Psychotherapy Dropout: Using the Adolescent Psychotherapy Q-Set to Explore the Early In-Session Process of Short-Term Psychodynamic Psychotherapy

Research suggests that short-term psychodynamic psychotherapy (STPP) is an effective treatment for depression in adolescence, yet treatment dropout is a major concern and what leads to dropout is poorly understood. Whilst studies have begun to explore the role of patient and therapist variables, there is a dearth of research on the actual therapy process and investigation of the interaction between patient and therapist. This study aims to address this paucity through the utilisation of the Adolescent Psychotherapy Q-set (APQ) to examine the early treatment period. The sample includes 69 adolescents aged 16–18 years with major depressive disorder receiving STPP as part of the First Experimental Study of Transference Work–in Teenagers (FEST-IT) trial. Of these, 21 were identified as dropouts and were compared to completers on pre-treatment patient characteristics, symptomatology, functioning, and working alliance. APQ ratings available for an early session from 16 of these drop out cases were analysed to explore the patient-therapist interaction structure. Results from the Q-factor analysis revealed three distinct interaction structures that explained 54.3% of the total variance. The first described a process of mutual trust and collaboration, the second was characterised by patient resistance and emotional detachment, the third by a mismatch and incongruence between therapist and adolescent. Comparison between the three revealed interesting differences which taken together provide further evidence that the reasons why adolescents drop out of therapy vary and are multidimensional in nature

Métodos de adaptação transcultural de instrumentos na área da enfermagem

Resumo OBJETIVO Identificar os métodos de adaptação transcultural de instrumentos mais utilizados na área da enfermagem. MÉTODOS Revisão integrativa, em fontes eletrônicas Medline via Pubmed, Cinahl, Lilacs, Scopus e Web of Science. Foram selecionados 96 artigos revisados por pares e publicados entre 2010 e 2015. RESULTADOS Os artigos que compuseram a amostra foram publicados em 59 periódicos diferentes, sendo 15,2% destes brasileiros. O maior número de publicações concentrou-se em 2015 (31,2%). Além disso, 28 países apareceram na lista liderada pelo Brasil (33,3%), seguido de China (10,4%). Utilizaram-se 27 modelos de adaptação transcultural diferentes. Entretanto, o proposto por Beaton e colaboradores foi citado em 47(49,0%) artigos, e o de Brislin em 12 (12,5%). CONCLUSÕES Não há consenso sobre adaptação transcultural, entretanto todos os métodos coincidiram na utilização da etapa de retrotradução. Além disso, diversos estudos em diferentes idiomas e países apontaram a aceitabilidade internacional do método desenvolvido por Beaton e colaboradores