Submitted by Silvana Teresinha Dornelles Studzinski (sstudzinski) on 2016-02-18T14:33:11Z No. of bitstreams: 1 Lisiane Geremia_.pdf: 459446 bytes, checksum: 3da35d89eb6da1c51b2777228edd1fa1 (MD5) / Made available in DSpace on 2016-02-18T14:33:11Z (GMT). No. of bitstreams: 1 Lisiane Geremia_.pdf: 459446 bytes, checksum: 3da35d89eb6da1c51b2777228edd1fa1 (MD5) Previous issue date: 2015-12-22 / Nenhuma / As pesquisas em psicoterapia têm contribuido para o estudo da Aliança Terapêutica, seu desenvolvimento e manutenção no processo de tratamento com pacientes diagnosticados com diversos transtornos. Através da exploração minuciosa de ações do processo, incluindo variáveis do paciente, do terapeuta e da interação, se torna possível compreender o que ocorre dentro de um setting terapêutico e como a Aliança Terapêutica se desenvolve em uma psicoterapia. Poucos estudos direcionam suas investigações para os pacientes diagnosticados com o Transtorno de Personalidade Borderline, principalmente, na descrição dos processos e dos resultados terapêuticos. Essa dissertação de mestrado teve como principal objetivo avaliar a Aliança Terapêutica no processo de psicoterapia de uma jovem diagnosticada com o Transtorno de Personalidade Borderline. Para tal, 12 sessões de psicoterapia psicanalítica foram codificadas através de dois instrumentos, um que avalia a Aliança Terapêutica e, o segundo focalizando o estudo do processo terapêutico. O Working Alliance Inventory Observer Form (WAI-O) busca avaliar a Aliança Terapêutica por meio de 36 itens que investigam as três subescalas presentes no tratamento, os Objetivos, as Tarefas, e o Vínculo. O Psychotherapy Process Q-set (PQS) visa avaliar sessões de psicoterapia através de 100 itens que descrevem o terapeuta, as atitudes e os comportamentos do paciente, bem como as interações terapeuta/paciente. O primeiro estudo consiste na análise e descrição da Aliança Terapêutica na psicoterapia durante o período de seis meses de tratamento, visando compreender as qualidades dessa relação ao longo desse recorte de sessões e posteriormente nas três etapas divididas do tratamento. O segundo, investiga em profundidade a Aliança Terapêutica no processo de uma psicoterapia através da integração das anotações clínicas, narrativas realizadas através dos cinco itens mais e cinco itens menos característicos do processo e da correlação das categorias do Psychotherapy Process Q-Set (PQS) com as subescalas do Working Alliance Inventory Observer Form (WAI-O). Portanto, esta dissertação aponta que a Aliança Terapêutica é um fator de muita importância no processo de uma psicoterapia, especialmente no tratamento de pacientes graves e, que o vínculo e a postura empática e sensível da terapeuta são ingredientes essenciais nesse processo. / Psychotherapy research have contributed for the study of therapeutic alliance, its development and maintenance during the treatment of patients diagnosed with many disorders. By thorough exploration of the actions of the process, including patient, interaction and therapist variables, it is possible understand what happens in a therapeutic setting and how the Therapeutic Alliance develops in psychotherapy. Few studies directed their research to patients diagnosed with Borderline Personality Disorder, especially in the description of processes and therapeutic results. This Master's dissertation aimed to evaluate the Therapeutic Alliance in the psychotherapy process of a young woman diagnosed with Borderline Personality Disorder. For such, 12 psychoanalytic psychotherapy sessions were coded by two instruments, one that evaluates the Therapeutic Alliance and the second focusing on the study of the therapeutic process. The Working Alliance Inventory Observer Form (WAI-O) seeks to assess the Therapeutic Alliance through 36 items, investigating the three subscales present in the treatment: the Objectives, the Tasks, and the Bond. The Psychotherapy Process (PQS) aims to assess the psychotherapy sessions through 100 items describing the therapist, the attitudes, the behavior of the patient and the therapist/patient interactions. The first study is the analysis and description of the Therapeutic Alliance in psychotherapy, during the six months of treatment, to understand the qualities of this relationship during these sessions, and later in the three stages of treatment. The second one investigates in depth the process of the Therapeutic Alliance of psychotherapy through the integration of clinical notes, narratives made through the five most typical items and five less typical items of the process, and the correlation of the categories of the Psychotherapy Process Q-Set (PQS) with the subscales of the Working Alliance Inventory Observer Form (WAI-O). Therefore, this dissertation points out that the Therapeutic Alliance is a factor of great importance in the process of psychotherapy, especially in the treatment of critically ill patients and the bond, as well as the empathic and sensitive attitude of the therapist are essential components in this process.

