Inledning: Uppsatsen syftar till att undersöka familjeterapeuters erfarenheter av processer och faktorer bakom hur allians byggs upp med ungdomar i familjeterapi. Studien visar på att ungdomars utvecklingspsykologiska position gör att terapeuter måste närma sig ungdomarna med en väl tilltagen dos respekt och lyhördhet, samt i det odla en medvetenhet om att ungdomarna är extra känsliga och observanta på hur familjeterapeuterna agerar i relation till dem och föräldrarna. Frågeställningar: Hur ser och beskriver ett antal familjeterapeuter alliansprocessen med ungdomar i familjeterapi? Finns det särskilt viktiga komponenter i ett förhållningssätt som är allians-befrämjande? Finns det särskilda hinder eller fallgropar att beakta i relation till ovanstående? Metod: Kvalitativ intervjuundersökning. Resultat: Studien visar på vikten av att familjeterapeuterna visar respekt, nyfikenhet och kan hantera balansen mellan föräldrar och ungdomar. Att fokusera på diagnoser eller inta en dömande attityd verkar försvåra allians med ungdomar i familjeterapi. Diskussion: Resultaten diskuteras och analyseras bland annat ur ett utvecklingspsykologiskt och intersubjektivt perspektiv. / This paper discusses and examines how a number of family therapists look at the processes and factors related to how to build alliance with adolescents in family therapy. The current state of knowledge on this issue raises the important thing to get right alliance with adolescents in family therapy in terms of how successful and Goal Completions therapy becomes. The study shows that therapists have to consider that youth are in a development psychological position when they approach the young people with a generous dose of respect and sensitivity, as well as the growing awareness that young people are particularly sensitive and observant of how family therapists act in relation to them and their parents.

The work deals with the family and drugs. The first part characterises the function and functionless family, her functions and interest to child. Next it describes causes drug addiction, division drugs into legal and illegal, prevention primary, secondary and tertiary. In the practical part there is research drug problem on second school. Most children have experience in drug and reason is within the family.

Este trabalho objetivou conhecer o processo de busca e a clientela atendida em terapia de casal e família. Para tanto, realizaram-se dois estudos. Inicialmente, através de uma revisão sistemática da literatura, foram identificados seis fatores associados à busca pelas terapias de casal e família: fatores pessoais, relacionais, culturais, de gênero, estratégias anteriores de ajuda e tipo de problema. Posteriormente, através de um estudo empírico, a clientela atendida em terapia familiar em uma clínica-escola de Porto Alegre (RS) foi caracterizada. Foram realizadas entrevistas estruturadas com 41 adultos encaminhados para terapia familiar, nas quais foram investigadas variáveis sociodemográficas e familiares, o processo de busca de ajuda, o problema apresentado, tentativas anteriores de ajuda utilizadas e expectativas sobre o tratamento. Os resultados permitem reflexões sobre a prática clínica com famílias em clínicas-escola, especialmente a respeito do envolvimento dos clientes no processo terapêutico e à transição da queixa para a demanda desde o período de avaliação inicial. / This research aimed to investigate the help seeking process and the clients attended in couples and family therapy. To achieve this objective, two studies were realized. First, a systematic literature review identified six factors associated with the search for couples and family therapy: personal factors, relationship factors, gender, cultural aspects, prior sources of help and type of problem. After that, a second study characterized the clients attended in family therapy in a school clinic located in Porto Alegre (RS). Structured interviews with 41 adults referred for family therapy were realized. Sociodemographic and familial variables, the search for help process, the main problem, the prior sources of help and the expectations about the treatment were investigated. These results allows reflections about family therapy practice in school clinics, especially about the involvement of the clients on therapeutic process and the transition from the first complaint to the real demand since evaluation period.

