Algunes reflexions sobre la psicoteràpia centrada en la persona

Aquest escrit pretén fer una breu presentació de l'Enfocament Centrat en la Persona com una proposta, bastant desconeguda a casa nostra, que arreu del món es fa servir en el camp ampli de les relacions d'ajuda, i destacar-ne les diferents aplicacions rellevants en psicoteràpia i en alguns àmbits de les ciències humanes. A més, informem que des de la Unitat d'Investigació Centrada en la Persona de la Universitat de València es treballa en el desenvolupament d'aquesta perspectiva

Curso clínico y resultados a largo plazo en el tratamiento cognitivo-comportamental del trastorno por angustia con agorafobia

El tratamiento cognitivo-comportamental se ha constituido como la alternativa terapéutica de elección para el trastorno por angustia. Sin embargo, aunque son numerosos los estudios que demuestran la eficacia terapéutica de este tipo de acercamientos, disponemos de pocos datos que indiquen sus efectos a largo plazo. Pocos estudios presentan seguimientos de los pacientes más allá de un año después de ser retirado el tratamiento. En este trabajo se presenta el procedimiento y resultados a corto y largo plazo (con un seguimiento de 5 años) de la aplicación de un programa cognitivo-comportamental para un caso de trastorno por angustia con agorafobia

Advances in psychological treatments: the use of new Communication and Information Technologies

Los tratamientos psicológicos han logrado avances importantes en los últimos años. Desde la puesta en marcha del movimiento de la psicología basada en la evidencia disponemos de un buen número de protocolos de tratamiento que han demostrado ser eficaces y eficientes. En este sentido, merece subrayarse el papel desempeñado por las nuevas tecnologías de la información y la comunicación (TICs). Nuestro grupo de investigación ha desarrollado y validado una serie de aplicaciones basadas en TICs que se comentan es este trabajo. En concreto, técnicas de Realidad Virtual, Realidad Aumentada y aplicaciones de Telepsicología basadas en internet. También se analizan algunas de las ventajas y limitaciones de estos procedimientos frente a los tratamientos tradicionales y se presentan datos acerca del grado de satisfacción manifestado por pacientes que recibieron un programa de tratamiento basado en TICs y se comentan algunas perspectivas de trabajo futuras.The psychological treatments have advanced notably in the last years. Since the beginning of the psychology movement based on evidence we have already available a high number of treatment protocols that have proved to be effective and efficient. In this sense, it should be highlighted the role played by the new communication and information technologies (CITs). Our research group has developed and validated a series of applications based on CITs that are presented in this work. Specifically, Virtual Reality, Augmented Reality techniques and Telepsychology applications based on the internet. The advantages that these new procedures have over the traditional treatments, as well as some limitations currently existent regarding the use of CITs are analysed. Finally, data about the level of satisfaction reported by patients who received a treatment program based on CITs are presented, and some future perspectives in the field are also analysed

La interferencia de la utilización concurrente de Alprazolam en el tratamiento cognitivo-comportamental del trastorno de pánico

 This study analyzes the role of alprazolam in the therapeutic effectiveness of cognitivebehavioral treatments for panic disorder. This work belongs to a wider study which aim was to study the differential effectiveness of two programs, a standard one and a brief one supported by self-help manuals. We demonstrated the effectiveness of both interventions. The aim of the present study is to analyze the differential effectiveness according to the use of alprazolam. The results shows that the patients who used alprazolam improve as well as patients that didn’t use it in mostly of the analyzed variables at postest and follow-up assessment (12-month follow-up)El presente estudio analiza el papel de la utilización concurrente del alprazolam en la eficacia de la terapia cognitivo-comportamental para el trastorno de pánico. El trabajo se engloba dentro de un estudio previo más amplio. El objetivo de dicho estudio fue estudiar la eficacia diferencial de dos tratamientos, uno estándar y otro abreviado apoyado por manuales de autoayuda. Los resultados indicaron que ambos tratamientos eran igualmente eficaces. El objetivo del presente estudio es analizar la eficacia diferencial en función de si los pacientes tomaban o no alprazolam. Los resultados indican que, en prácticamente la totalidad de las variables analizadas, los sujetos mejoran por igual en el postest y en el seguimiento (a los doce meses de finalizada la terapia), independientemente de si empezaron el programa cognitivo-comportamental tomando o no un tratamiento farmacológico (alprazolam)

Personality disorders among patients with panic disorder and individuals with high anxiety sensitivity