Motivational Interviewing (MI) is a client-centered, directive approach for behavior change. Self-Determination Theory (SDT) is a theory of human motivation and self-determined growth. Both of these social-cognitive theories aim to explain motivation and health behavior change and have generated a lot of research on how to increase human motivation. However, MI lacks a definite theory on mechanisms of behavior change and SDT offers a theory of motivation based on extensive research on human interactions. This paper aims to critically look at facilitators of client motivation for behavior change in-session from a social-cognitive perspective on one hand, and neural correlates related to client behavior change on the other hand. MI and SDT somewhat similarly explain what most importantly determines client motivation for change in-session. However, SDT mainly focus on psychological needs such as fostering client autonomy, and MI focus on the therapeutic alliance and on generating client change talk in-session. Efforts to bridge the two methods aim at generating a clearer definition of motivation in MI, and a better framework of practice in SDT. Studies on neural correlates of behavior change support and challenge elements of both approaches, indicating the importance of autonomy and relatedness for motivating positive behavior change.

Aims: The purpose of the qualitative study was to gain insight into the way parents experience and manage the waiting process following a referral to a Child and Adolescent Mental Health Service. The aim was to use the information for future service delivery and therapeutic engagement. Method: 6 parents whose child had been referred to a Child and Adolescent Mental Health Service and had been waiting for more than eight weeks were recruited using a purposive sampling method and participated in a semi-structured interview. The interviews were transcribed and analysed using the principles of Pidgeon & Henwood’s (1992) grounded theory techniques, facilitating the development and refinement of a theoretical model. Results: The resulting model highlights the waiting experience as fraught by loneliness, abandonment and self blame resulting in an interchanging role of being active or passive and the subsequent cycle they subside into. Some parents use the waiting time effectively by searching for their own answers but may eventually become passive following a belief that their parenting is insufficient. The disempowerment and self blame that is perpetuated through waiting intensifies the parents’ helplessness and results in a wide disparity between a negative self view and the idealised view of the professional. Conclusion: This study described the difficult experiences parents face while waiting for their child’s initial appointment. Parents need to be offered support, information and empowerment while waiting with ongoing communication from the service. Recommendations for future service and clinical delivery are provided.

The purpose of this study was to examine the lived experience of the day-to-day and continuing work motivation of professional counsellors and psychotherapists. A life history methodology was employed to distill discrete motivational factors and to construct broader motivational frameworks. Nine professional mid-career counsellors/psychotherapists (6 women, 3 men, 3 psychologists, 3 social workers, 2 counselling psychologists and 1 privately trained PhD) drawn from private practice (3) and institutional workplaces (6) were given in-depth interviews to delve into the motivational experience occasioned by their work. Employing a series of guided questions each of the research participants were interviewed about the overall experience of the gratifications, satisfactions, and motivations occasioned by their work and discrete motivational experiences in session, in-the moment. Other questions delved into the experience of dissatisfaction and de-motivation, the factors that allowed them to persist in adverse circumstances, changes in their work motivation from the time they first entered the profession, and the effects of their work on their feelings of self-esteem and well-being. Through a grounded theory analysis of the interview transcripts and informed by work motivation theory, the research participants’ observations on their motivational experience were used to construct three models. The first model demonstrated that the overall work motivation of the research participants was generated by the opportunity to simultaneously meet the three universal needs postulated by self-determination theory – autonomy, competence, and relatedness. The second model was based on the phenomenon of privilege experienced by the research participants. In essence, the research participants were motivated to return the gift of intimacy, honour, and trust accorded to them by vulnerable clients in the establishment of the therapeutic bond and alliance, which allowed them to meet their own needs for relatedness and competence and generated feelings of responsibility and obligation to safeguard trust and protect vulnerability. The third model was generated from the research participants’ experience of the process of counselling and psychotherapy, incorporating goal-setting with clients, privilege, in-the-moment experiences of efficacy, and effectance feedback to the realization of proximal goals within the process, which reinforced the motivation to work towards the distal goals of positive outcome. The three models were incorporated into an integrated framework, describing the factors and processes underlying the work motivation, work satisfaction, self-esteem, and well-being of the research participants. The research may be useful for professional counsellors and psychotherapists and the institutions which employ them.