Adolescentes do sexo feminino são a população mais frequentemente acometida pela anorexia nervosa (AN), com prevalência média de 2,5%, quando considerados critérios diagnósticos adaptados para esta faixa etária. A apresentação da AN em adolescentes é semelhante a de adultos, no entanto existem particularidades nos sintomas relacionadas ao nível de desenvolvimento cognitivo e emocional. A AN manifesta-se por: perda de peso, perturbações na forma de vivenciar a forma corporal, medo de engordar, restrição alimentar, comportamentos compensatórios e alterações menstruais. No Brasil, existem poucos recursos especializados para o tratamento da AN na adolescência e não foram realizados previamente estudos sistematizados sobre o tema. Estudos realizados em países de língua inglesa demonstram que o tratamento familiar (TF) apresenta bons resultados no tratamento da AN em adolescentes. Este estudo tem como objetivo a comparação de efetividade e de custos entre o TF e o tratamento multidisciplinar (TM). Inicialmente foi realizado um estudo piloto, incluindo nove pacientes de 11 a 17 anos do sexo feminino com diagnóstico de AN, tratadas com o TF. Posteriormente foi realizado um estudo comparativo, com os mesmos critérios de inclusão, com 20 pacientes que receberam o TF e foram comparadas com um grupo-controle histórico de 24 pacientes tratadas com TM. Foram calculados os custos diretos de ambas as modalidades de tratamento. Foram utilizadas como medidas de avaliação: DAWBA, CGAS, EDE-Q. No estudo piloto, as variáveis peso, IMC, EDE-Q, CGAS e amenorreia foram comparadas antes e após o TF. Foram observados resultados estatisticamente significativos em recuperação de peso e IMC (p=0,036). Foi observada melhora das demais variáveis após o tratamento, no entanto estes resultados não foram estatisticamente significativos. No estudo comparativo, 75% das pacientes que receberam o TF e 62,5% das pacientes que receberam TM apresentaram recuperação dos sintomas de AN, sem diferença estatisticamente significativa entre os grupos (p=0,378). Ambos os grupos apresentaram recuperação de peso, IMC e CGAS satisfatórias após o tratamento, sem diferença estatisticamente significativa entre os grupos. Tanto no TF quanto no TM, o maior tempo de sintomas antes do início do tratamento interferiu negativamente na resposta ao tratamento, reduzindo a chance de recuperação dos sintomas. Os custos diretos do TM são aproximadamente o dobro dos custos do TF. Tanto o TF quanto o TM demonstraram-se alternativas efetivas de tratamento para AN ! na população estudada. No entanto, o custo do TM é consideravelmente maior. O TF é uma alternativa de tratamento efetiva e economicamente viável, podendo ser disseminado para outros centros, possibilitando maior acesso a tratamento para adolescentes com AN / Female adolescents are the population most frequently affected by anorexia nervosa (AN), with average prevalence of 2.5% when adapted diagnostic criteria for this age group are considered. AN presentation in adolescents is similar to that of adults, but there are peculiarities in symptoms related to the level of cognitive and emotional development. AN main symptoms are: weight loss, disturbance in the way body shape is experienced, fear of becoming fat, dietary restriction, compensatory behaviors and menstrual abnormalities. In Brazil, there are few specialized resources for AN treatment in adolescence and no previous systematic studies have been conducted on this theme. In English-speaking countries, some studies have shown that the family-based treatment (FBT) is effective for adolescent AN. The aim of this study is to compare the effectiveness and the costs between the FBT and the multidisciplinary treatment (MT). Initially, a pilot study was conducted, including nine female patients from 11 to 17 years old diagnosed with AN, and treated with FBT. It was later performed a comparative study with the same inclusion criteria. Twenty patients who received FBT were compared with a historical control group of 24 patients treated with MT. We calculated the direct costs of both treatment modalities. The evaluation measures were: DAWBA, CGAS, EDE-Q. In the pilot study, the variables weight, BMI, EDE-Q, CGAS and amenorrhea were compared before and after FBT. We observed statistically significant results in weight and BMI recovery (p=0.036). The other variables have improved after treatment, although results were not statistically significant. In the comparative study, 75% of patients receiving FBT and 62.5% of patients receiving MT recovered from AN symptoms, no statistically significant difference was found between groups (p=0.378). Both groups have shown satisfactory recovery of weight, BMI and CGAS after treatment, with no statistical significant difference between groups. Both in the FBT and in the MT, the greater duration of symptoms before starting treatment had negative influence on treatment response, reducing the chance of recovery. The direct costs of the MT are approximately twice the cost of the FBT. Both the FBT and the MT were shown to be effective for AN treatment in the study population. However, the costs of MT are considerably higher. The FBT is an effective and economically viable treatment alternative and, can be disseminated to other centers, allowing ! greater treatment access for adolescents with AN