Background: No studies have been found that compared the psychopathology features, including personality disorders, of Panic Disorder (PD) and Panic Disorder with Agoraphobia (PDA), and a nonclinical sample with anxiety vulnerability. Method: The total sample included 152 participants, 52 in the PD/PDA, 45 in the high anxiety sensitivity (AS) sample, and 55 in the nonclinical sample. The participants in PD/PDA sample were evaluated with the structured interview ADIS- IV. The Brief Symptom Inventory and the MCMI-III were used in all three samples. Results: Statistically significant differences were found between the PD/PDA and the nonclinical sample in all MCMI-III scales except for antisocial and compulsive. No significant differences were found between PD/PDA and the sample with high scores in AS. Phobic Anxiety and Paranoid Ideation were the only scales where there were significant differences between the PD/PDA sample and the high AS sample. Conclusions: Our findings showed that people who scored high on AS, despite not having a diagnosis of PD/PDA, were similar in regard to psychopathology features and personality to individuals with PD/PDA

Acceptability of an internet-delivered intervention for adjustment disorder and its role as predictor of efficacy

Background: Internet-delivered interventions offer a feasible way to facilitate access to mental healthcare and considerable evidence supports their effectiveness for the treatment of different mental disorders. However, potential users' attitudes toward these interventions are crucial for their successful implementation. A better understanding of factors related to treatment acceptance and adherence is required to exploit the full potential of internet interventions. Hence, the aim of the present work was to analyze the acceptability of a therapist-guided internet-delivered CBT intervention for adjustment disorder and its impact on treatment outcomes. Methods: The acceptability was estimated from the acceptance to participate in the randomized controlled trial addressed to explore the effectiveness of the internet intervention in question. Other indicators of acceptability were treatment adherence, expectations, satisfaction, and opinion reported by 34 participants from the trial. Results: Willingness to try an internet intervention was observed and 76.5% of participants completed all seven treatment modules. Less positive initial expectations did not reduce treatment effectiveness, yet they might have led to treatment abandonment. Overall, participants were satisfied with the internet intervention and perceived it as a useful, comfortable and attractive way of receiving psychological assistance. Treatment modules aimed at promoting identification with the treatment goals, relapse prevention, and change in the meaning of the stressor were found to be related to posttraumatic growth and increase in positive affect and quality of life. Participants also expressed that the intervention required considerable motivation. In this regard, therapeutic support was perceived as an important adherence facilitator. Conclusion: The findings from this work support the suitability of internet interventions for the treatment of adjustment disorder. However, further research is required in order to develop guidelines for the design of more attractive and engaging internet interventions

Designing ICTs for Users with Mild Cognitive Impairment: A Usability Study

Background: Research has supported the cost-effectiveness of cognitive training tools enhanced by information and communication technologies (ICT) in several populations, including individuals with mild cognitive impairment (MCI) and age-related cognitive decline. The implementation of ICTs in this population, however, is sometimes challenging to their cognitive and age characteristics. Ultimately, this might compromise the effectiveness of ICT-enhanced therapies in this population. The aim of this study is to test the usability and acceptability of a European project prototype for elderly care, in an attempt to explore the ICT design needs of users with MCI. Methods: Participants were 28 individuals aged 58-95 years and with a diagnosis of MCI. Results: The results showed a low perception of peripheral elements and the need to place main interaction elements in the centre of the screen. The correlation between the general level of autonomy (daily life activities) and the ICT autonomy level was significant and positive. The speed of audio help had a significant impact on performance. Conclusion: The present work contributes to the literature on ICT usability needs of users with MCI. Some usability recommendations for designing interfaces for this type of user are provided in the text

A guided Internet-delivered intervention for adjustment disorders: A randomized controlled trial

Evidence of self‐help interventions for adjustment disorder (AjD) is limited. This study aims at testing in a randomized controlled trial (RCT) the effectiveness of a disorder‐specific, Internet‐delivered cognitive-behavioural therapy (ICBT) intervention for AjD. Participants were randomly allocated to either an ICBT with brief weekly telephone support (n = 34) or a waiting list group (n = 34). Beck's inventories for depression and anxiety were used as primary outcomes. The secondary outcomes were AjD symptoms, post‐traumatic growth, positive and negative affect, and quality of life. In all, 76.5% of the participants completed the intervention. Compared with the control group, participants in the intervention condition showed significantly greater improvement in all outcomes (Cohen's d ranged from 0.54 to 1.21) except in anxiety symptoms measured by Beck Anxiety Inventory (d = 0.27). Only ICBT group showed a significant improvement in post‐traumatic growth, positive and negative affect, and quality of life. The number of cases that achieved clinically meaningful change in all outcome measures was also higher in the ICBT group. All therapeutic gains were maintained at 3‐, 6‐ and 12‐month follow‐ups. The current study provides evidence on the effectiveness of ICBT interventions to reduce the impact of AjD. Results suggest that brief self‐help intervention with minimal therapist support is more effective than the mere passage of time in reducing the distress symptoms associated to the disorder and also can confer additional benefits