This study primarily investigated factors which impact abstaining from drugs for adolescent men after finishing treatment at a specific treatment center in Sweden. The method chosen for this essay was quantitative, using surveys sent to males that finished a treatment period of a minimum time of 4 months at this therapeutic community. Of the 83 questionnaires that were originally sent, 23 responded. Further, the empirical data was tested in the computer program SPSS using gamma and lambda tests obtaining results for the factors to determine whether they correlated with one another other. The essay is based upon the theoretical framework of the salutogenic perspective, systems theory and therapeutic alliance theory. During this study results showed that factors such as relocation, post treatment programs were effective for the dis-continued use of drugs.

The purpose of this study was to examine the lived experience of the day-to-day and continuing work motivation of professional counsellors and psychotherapists. A life history methodology was employed to distill discrete motivational factors and to construct broader motivational frameworks. Nine professional mid-career counsellors/psychotherapists (6 women, 3 men, 3 psychologists, 3 social workers, 2 counselling psychologists and 1 privately trained PhD) drawn from private practice (3) and institutional workplaces (6) were given in-depth interviews to delve into the motivational experience occasioned by their work. Employing a series of guided questions each of the research participants were interviewed about the overall experience of the gratifications, satisfactions, and motivations occasioned by their work and discrete motivational experiences in session, in-the moment. Other questions delved into the experience of dissatisfaction and de-motivation, the factors that allowed them to persist in adverse circumstances, changes in their work motivation from the time they first entered the profession, and the effects of their work on their feelings of self-esteem and well-being. Through a grounded theory analysis of the interview transcripts and informed by work motivation theory, the research participants’ observations on their motivational experience were used to construct three models. The first model demonstrated that the overall work motivation of the research participants was generated by the opportunity to simultaneously meet the three universal needs postulated by self-determination theory – autonomy, competence, and relatedness. The second model was based on the phenomenon of privilege experienced by the research participants. In essence, the research participants were motivated to return the gift of intimacy, honour, and trust accorded to them by vulnerable clients in the establishment of the therapeutic bond and alliance, which allowed them to meet their own needs for relatedness and competence and generated feelings of responsibility and obligation to safeguard trust and protect vulnerability. The third model was generated from the research participants’ experience of the process of counselling and psychotherapy, incorporating goal-setting with clients, privilege, in-the-moment experiences of efficacy, and effectance feedback to the realization of proximal goals within the process, which reinforced the motivation to work towards the distal goals of positive outcome. The three models were incorporated into an integrated framework, describing the factors and processes underlying the work motivation, work satisfaction, self-esteem, and well-being of the research participants. The research may be useful for professional counsellors and psychotherapists and the institutions which employ them.

Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2009. / Includes bibliographical references (p. 50-53).