Ao longo da formação em psicologia, o estudante realiza atendimentos clínicos com o objetivo de construir sua identidade de terapeuta e utilizar, na prática, as teorias e técnicas que aprendeu. Na literatura brasileira são poucos os estudos que abordam essa etapa da formação quando se refere ao atendimento familiar. Através da análise e interpretação de material clínico oriundo de quatro casos atendidos por estudantes em um serviço-escola, esta pesquisa, de natureza clínico-qualitativa, teve como objetivo investigar, sob o referencial teórico da psicanálise familiar, as várias dimensões desse processo terapêutico na interface com a formação clínica do aluno. Os estudantes apresentaram dificuldades em identificar e manejar a transferência e contratransferência, atuando em papéis diversos que não o que lhes cabia enquanto terapeutas. Sensações corporais e sentimentos negativos como raiva e desapontamento foram registrados por parte dos terapeuta-estagiários ao longo dos atendimentos. O manejo adequado e a possibilidade de fazer interpretações e apontamentos mais precisos, favoreceu, em alguns casos, a transição de uma queixa depositada em um membro (paciente identificado) para uma demanda que envolvia o grupo. A supervisão, o procedimento de registro de sessão e materiais artísticoexpressivos auxiliaram os alunos na construção da identidade de terapeuta. A análise do material coletado permitiu constatar que, ao longo do(s) processo(s) psicoterápico(s) muitos deles foram se posicionando de forma mais segura, podendo fazer apontamentos ao mesmo tempo em que já não atuavam tanto em sessão, assegurando-se de suas funções. O atendimento familiar, por um lado, mobilizou alguns terapeutas no sentido de dificultar a construção e assunção desse papel. Por outro lado, foi notável o crescimento e desenvolvimento de diversas habilidades importantes no processo terapêutico. Outros aspectos além dos aqui estudados também são fundamentais para o processo de formação do terapeuta familiar tais como a terapia do próprio estudante e a aprendizagem da teoria psicanalítica familiar / During the training in psychology, the undergraduate student performs clinical care in order to build his therapist identity and use in practice the theories and techniques he learned. In Brazilian literature there are few studies that address this stage of training when it comes to family treatment. Through the analysis and interpretation of clinical material from four cases attended by undergraduate students in a clinic-school, this research, clinical and qualitative nature, aimed to investigate under the theoretical framework of family psychoanalysis, the various dimensions of this therapeutic process in interface with the clinical training of the undergraduate student. The undergraduate students presented difficulties in identifying and handling the transference and countertransference, acting in different roles than it was up to them as therapists. Bodily sensations and negative feelings such as anger and disappointment were recorded by the therapist interns over the calls. Proper management and the ability to make more precise interpretations and notes, favored in some cases, the transition to a complaint filed in a member (identified patient) to a demand that enveloped the group. Supervision, the session registration procedure and artistic and expressive materials helped undergraduate students in building therapist identity. The analysis of the collected material it was established that, over method psychotherapy many of them were positioning themselves more safely and can make interventions at the same time that they no longer act out in session, assuring their role as therapist. The family treatment, on the one hand, mobilized some therapists in order to hinder the construction and assumption of that role. On the other hand, was remarkable growth and development of several important skills in the therapeutic process. Other aspects than those studied here are also central to the family therapist formation process such as the student\'s own therapy and learning of family psychoanalytic theory

