The therapeutic relationship and change processes in child psychotherapy: a qualitative, longitudinal study of the views of children, parents and therapists

Through the perspectives of children, parents and therapists, this study explored the therapeutic relationship as a change facilitator in different moments of psychotherapy. The children, parents, and therapists (N=15) who formed part of five therapeutic treatments were studied using a qualitative, longitudinal design. Thirty semi-structured interviews were done; half at the beginning and half after four months of psychotherapy. Children's drawings were incorporated, and data were analysed through grounded theory methods and qualitative analysis guidelines for drawings. Participants identified several aspects of the therapeutic relationship as change facilitators. From the first encounters, the therapists' close and adaptable attitude promoted an improved motivation for psychotherapy and enhanced engagement among children and parents. Later in the process, a positive, child-centred and affective therapeutic relationship fostered the child's trust with the therapist as well as a positive relational experience, promoting associated changes in children and the development of socio-affective tools. Parents and therapists saw their own relationship as a change facilitator, as well as a broader understanding in parents of their children and an improved relationship with them. Parent's and child's changes helped each other. Specific and common aspects between participants' perspectives provided a richer understanding of the studied phenomena. This study supports the view that a positive therapeutic relationship facilitates early changes in the motivation of children and parents, and provides them with a healing, relational experience as it develops. A positive parent-therapist relationship is also key for changes to further progress

Expectativas de niños y padres consultantes frente a la psicoterapia infantil

El objetivo de la presente investigación fue analizar cualitativamente las expectativas de niños y sus padres frente a la psicoterapia infantil desde la perspectiva de cada uno de ellos, y relacionar los elementos que intervienen en el proceso de construcción de dichas expectativas. Los participantes de este estudio fueron 10 díadas compuestas por niños entre 7 a 10 años y sus padres. La información se recolectó a través de un total de 20 entrevistas semiestructuradas, realizadas en forma independiente a cada participante antes de la sesión de ingreso a la terapia. Se realizó un análisis cualitativo de la información basándose en procedimientos de codificación abierta y axial propuestos por la Teoría Fundamentada. Los resultados muestran que los niños desarrollan expectativas sobre el proceso y los resultados, a partir de las experiencias previas con psicólogos y de la información entregada por los padres acerca de la función del psicólogo como “alguien que ayuda”. Los resultados esperados por los niños son “sentirse mejor” y relacionarse mejor con los pares. En el caso de los padres sus expectativas se construyen con base en experiencias psicológicas previas y la información obtenida del contexto sociocultural. Estas experiencias influyen en su visión psicológica del problema de su hijo y en una percepción de la función del psicólogo como un profesional que ayuda, no sólo a su hijo, sino también a ellos en el desarrollo de habilidades parentales. Además, a partir de estas experiencias los padres esperan tener un rol más participativo en el proceso de sus hijos

Comprensión del cambio psicoterapéutico en adolescentes: voces de pacientes y terapeutas

Este estudio tuvo como objetivo comprender el proceso de cambio psicoterapéutico desde las perspectivas subjetivas de adolescentes y terapeutas que participaron en una terapia. Método: se utilizó un enfoque cualitativo; la recolección de información se realizó a través de entrevistas semiestructuradas audiograbadas, luego de finalizar la terapia. Participaron 17 díadas terapéuticas (adolescentes: edad promedio 15,8 años; 64,7% género femenino; terapeutas: edad promedio 30,3 años; 55,5 % género femenino), que realizaron sus terapias en contextos naturales y con diferentes enfoques teóricos. Codificadores entrenados analizaron los datos a través de los procedimientos propuestos por la Teoría Fundamentada, codificación abierta y axial, y procesos de reorganizaciones y triangulaciones permanentes. Resultados: se identificaron dos fenómenos comprensivos relacionados con los procesos de cambio psicoterapéutico: (a) El encuentro con “otro” como plataforma segura y sustrato relacional generador del cambio y, (b) El cambio como empoderamiento y desarrollo. Discusión: se examina el rol central que ocupan la relación terapéutica y el logro de las tareas del desarrollo (identidad, autonomía y autodeterminación) en el cambio psicoterapéutico. Además, se reflexiona acerca de las habilidades y acciones de los terapeutas

Understanding the use/non-use of an internet-based intervention complementing standard depression treatment: A qualitative study of user's experiences

