Functional analysis of the verbal interaction between psychologist and client during the therapeutic process

The goal of this study is to analyze the verbal interaction that takes place between client and therapist over the course of a clinical intervention so as to analyze the potential learning processes that may be responsible for changes in the client's behavior. A total of 92 sessions were analyzed, corresponding to 19 clinical cases treated by 9 therapists specializing in behavioral therapy. The variables considered were therapist and client verbal behaviors, and these were categorized according to their possible functions and/or morphologies. The Observer XT software was used as a tool for the observational analysis. The results led to the conclusion that the therapist responds differentially to client verbalizations, modifying the verbal contingencies as his or her client content approaches or becomes more distant from therapeutic objectives. These results suggest the possible existence of verbal "shaping" processes through which the therapist guides the client's verbal behavior toward more adaptive forms. In addition, this study proposes an alternative to the traditional controversy regarding the relevance of the therapeutic relationship versus the treatment techniques used to explain clinical change. This article suggests that such differentiation is unnecessary because the therapeutic relationship and the treatment techniques should act in the same manner, this is, in providing the context for the occurrence of what is truly therapeutic, namely, the learning processe

Somatostatin receptor-targeted organometallic iridium(III) complexes as novel theranostic agents

A novel somatostatin receptor-targeted anticancer agent based on the conjugation of a highly cytotoxic and luminiscent cyclometalated iridium(III) complex to tumor-targeting vectors based on octreotide peptide has been described, and its potential for targeted theranostic applications has been demonstrated

Descriptive Study of the socratic method: evidence for verbal shaping

In this study we analyzed 65 fragments of session recordings in which a cognitive behavioral therapist employed the Socratic method with her patients. Specialized coding instruments were used to categorize the verbal behavior of the psychologist and the patients. First the fragments were classified as more or less successful depending on the overall degree of concordance between the patient’s verbal behavior and the therapeutic objectives. Then the fragments were submitted to sequential analysis so as to discover regularities linking the patient’s verbal behavior and the therapist’s responses to it. Important differences between the more and the less successful fragments involved the therapist's approval or disapproval of verbalizations that approximated therapeutic goals. These approvals and disapprovals were associated with increases and decreases, respectively, in the patient’s behavior. These results are consistent with the existence, in this particular case, of a process of shaping through which the therapist modifies the patient’s verbal behavior in the overall direction of his or her chosen therapeutic objectivesThis research was funded by the Spanish Government (Ministerio de Ciencia e Innovación, I+D+I Research Grants SEJ2007-66537-PSIC, PSI2010-15908

Therapists’ and patients’ verbal behavior during the application of the different components of the cognitive restructuring technique

El propósito del trabajo es analizar los componentes terapéuticos aplicados en la reestructuración cognitiva y la frecuencia con que cada uno de ellos se utiliza, así como el comportamiento verbal de psicólogos y pacientes en estos componentes. Se observaron las grabaciones de 153 fragmentos de reestructuración obtenidos de 22 casos clínicos de cuatro psicólogos cognitivo-conductuales. La conducta verbal se categorizó atendiendo a las operaciones conductuales básicas que pueden tener lugar en la clínica según el sistema sisc-inter y con la ayuda de la herramienta The Observer xt. El debate fue el componente más utilizado, seguido de la explicación y la propuesta y repaso de tareas. Se encontraron diferencias en la conducta verbal de psicólogos y pacientes en los distintos componentes, lo que supone un avance en la investigación de los procesos de cambio implicados en esta técnicaStudy aims to analyse therapeutic components applied in cognitive restructuring and their frequency. Verbal behavior of psychologists and patients in these components is studied. Recordings of 153 restructuring fragments from 22 clinical cases were observed. Four cognitive-behavioral psychologists collaborated. Verbal behavior was coded with The Observer XT according to the basic behavioral operations that could take place in clinical contexts following the sisc-inter system. The Socratic method was the most frequent component, followed by explanation and proposal and checking of tasks. Differences in verbal behavior of psychologists and patients in the different components were found, representing an advance in the research on processes of change involved in this techniqueParte de este trabajo ha sido financiado por el Ministerio de Ciencia e Innovación en el marco del Plan Nacional de I+D+I 2004-2007 (Proyecto sej2007_66537_psic) y 2008-2011 (Proyecto psi2010-15908

A Review and Follow-Up of Uterine Smooth Muscle Tumours of Uncertain Malignant Potential (STUMP): A Case Series and Literature Review