Introdução: A presente dissertação foi desenvolvida com o intuito de investigar as possíveis mudanças na dinâmica das famílias incestuosas, após intervenção do tratamento psicoterapêutico. A hipótese é de que mudanças primárias e secundárias ocorrem nas famílias encaminhadas ao Centro de Estudos e Atendimentos Referente ao Abuso Sexual (CEARAS) a partir do tratamento proposto. Essa dissertação foi elaborada a partir de uma perspectiva psicanalítica, com enfoque psicossocial, na qual o sujeito é considerado a partir de sua imersão na cultura. Para tanto, se tomou como base de reflexão o trabalho desenvolvido por este Centro de Estudos, em relação às famílias incestuosas. Objetivo: Refletir sobre as mudanças primárias e secundárias apresentadas pelas famílias incestuosas que foram atendidas no CEARAS. Metodologia: Trata-se de uma pesquisa retrospectiva documental. Foram analisados os prontuários de 19 famílias atendidas no CEARAS no período de 1993 a 2013 que compuseram a amostra final. Levantaram-se as informações sobre os atendimentos, condições de prontuários e quanto ao tratamento. As mudanças descritas nos prontuários foram divididas em dois grupos: mudanças primárias e secundárias. Uma análise descritiva e quantitativa das variáveis foi realizada. Resultados: A maior parte das famílias que foram encaminhadas para o CEARAS não finalizaram o tratamento proposto. Em relação às mudanças observadas, 53% das famílias apresentaram mudanças primárias e secundárias, 37% primárias e 10% secundárias. Em relação às mudanças primárias, a simbolização das funções familiares foi a mais frequente e a autonomia do membros familiares a menos frequente nos prontuários analisados. Não houve predomínio de mudanças secundárias. Observou-se um maior número de mudanças nas familías que não passaram pelo processo de troca de terapeutas. Conclusão: Percebeu-se a viabilidade do trabalho, o quanto ele se faz necessário. A pesquisa apontou que as mudanças primárias e secundárias são possíveis de acontecer através da terapia familiar. A transferência das famílias não ocorre somente com a instituição, mas também com os terapeutas envolvidos no tratamento / Introduction:This research aims to investigate possible changes to the dynamics of incestuous families after the commencement of psychotherapeutic treatment. Hypothetically, primary and secondary changes happen to the families taken to the Sexual Abuse Study and Help Center (Centro de Estudos e Atendimentos Referente ao Abuso Sexual - CEARAS) from the proposed treatment. This essay has been elaborated from a psychoanalytical perspective with psychosocial emphasis, in which the individual is considered from his cultural context. To do so, the grounds for the analysis is the work developed by the Study Center with the incestuous families. Objective: To think about the primary and secondary changes that arose from the therapeutic treatment provided by CEARAS to the dysfunctional families. Methodology: This is a retrospective document research. The handbook of the 19 families supported by CEARAS from the period between 1993 and 2013 which were part of the final sample have been analysed. The information about the calls, handbook conditions and treatment have been searched. The changes described in the handbooks were split in two groups: primary and secondary changes. Results: Most families under CEARAS\' care have not finished the proposed treatment. In relation to the changes detected, 53% of the families have shown primary and secondary changes; 37% have shown primary; and 10% secondary. It has been observed in the handbooks under analysis that, in relation to primary changes, the simbolization of the family functions was the most outstanding change whereas the autonomy of the family members was the least. There was no predominance of secondary changes. There has been a higher number of changes in families that did not have to change therapists. Conclusion: It is noticeable that the work is feasible and how necessary it is.The research shows that the primary and secondary changes are possible to take place by way of family therapy. The transfer in families does not happen only with the institution but also with the therapists involved in the treatment

Children’s mental health is a topic of concern, not only in the escalating number of children who meet diagnostic criteria for disorders, but also for the practitioners desiring to treat them effectively. Parental involvement in treatment results in more favorable outcomes with longer treatment gains observed, thus reducing mental health issues. An additional factor in children’s mental health is the effect of levels of parental acceptance toward the child. Parental acceptance is a positive outcome that has been observed in previous studies conducted with Child-Parent Relationship Therapy (CPRT). There are many reported barriers to seeking treatment for mental health issues, including time, cost, distance, and access. Online therapies have been found to reduce or eliminate most barriers to treatment, and is a preferred format for certain populations. To date, however, there have been no studies conducted on whether CPRT is effective in increasing levels of parental acceptance in an online format. Eight participants from around the world completed the ten-week CPRT training in an online format. Levels of parental acceptance were measured by the Porter Parental Acceptance Scale (Porter, 1954; PPAS) in self-reported pre- and post-treatment assessments. A perception survey was also conducted to assess participants’ perception of the process of an online parent training format, including benefits and challenges. This mixed-methods study found that an online version of CPRT does significantly increase parental acceptance levels. Participants also reported positive perceptions of the online training format. Positive themes reported in the survey responses related to convenience, community, access, and user experience.