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-04-27T13:36:16Z No. of bitstreams: 1 biancaaparecidaribeirosingulane.pdf: 1026859 bytes, checksum: 6891320e0ee0d08d8facc3e7176b9dc9 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-05-02T00:59:28Z (GMT) No. of bitstreams: 1 biancaaparecidaribeirosingulane.pdf: 1026859 bytes, checksum: 6891320e0ee0d08d8facc3e7176b9dc9 (MD5) / Made available in DSpace on 2016-05-02T00:59:28Z (GMT). No. of bitstreams: 1 biancaaparecidaribeirosingulane.pdf: 1026859 bytes, checksum: 6891320e0ee0d08d8facc3e7176b9dc9 (MD5) Previous issue date: 2016-02-22 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico / Introdução: O consumo de álcool salienta-se como um grave problema de saúde pública no Brasil e no mundo. Porém, o número de usuários que procuram ajuda ou que conseguem tratamento ainda é reduzido. As terapias por computador (e-terapias) têm sido apontadas como alternativas de tratamento para diversos transtornos mentais, dentre eles o uso problemático de álcool e outras drogas. Uma preocupação importante relacionada a esta modalidade de atendimento refere-se à aliança terapêutica e a satisfação com o tratamento, condições básicas para que haja um atendimento psicoterapêutico de qualidade. Objetivo: O presente trabalho contempla objetivos de dois estudos: o primeiro pretendeu avaliar a literatura sobre aliança terapêutica nas Terapias cognitivo-comportamentais realizadas por videoconferência para diferentes transtornos mentais; e o segundo almejou avaliar a aliança terapêutica e a satisfação com o tratamento em uma psicoterapia por videoconferência para dependentes de álcool. Metodologia: No primeiro estudo foi realizada uma revisão sistemática de literatura, incluindo artigos empíricos dos últimos 11 anos, escritos nas línguas inglesa, portuguesa ou espanhola, que avaliavam a aliança terapêutica na TCC realizada por videoconferência. No segundo estudo, foi realizado um estudo de casos múltiplos, retirados de uma amostra que participou da TCC por videoconferência para dependentes de álcool. Os resultados foram analisados por meio de uma triangulação de dados, trabalhados de forma qualitativa e quantitativa. Resultados: No artigo 1 observou-se que a maioria dos estudos indicou que a aliança foi alta no decorrer das sessões de TCC por videoconferência, podendo ser comparada com a formada na psicoterapia presencial. Já os resultados do estudo 2 mostraram que, na TCC por videoconferência, houve formação de uma aliança terapêutica de qualidade e que os clientes ficaram satisfeitos com tratamento. Discussão: Apesar das limitações destes estudos, podemos inferir que há indícios tanto na revisão de literatura, quanto no estudo empírico, de que a aliança terapêutica e a satisfação com o tratamento na TCC por videoconferência pode ser comparável com os resultados encontrados na psicoterapia presencial. Assim, ela pode ser uma alternativa viável de tratamento para indivíduos com dependência de álcool. / Introduction: Alcohol consumption stands out as a serious public health problem in Brazil and worldwide. However, the number of users seeking help or who fail treatment is still low. The computer therapies (e-therapies) have been identified as alternative treatment for various mental disorders, including the abuse of alcohol and other drugs. A major concern related to this type of service refers to the therapeutic alliance and treatment satisfaction, basic conditions so that there is a psychotherapeutic care quality. Objective: This study includes two study objectives: the first aimed to evaluate the literature on therapeutic alliance in cognitive-behavioral therapies conducted by videoconference for different mental disorders; and the second craved evaluate the therapeutic alliance and treatment satisfaction in psychotherapy by videoconference to alcoholics. Methodology: In the first study was carried out a systematic review of the literature, including empirical articles from the past 11 years, written in English, Portuguese or Spanish that evaluated the therapeutic alliance in CBT held by videoconference. In the second study, we conducted a study of multiple cases, drawn from a sample of CBT participated by videoconference for alcoholics. The results were analyzed by means of a data triangulation worked qualitative and quantitative manner. Results: In Article 1 it was observed that most studies indicated that the alliance was high during the CBT sessions by videoconference and can be compared to that formed in the presence psychotherapy. Already the second study results showed that, in CBT by video conference, there is formation of a therapeutic alliance of quality and that clients were satisfied with treatment. Discussion: Despite the limitations of these studies, we can infer that there is evidence of the therapeutic alliance and treatment satisfaction in CBT by videoconference can be comparable with the results found in face psychotherapy. Thus, it can be a viable alternative treatment for patients with alcohol dependence.