[EN]Objectives: to analyse the clinical-pathological characteristics, treatment, and evolution of uterine smooth muscle tumours with uncertain malignant potential (STUMP) diagnosed in the Salamanca University Hospital with the implementation of the 2014 WHO criteria. Materials and methods: a retrospective descriptive study of patients diagnosed with STUMP from January 2015 to March 2023 at the Salamanca University Hospital. Demographic data, preoperative clinical data, treatment, complications, therapeutic results, anatomopathological findings and recurrence time were obtained. Results: a total of four patients were identified and included in the study. The mean age at diagnosis was 48 years (range 36-67). The surgical indications were abnormal uterine bleeding, compressive symptoms, and the growth of a pelvic mass suspected to be a degenerated myoma from the residual cervix after a subtotal hysterectomy 6 years earlier. In all cases, a laparotomic procedure was performed. A total hysterectomy, sub-total hysterectomy, and the excision of the cervix with STUMP localization were accomplished in two, one, and one patient, respectively. The mean diameter of the tumour pieces was 13 cm (range 8-17 cm), with a mean volume of 816 cc (range 234-1467 cc). The mean follow-up was 47 months, with no recurrence to date. Conclusions: STUMPs are a heterogeneous group of tumours with a difficult-to-predict clinical evolution. In most cases, their diagnosis is histological after performing surgery for suspected leiomyoma. Due to their low incidence, there are no specific guidelines for their treatment and control. However, considering their potential risk of recurrence and metastasis, it is advisable to maintain six-monthly controls for 5 years and then annual controls for 5 years more

Comparative study of therapist’s verbal behavior according its experience during clinical assessment

En el presente trabajo se ha realizado una primera aproximación al estudio de las diferencias entre terapeutas con diversos grados de experiencia. La lógica de este tipo de trabajos se centra en el supuesto de que el terapeuta experto es el que lo hace bien y analizar su comportamiento nos permitirá aprender cómo hacer terapia más eficientemente. La metodología de trabajo empleada es la obser-vación y análisis de sesiones terapéuticas grabadas directamente y registradas me-diante un sistema de categorías construido a tal efecto. Los resultados muestran que las categorías Función Discriminativa, Función de Refuerzo y Otras son las más utilizadas por los terapeutas inexpertos mientras que las categorías Función de Casti-go, Función Evocadora, Función Motivadora, Función Instruccional y Función Informativa son las más usadas por expertos, observándose en la mayoría de los casos valores intermedios en los terapeutas de mediana experiencia. A pesar de las limitaciones encontradas, estos resultados indican que pueden existir diferencias tanto cuantita-tivas como cualitativas respecto a lo que hacen los terapeutas en sesión en función de su grado de experienciaThe present study is an initial approach to the study of differ-ences between therapists with regard to their experience level. This type of study is based on the assumption that it is the expert therapist who does things well, and that the analysis of his/her behaviour will enable us to learn how to do therapy more efficiently. We used an observational meth-odology for the analysis of video-taped sessions. Verbal behaviour was coded with a coding system created for that purpose. Results show that the Discriminative, Reinforcement and “Others” functions were the most used by inexpert therapists, while Punishment, Elicitation, Motivating, Instructional, and Informative were the functions most used by expert therapists. Inter-mediate values were observed for most therapists with a middle degree of experience. Despite certain limitations, results indicate that there may be quantitative, as well as qualitative, differences with respect to what thera-pists do in session as a function of their experience level.Parte de este trabajo ha sido financiado por el Ministerio de Ciencia e Innovación en el marco del Plan Nacional de I+D+I 2004-2007 (Proyecto SEJ2007-66537-PSIC). Asimismo, durante el tiempo de realización de este estudio Montserrat Montaño Fidalgo y Ana Calero Elvira disfrutaron de una beca FPI otorgada por la Consejería de Educación de la Comunidad de Madrid para el desarrollo de sus respectivas tesis doctorale

Olanzapine compared to quetiapine in adolescents with a first psychotic episode

Objective: To compare the efficacy, safety, and tolerability of olanzapine and quetiapine in adolescents with first episode psychosis. Method: Fifty adolescents (age 16 ± 1.25) with a first episode of psychosis were randomized to quetiapine or olanzapine in a 6-month open label study. Efficacy and side effect scales, as well as vital signs and laboratory data were recorded at baseline, 7, 15, 30, 90, and 180 days (end of study). Results: Out of the total sample included in the study, 32 patients completed the trial (quetiapine n = 16, olanzapine n = 16). Patients in both treatment groups had a significant reduction in all clinical scales with the exception of the negative scale of the Positive and Negative Symptom Scale (PANSS) for olanzapine and the general psychopathology scale of the PANSS for quetiapine. The only difference between treatment arms on the clinical scales was observed on the patients' strength and difficulties questionnaire (SDQ) scale, with greater improvement for olanzapine. Patients on olanzapine gained 15.5 kg and patients on quetiapine gained 5.5 kg. Conclusion: Olanzapine and quetiapine reduced psychotic symptoms in this adolescent sample. Patients on olanzapine gained significantly more weight. Side effects with both drugs seemed to be more prevalent than those reported in adult studies