Syftet med denna studie är att undersöka i vilken utsträckning man kan se studier på en legitimationsgrundande psykoterapeututbildning som ett karriärdrag, och hur en sådan karriär i så fall kan definieras. I studien har 60 legitimerade psykoterapeuter med inriktning familjeterapi som studerat vid Linköpings universitet under åren 2002-2014 (n=87) svarat på en enkät med fasta svarsalternativ, samt några öppna frågor. Resultaten visar att titeln som legitimerad psykoterapeut medfört löneökning för 63 %. Av respondenterna titulerar sig 58 % som legitimerad psykoterapeut, 27 % har fått utökade befogenheter i samband med legitimationen, och 12 % har befordrats. I samband med legitimationen har 33 % fått utökat ansvar och 40 % anger familjeterapi som huvudsaklig sysselsättning. De stora arbetsgivarna även efter avslutad utbildning är kommun och landsting, där 73 % är anställda. En markant ökning har dock skett av antalet egna företagare, från 20 % till 40 %. Den karriär som görs av legitimerade psykoterapeuter är huvudsakligen en expertkarriär, dvs. en karriär där man är expert inom sitt yrkesområde, en horisontell karriär. En utbildning till legitimerad psykoterapeut leder till en ökad grad av eget företagande. / This study aims to examine to what extent following a course of study leading to a diploma in psychotherapy can be seen as a strategic career-related move, and how, in that case, such a career can be defined. The degree entitling the recipient to the Swedish title "legitimerad psykoterapeut" is difficult to translate literally; it is usually considered equivalent to, but is not specified as, an M.Sc. It is officially a degree within the health care field, with concurrent obligations, and is hereafter referred to as "qualified psychotherapist". 60 qualified family psychotherapists who studied at Linköping University between 2002 and 2014 (n=87), replied to a questionnaire containing fixed answer alternatives and a few open questions. The results show that acquiring the title of qualified psychotherapist led to a rise in income by 63%. Of all the respondents, 53% actually use the title, 27% acquired more authority, 12% were promoted, and 33% reported being granted a higher level of responsibility after acquiring the title. Family therapy was reported as the major occupation of 40% of the respondents. Local councils (kommuner) or district health authorities (landsting) employed 73% of the respondents, although there has been a significant increase, from 20% to 40%, in the proportion of family psychotherapists who are also partly or solely self-employed. The career of a qualified psychotherapist is thus largely the career of an expert within the field, a "horizontal" career. Completing the requirements for qualification as a psychotherapist leads to an increased level of self-employment.

Doctor of Philosophy / Department of Family Studies and Human Services / Anthony Jurich / Until recently, minimal research has been done regarding the impact of veterinary student stress on the student’s significant intimate relationships. In this study of 466 veterinary students enrolled in five different accredited U.S. Colleges of Veterinary Medicine, the association of five primary variables, perceived stress, self-esteem, academic satisfaction, relationship satisfaction, and general life satisfaction was investigated, utilizing McCubbin and Patterson’s (1983) Double ABCX Model as a guide. Six of the seven hypotheses were supported and further regression analysis yielded a model of variable associations that supported the Double ABCX Model, though significant gender differences were found. Specifically, female students perceived significantly more stress than did male students. With the exception of academic satisfaction and relationship satisfaction, all of the major variables were strongly correlated with each other. For the women, who comprised a significant majority of the sample, perceived stress had a significant impact on relationship satisfaction, as well as on self-esteem, which in turn significantly impacted academic satisfaction. Relationship satisfaction and academic satisfaction both significantly, and separately, impacted general life satisfaction, suggesting that relationship satisfaction and academic satisfaction are different constructs that operate independently of each other. However, both have a significant impact upon and are significantly associated with general life satisfaction, suggesting that neither can be neglected during veterinary training if a positive outcome is desired. For the men in this sample, stress impacted directly upon academic satisfaction, self-esteem, and general life satisfaction but did not have a direct impact upon relationship satisfaction. Instead, relationship satisfaction and general life satisfaction had a highly correlated relationship, with both significantly and strongly associated with the other. Although academic satisfaction and relationship satisfaction appear to be two separate entities, they are both important elements to achieving general life satisfaction during veterinary training and, therefore, should be equally attended to during the training process. These findings are interpreted and discussed in light of the implications for and importance of continued collaboration between veterinary students and programs and the field of Marriage and Family Therapy in an effort to understand and support students and their significant relationships during the veterinary training process.

Doctor of Philosophy / Department of Family Studies and Human Services / William H. Meredith / This study made use of a three round Delphi survey process to explore the influential factors in the personal clinical theory development of marriage and family therapists. The sample consisted of marriage and family therapy trainees in COAMFTE accredited masters programs around the country. The initial round began with 64 items and resulted in 94 items. The last round resulted in 94 items being rated as to their amount of influence upon the personal clinical theory development of the trainees. A core set of variables were identified that were seen to be highly influential in the theory development process. Panelists were able to reach a strong consensus on all but one of these variables. A much larger set of variables were deemed moderately high in importance and varied in the overall degree of consensus that was obtained among all panelists. The results of this study, in terms of personal clinical theory development, point to the power of the personal relationships formed in the training process. Multiple variables related to the power of personal relationships with MFT program supervisors/professors. Key graduate and undergraduate courses were identified as being highly influential. Recommendations for future study, and program emphasis are offered.