Submitted by Geandra Rodrigues (geandrar@gmail.com) on 2018-03-26T19:17:15Z No. of bitstreams: 0 / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-03-27T14:26:14Z (GMT) No. of bitstreams: 0 / Made available in DSpace on 2018-03-27T14:26:14Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-12-07 / Os estudos sobre intervenções para dependentes de álcool têm priorizado compreender os ingredientes ativos que influenciam o processo psicoterapêutico, sendo a aliança terapêutica (AT) um desses mecanismos. Tem sido recomendado o uso de medidas preenchidas por um observador clínico para a avaliação da AT. Todavia, observa-se a ausência de medidas observacionais de AT no Brasil, sendo o seu estudo ainda incipiente. Objetivo: Os objetivos deste trabalho envolveram dois estudos: 1) desenvolver uma revisão da literatura visando caracterizar os instrumentos de AT; 2) e realizar a adaptação transcultural do Working Alliance Inventory - Short Revised Observer (WAI-SR-O) e analisar suas evidências de validade para dependentes de álcool em tratamento cognitivo-comportamental breve. Método: Para a revisão, foram coletados os dados bibliométricos e realizada análise de conteúdo categorial temática. O segundo estudo envolveu a adaptação transcultural do WAI-SR-O, o qual foi submetido à análise de evidências de confiabilidade baseadas na estrutura interna, evidências de validade baseadas nas relações com variáveis externas, avaliação das diferenças das médias inter e intravaliadores, além do cálculo do Coeficiente de Correlação Intraclasse (CCI) do WAI nas versões terapeuta e cliente. Resultados: Os resultados da revisão indicam instrumentos de AT em variadas versões, avaliados sob diferentes perspectivas e fundamentados em diversos modelos teóricos. Eles apresentaram boas propriedades psicométricas, embora tenham sido identificadas importantes questões quanto à estrutura fatorial. O segundo estudo abarcou a tradução, retrotradução e avaliação do WAI-SR-O por peritos. Foi realizado um treinamento com os avaliadores que culminou em alguns ajustes no intrumento. As análises iniciais das suas propriedades psicométricas indicaram bom alfa de Cronbach (α = 0,86), evidências de validade convergente com o WAI-Terapeuta e alto CCI intravaliadores para escala geral e subescalas. Discussão: Os problemas na estrutura fatorial dos instrumentos de AT levantados no primeiro estudo podem ser uma explicação para as dificuldades dos observadores na diferenciação das dimensões do WAI-SR-O. De modo geral, os resultados psicométricos do WAI-SR-O em versão adaptada apontam que este instrumento pode ser promissor quanto aos estudos do processo psicoterapêutico no Brasil. / Studies regarding interventions for alcohol dependents have prioritized understanding psychotherapeutic process active ingredients, being therapeutic alliance (TA) one of these mechanisms. The measures which are evaluated by a clinical observer have been widely recommended to assess TA. However, it is observed the absence of observational measures of TA in Brazil, and its study is still incipient. Aim: The present work encompasses two studies: 1) developing a literature review to characterize the TA instruments; 2) to conduct the Working Alliance Inventory - Short Revised Observer (WAI-SR-O) cross-cultural adaptation and investigate its validity evidences for alcohol dependents on brief cognitive-behavioral treatment. Method: Bibliometric data were collected and thematic content analysis was performed on literature review study. On the second study, the WAI-SR-O were submitted to the analysis of reliability evidences based on the internal structure, evidence of validity based on relations with external variables, evaluation of inter and intra raters mean differences, and Intraclass Correlation Coefficient (ICC) of the WAI in the therapist and client versions. Results: Literature review indicates TA instruments in various versions, assessed from different perspectives and based in a whole range of theoretical models. They presented appropriated psychometric properties although important factorial structure issues were indentified. In the second study, the WAI-SR-O were translated, backtranslated and evaluated by experts. Observer raters training was carried out, resulting in some adjustments on instrument. The results pointing out good psychometric properties, with a high Cronbach’s alpha (α = 0.86), convergent validity evidences among WAI-SR-O and WAI-Therapist and high ICC intra raters for general scale and subscales. Discussion: Problems in the TA instruments factorial structure raised on the first study could be a explanation for the observer difficulties in differenciate the WAI-SR-O dimensions. On the whole, the adapted WAI-SR-O initial psychometric properties shows its may be a promising instrument for studying of psychotherapeutic process in the Brazil.

Syftet med studien var att beskriva arbetsalliansens funktion i familjebehandlares arbete ur behandlarens perspektiv för att bidra till kunskapsdiskussionen om arbetsalliansens betydelse inom socialt arbete. Studiens frågeställningar var vilken betydelse arbetsallians har för familjebehandlares uppdrag samt vilka faktorer som har betydelse för hur arbetsallians skapas, vidmakthålls och avslutas på ett bra sätt i arbetet med familjer. Med en fenomenologisk ansats genomfördes kvalitativa, halvstrukturerade intervjuer med sex familjebehandlare verksamma inom socialtjänsten. Respondenterna delgav nyanserade beskrivningar av arbetsalliansens betydelse för familjebehandling. Studiens resultat analyserades utifrån socialkonstruktionism, systemteori och anknytningsteori. Studiens centrala resultat var att familjebehandlarna upplevde arbetsalliansen som mycket betydelsefull i sitt arbete. Studiens resultat ligger i linje med psykoterapiforskningen som också betonar arbetsalliansens betydelse för att uppnå ett positivt behandlingsresultat. / The aim of this study was to describe the function of a working alliance in the social work of family therapists in order to make contribute to the knowledge discourse of the importance of working alliance in social work. The questions were what of importance the work alliance is in the task of family therapists and what the important factors are in how to create, sustain and end a working alliance in a good way within the social work with families. Interviews were pursued with six family therapists. The respondents described the function of the working alliance from their perspective. The result was analysed with social construction theory, system theory, attachment theory and a multidimensional perspective. The central result of the study was that the therapists experienced that the working alliance was of great importance in their work which is in agreement with psychotherapy research which emphasise the importance of a working alliance in order to reach a good result of the therapy.