4) tinham TEA . As pacientes foram avaliadas antes e após intervenção psicoterápica através das escalas: Davidson Trauma Scale (DTS), Inventário Beck de Depressão (BECK), Defense Style Questionaire (DSQ-40), Childhood Trauma Questionnaire (CTQ) Impressão Clínica Global (CGI) e Avaliação Global do Funcionamento (GAF). Resultados: Após tratamento houve melhora na sintomatologia das escalas DTS, BECK, CGI E GAF, mesmo controlando para uso de psicofármacos. Com tamanho de efeito elevado na comparação entre as escala no pré e pós-tratamento: CGI d=1,18, GAF d= 1,03, DTS d=0,95 e BDI d=0,9. Houve uma redução da defesa de projeção (p=0,036) e um aumento na defesa humor (p=0,024). Encontramos uma associação positiva entre a diminuição de sintomas de TEPT e a diminuição no escore do fator imaturo (p=0,032 r=0,43). Conclusões: A psicoterapia ultra-breve psicodinamicamente orientada mostrou-se eficaz para o tratamento do TEPT e TEA. Houve melhora na sintomatologia das escalas DTS, BECK, CGI E GAF, mesmo controlando para uso de psicofármacos. / Introduction: Traumatic events in our society, the severity of psychopathology that may result from such events and therapeutic difficulty may mean that lead to the necessity of basing solidly therapeutic measures of prevention and individual characteristics of victims of trauma, the Posttraumatic Stress Disorder (PTSD), the main psychiatric disorders associated with accidents and violence. Objective: To evaluate the effects of psychotherapy ultra-brief psychodynamically oriented PTSD and ASD. Method: The sample consisted of 27 women who were treated between May 2008 and November 2009 who completed at least four weeks of treatment in the Center for Research and Treatment of Psychic Trauma (NET-TRAUMA), Hospital de Clinicas de Porto Alegre ( HCPA), Brazil. 85.2% (23) of patients met criteria for PTSD and 14.8% (4) had ASD. Scales used were: Davidson Trauma Scale (DTS), Beck Depression Inventory (BECK), Defense Style Questionaire (DSQ-40), Childhood Trauma Questionnaire (CTQ), Clinical Global Impression (CGI), and the Global Assessment of Functioning (GAF). Results: After treatment there was improvement in symptoms scales DTS, BECK, CGI and GAF, even controlling for use of psychoactive drugs. With such a large effect on the comparison between the scale before and after treatment: d = 1.18 CGI, GAF d = 1.03, d = 0.95 DTS and BDI d = 0.9. There was a reduction in the defense of projection (p = 0.036) and an increase in defense humor (p = 0.024). We found a positive association between the reduction of PTSD symptoms and reduction in score of the immature factor (p = 0.032 r = 0.43). Conclusions: The ultra-brief psychotherapy psychodynamically oriented proved effective for the treatment of PTSD and ASD. There was improvement in symptoms scales DTS, BECK, CGI and GAF, even controlling for use of pharmacological drugs.

Given a probability space, we analyze the uncertainty, that is, the amount of information of a finite system, by studying the entropy of the system. We also extend the concept of entropy to a dynamical system by introducing a measure preserving transformation on a probability space. After showing some theorems and applications of entropy theory, we study the concept of ergodicity, which helps us to further analyze the information of the system.