Therapists’ verbal behavior category system

En este trabajo se presentan los fundamentos teóricos y metodológicos para el desarrollo de un sistema de categorización de la conducta verbal del psicólogo clínico durante la intervención terapéutica, que nos permita el estudio de ésta desde una perspectiva analítico-funcional basada en una rigurosa metodología observacional. El procedimiento de construcción de dicho sistema es detallado desde las etapas iniciales de observación exploratoria hasta la observación sistemática de la conducta a analizar con la ayuda del software The Observer XT. Asimismo, se lleva a cabo un estudio del grado de acuerdo inter e intra observadores mediante el cálculo del coeficiente kappa y la consideración de los factores que afectan a los valores de dicho índice. Los resultados del análisis muestran altos niveles de precisión de los observadores (entre un 87 y un 93%, aproximadamente) que justifican la utilización del sistema de categorías elaborado para el estudio del lenguaje de los terapeutas en la clínicaThis paper presents the theoretical and methodological basis of a therapist’s verbal behavior category system that allows us to study clinical psychologists’ language from a functional-analytic framework and with a rigorous observation method. The procedure to develop the coding system is explained in detail from a very early stage of exploratory observation, to the systematic observation through the use of The Observer XT software. An analysis of intra-and inter-rater reliability using the kappa coefficient and taking into account the factors that affect the values of Cohen’s index was carried out. Results show high levels of observer accuracy (between approximately 87% and 93%) that justify the application of this category system to study therapists’ verbal behavior in sessionParte de este trabajo ha sido financiado por el Ministerio de Ciencia e Innovación en el marco del Plan Nacional de I+D+i 2004-2007 (Proyecto SEJ2007_66537_PSIC). Asimismo, durante el tiempo de realización de este estudio Montserrat Montaño y Ana Calero disfrutaron de una beca FPI otorgada por la Consejería de Educación de la Comunidad de Madrid para el desarrollo de sus respectivas tesis doctorale

Non-destructive production of exosomes loaded with ultrathin Palladium nanosheets for targeted bioorthogonal catalysis

The use of exosomes as selective delivery vehicles of therapeutic agents, such as drugs or hyperthermia-capable nanoparticles, is being intensely investigated on account of their preferential tropism toward their parental cells. However, the methods used to introduce a therapeutic load inside exosomes often involve disruption of their membrane, which may jeopardize their targeting capabilities, attributed to their surface integrins. On the other hand, in recent years bio-orthogonal catalysis has emerged as a new tool with a myriad of potential applications in medicine. These bio-orthogonal processes, often based on Pd-catalyzed chemistry, would benefit from systems capable of delivering the catalyst to target cells. It is therefore highly attractive to combine the targeting capabilities of exosomes and the bio-orthogonal potential of Pd nanoparticles to create new therapeutic vectors. In this protocol, we provide detailed information on an efficient procedure to achieve a high load of catalytically active Pd nanosheets inside exosomes, without disrupting their membranes. The protocol involves a multistage process in which exosomes are first harvested, subjected to impregnation with a Pd salt precursor followed by a mild reduction process using gas-phase CO, which acts as both a reducing and growth-directing agent to produce the desired nanosheets. The technology is scalable, and the protocol can be conducted by any researcher having basic biology and chemistry skills in ~3 d.We gratefully acknowledge financial support from the ERC Advanced Grant CADENCE (grant no. ERC-2016-ADG-742684) and the EPSRC (Healthcare Technology Challenge award no. EP/N021134/1). M.S.-A. thanks the Spanish Government for an FPU PhD research fellowship. B.R.-R. thanks the EC (grant no. H2020-MSCA-IF-2014–658833). V.S. acknowledges the financial support of Ministerio de Ciencia, Innovación y Universidades, Programa Retos Investigación, Proyecto REF: RTI2018-099019-A-I00. M.A. acknowledges the financial support of the ERC Consolidator Grant programme (grant no. ERC-2013-CoG-614715). P.M.-D. also thanks Instituto de Salud Carlos III (PI19/01007). We also thank CIBER-BBN, an initiative funded by the VI National R&D&i Plan 2008–2011 financed by the Instituto de Salud Carlos III and by Fondo Europeo de Desarrollo Regional (Feder) ‘Una manera de hacer Europa’, with the assistance of the European Regional Development Fund. This study is also partially funded by the Aragon Government (T57_17R p) cofounded by Feder 2014–2020 ‘Building Europe from Aragon’.Peer reviewe