Introduction There is sufficient evidence about the effectiveness of internet-based interventions; however, the users’ level of adoption and utilization remains low, with this phenomenon requiring adequate explanation. Objective The aim of this qualitative study was to explore the users’ perceptions and experience of a web-based program (ASCENSO), designed to complement (usual) in-person depression treatment. Method Twelve participants of the ASCENSO program, comprised of adult individuals ( M  = 44.3, SD  = 13.4) of both genders (67% women) undergoing treatment for depression, were interviewed through semi-structured interviews. The data obtained from these interviews were analyzed utilizing a constructivist grounded theory approach. The interviews were transcribed and analyzed by trained coders. A constant comparative analysis of emergent themes was conducted. Results These show that users employ and appreciate the program when their interaction with it emulates a “humanized relationship,” that is, when the program is proactive in assisting users with their requests and when it responds in a pertinent and individualized manner to their emotional states and needs. Conclusions Our findings highlight the challenges associated with the development of algorithms capable of attracting different potential users. These should be designed to generate a virtual relationship that emulates human interaction and targets the characteristics of each user, for example, considering the specific phenomenology of their health condition, their present emotional states, and perceived needs. Elements that will vary as mental symptomatology evolve

Host dispersal shapes the population structure of a tick-borne bacterial pathogen

Birds are hosts for several zoonotic pathogens. Because of their high mobility, especially of longdistance migrants, birds can disperse these pathogens, affecting their distribution and phylogeography. We focused on Borrelia burgdorferi sensu lato, which includes the causative agents of Lyme borreliosis, as an example for tick-borne pathogens, to address the role of birds as propagation hosts of zoonotic agents at a large geographical scale. We collected ticks from passerine birds in 11 European countries. B. burgdorferi s.l. prevalence in Ixodes spp. was 37% and increased with latitude. The fieldfare Turdus pilaris and the blackbird T. merula carried ticks with the highest Borrelia prevalence (92 and 58%, respectively), whereas robin Erithacus rubecula ticks were the least infected (3.8%). Borrelia garinii was the most prevalent genospecies (61%), followed by B. valaisiana (24%), B. afzelii (9%), B. turdi (5%) and B. lusitaniae (0.5%). A novel Borrelia genospecies “Candidatus Borrelia aligera” was also detected. Multilocus sequence typing (MLST) analysis of B. garinii isolates together with the global collection of B. garinii genotypes obtained from the Borrelia MLST public database revealed that: (a) there was little overlap among genotypes from different continents, (b) there was no geographical structuring within Europe, and (c) there was no evident association pattern detectable among B. garinii genotypes from ticks feeding on birds, questing ticks or human isolates. These findings strengthen the hypothesis that the population structure and evolutionary biology of tick-borne pathogens are shaped by their host associations and the movement patterns of these hosts.This study received financial support from Fundação para a Ciência e a Tecnologia by the strategic program of MARE (MARE ‐ UID/MAR/04292/2013) and the fellowship to Ana Cláudia Norte (SFRH/BPD/108197/2015), and the Portuguese National Institute of Health. Raivo Mänd, Tomi Trilar, Tapio Eeva, Tomas Grim and Dieter Heylen were supported by the Estonian Research Council (research grant # IUT34‐8), the Slovenian Research Agency ‐programme “Communities, relations and communications in the ecosystems” (No. P1‐0255), the Academy of Finland (project 265859), the Internal Grant Agency of Palacky University (PrF_2014_018, PrF_2015_018, PrF_2013_018) and the Marie Sklodowska‐Curie Actions (EU‐Horizon 2020, Individual Global Fellowship, project no 799609), respectively

The checkpoint-dependent nuclear accumulation of Rho1p exchange factor Rgf1p is important for tolerance to chronic replication stress

Guanine nucleotide exchange factors control many aspects of cell morphogenesis by turning on Rho-GTPases. The fission yeast exchange factor Rgf1p (Rho gef1) specifically regulates Rho1p during polarized growth and localizes to cortical sites. Here we report that Rgf1p is relocalized to the cell nucleus during the stalled replication caused by hydroxyurea (HU). Import to the nucleus is mediated by a nuclear localization sequence at the N-terminus of Rgf1p, whereas release into the cytoplasm requires two leucine-rich nuclear export sequences at the C-terminus. Moreover, Rgf1p nuclear accumulation during replication arrest depends on the 14-3-3 chaperone Rad24p and the DNA replication checkpoint kinase Cds1p. Both proteins control the nuclear accumulation of Rgf1p by inhibition of its nuclear export. A mutant, Rgf1p-9A, that substitutes nine serine potential phosphorylation Cds1p sites for alanine fails to accumulate in the nucleus in response to replication stress, and this correlates with a severe defect in survival in the presence of HU. In conclusion, we propose that the regulation of Rgf1p could be part of the mechanism by which Cds1p and Rad24p promote survival in the presence of chronic replication stress. It will be of general interest to understand whether the same is true for homologues of Rgf1p in budding yeast and higher eukaryotes