Zugl.: Nijmegen, Radboud Univ., Diss., 2007

<p>The 1990s were a period of economic crisis and mass unemployment. The dissertation shows that in the labour market policy guidelines in the period 1978–2004, a dichotomy was constructed between, on the one hand, a group of unemployed described in positive terms as potentially able to gain new employment, and, on the other hand, a group – referred to in the dissertation as the Others – whose exclusion and marginalisation were seen as permanent. </p><p>Unemployment has not always been defined as a social problem. The nature of the problem of unemployment has been understood and conceptu­alised differently over time. Frames of interpretation contribute to the construction and/or reproduction of categories of unemployed within the context of active Swedish labour market policies. The point of departure for the study is that the definition of social problems is a complex process of social construction. It is an active process of re(construction), in which certain problems become perceived as social problems while others are not. </p><p>The flexibilisation of the labour market, and of labour market policy, is an institutional and discursive process that leads to new categorisations and otherings on the labour market.<i> </i></p><p>In the wake of the 1990s crisis, and of the more structural transformation of the Swedish labour market, a group of long-term unemployed has emerged. In the official guidelines of the labour market policy, the recommendations are to treat this group within the framework of the measures and activities that earlier applied to groups with disabilities. In this process, the structural labour market problem becomes defined politically in terms of individual disabilities. This is not only a process of individualisation, but also a process of medicalization. In this manner, unemployment, and particularly long-term unemployment, becomes analogous to disability.</p>

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<p>Aim: To establish whether a family centered approach to HIV care in which HIV positive adults are counseled on the importance of having their children tested results in the adults bringing their children under the age of five years for testing and or accessing HIV care, and to explore challenges faced by caregivers in bringing children for testing and care.</p>

The 1990s were a period of economic crisis and mass unemployment. The dissertation shows that in the labour market policy guidelines in the period 1978–2004, a dichotomy was constructed between, on the one hand, a group of unemployed described in positive terms as potentially able to gain new employment, and, on the other hand, a group – referred to in the dissertation as the Others – whose exclusion and marginalisation were seen as permanent. Unemployment has not always been defined as a social problem. The nature of the problem of unemployment has been understood and conceptu­alised differently over time. Frames of interpretation contribute to the construction and/or reproduction of categories of unemployed within the context of active Swedish labour market policies. The point of departure for the study is that the definition of social problems is a complex process of social construction. It is an active process of re(construction), in which certain problems become perceived as social problems while others are not. The flexibilisation of the labour market, and of labour market policy, is an institutional and discursive process that leads to new categorisations and otherings on the labour market. In the wake of the 1990s crisis, and of the more structural transformation of the Swedish labour market, a group of long-term unemployed has emerged. In the official guidelines of the labour market policy, the recommendations are to treat this group within the framework of the measures and activities that earlier applied to groups with disabilities. In this process, the structural labour market problem becomes defined politically in terms of individual disabilities. This is not only a process of individualisation, but also a process of medicalization. In this manner, unemployment, and particularly long-term unemployment, becomes analogous to disability.

Children who express externalizing behaviors in school are at greater risk of school failure and peer rejection. They are also at greater risk of developing antisocial behaviors, addiction to drugs, mental health problems and delinquency. Many teachers experience difficulties in working with pupils expressing externalizing behaviors. The aim of this thesis is to evaluate a classroom behavior management program called Comet. The main principle of Comet is to get the teacher to use effective strategies when the pupil who is targeted for intervention, and the rest of class, are behaving appropriately and inappropriately. Two versions of the program are evaluated in the thesis: Comet for teachers (Comet-T) and Comet for parents (Comet-P). Three studies are committed to evaluate Comet-T. In the first study Comet-T was compared to an active control group. 100 children (aged 8) were randomized into Comet-T or the control group. At post test and follow-up Comet-T received a better results in reducing externalizing problems, peer problems and teacher behavior management. An analysis of mediators showed that changes in teacher behaviors mediated externalizing behavior. In the second study, children (aged 6 -13) were randomized into two groups. 44 pupils received Comet-T and 42 pupils received a combined intervention consisting of Comet-T at school and Comet-P at home. At post test and follow-up the results show that the combination of Comet-T and Comet-P reduced the externalizing behaviors at home more than Comet-T (only). However, there were no significant differences between the two conditions regarding decrease in externalizing behaviors at school. In the third study Comet-T was compared to a brief version called Comet-TB. At post test Comet-TB had a greater reduction of externalizing behaviors compared to Comet-T. The studies conclude that teachers can use behavior management techniques to decrease externalizing behaviors in the classroom. Furthermore, teachers cannot rely on parent management programs in order to decrease externalizing problems in school. Instead, behavior problems in school need to be solved within school settings. Finally, even a brief program can be effective in order to decrease externalizing behaviors.