O impacto dos acontecimentos significativos no processo terapêutico: Um estudo de caso de sucesso

Andriza Corrêa, Eugénia Ribeiro, Sara Costa

Abstract


A investigação sobre os acontecimentos significativos tem como objetivo identificar e analisar os momentos mais produtivos em terapia, que contribuem para o avanço do cliente durante o processo terapêutico. O presente estudo teve como objetivo descrever os impactos associados aos acontecimentos significativos, identificados pelo cliente e pelo terapeuta, ao longo de um caso de sucesso clínico. Utilizamos a metodologia de estudo de caso, procedendo a uma análise qualitativa dos impactos dos acontecimentos identificados em sessões de terapia cognitivo-comportamental. A versão portuguesa do questionário Helpful Aspects of Therapy foi administrada no final de cada sessão, para a recolha dos acontecimentos significativos e respectivos impactos. O resultado da terapia foi avaliado com base na versão portuguesa do Outcome Questionnaire. Analisamos qualitativamente e categorizamos o tipo de impacto percebido do acontecimento no processo de mudança do cliente a partir de uma grelha de análise temática, construída com base na literatura. Os resultados mostram que os impactos dos acontecimentos significativos incidem preferencialmente sobre a Consciência/ Insight/ Autocompreensão, Sensação de fortalecimento, Resolução de problemas/ Mudança de comportamento, e Orientação. Os resultados deste estudo sugerem a necessidade dos terapeutas atenderem à divergência e complementaridade de perspetivas na experiência da psicoterapia e sua contribuição para a mudança do cliente.

Palavras-chave: ACONTECIMENTOS SIGNIFICATIVOS; CATEGORIAS DE IMPACTO; ESTUDO DE CASO.

Keywords


ACONTECIMENTOS SIGNIFICATIVOS; CATEGORIAS DE IMPACTO; ESTUDO DE CASO.

References


Craske, M.G., & Barlow, D.H.(1993).Panic disorder and agoraphobia. In D.H. Barlow (Ed.), Clinical handbook of psychological disorders (pp. 1–47). New York: Guilford Press.

Elliott, R. & Shapiro, D. A. (1992) Client and therapist as analysis of significant events. In S.G. Toukmanian & D.L. Rennie (Eds.). Psychotherapy Process Recall: Paradigmatic and narrative approaches (pp. 163-186). Sages Publications.

Elliott, R. (1985). Helpful and nonhelpful events in brief counseling interviews: An empirical taxonomy. Journal of Counseling Psychology, 32, 307-322.

Elliott, R. (1989a). Comprehensive process analysis: Understanding the change process in significant therapy events. In Packer, M.J. & Addison, R.B. (Eds.), Entering the Circle: Hermeneutic Investigation in Psychology. New York: State University of New York Press.

Elliott, R. (1993). Helpful aspects of therapy form. Disponível em http:// www.experiential-researchers.org/instruments/elliott/hat.pdf.

Elliott, R., & James, E. (1989). Varieties of client experience in psychotherapy: An analysis of the literature. Clinical Psychology Review, 9, 443-467.

Elliott, R., & Shapiro, D. A. (1988). Brief Structured Recall: A more efficient method for studying significant therapy events. British Journal of Medical Psychology, 61, 141–153.

Elliott, R., Barker, C. B., Caskey, N., & Pistrang, N. (1982). Diferential helpfulness of counselor verbal response modes. Journal of Counseling Psychology, 29, 354-361.

Elliott, R., James, E., Reimschuessel, C., Cislo, D., & Sack, N. (1985). Significant events and the analysis of immediate therapeutic impacts. Psychotherapy, 22, 620-630.

Elliott, R., Shapiro, D. A., Firth-Cozens, J., Stiles, W.B., Hardy, G. E., Llewelyn, S. P., & Margison, F. R. (1994). Comprehensive process analysis of insight events in cognitive-behavioral and psychodynamic-interpersonal psychotherapies. Journal of counseling psychology, 41, 449-463.

First, M. B., Spitzer, R. L, Gibbon M., and Williams, J.B.W. (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition. (SCID-I/NP) New York: Biometrics Research, New York State Psychiatric Institute.

Grafanaki, S., & McLeod, J. (1999). Narrative processes in the construction of helpful and hindering events in experiential psychotherapy. Psychotherapy Research, 9, 289–303 doi:10.1093/ptr/9.3.289.

Grafanaki, S., & McLeod, J. (2002). Experiential congruence: Qualitative analysis of client and counselor narrative accounts of significant events in time-limited person-centred therapy. Counselling and Psychotherapy Research, 2, 20–32. doi:10.1080/14733140212331384958

Grosse-Holtfort, M., Castonguay, L. G., Boswell, H. F.,Wilson, L. A., Kakouros, A. A., & Borkovec, T. D. (2007). Insight in cognitive-behavioral therapy. In L. G. Castonguay & C. E. Hill (Eds.), Insight in psychotherapy (pp. 57–80). Washington, DC: American Psychological Association.

Hardy, G. E., Aldridge, J., Davidson, C., Rowe, C., Reilly, S., & Shapiro, D. A. (1999). Therapist responsiveness to client attachment styles and issues observed in client-identified significant events in psychodynamic-interpersonal psychotherapy. Psychotherapy Research, 9, 36–53. doi:10.1093/ptr/9.1.36

Hill, C. E., & O’Brien, K. M. (1999). Helping skills: Facilitating, exploration, insight, and action. Washington, DC: American Psychological Association.

Hill, C. E., Helms, J. E., Tichenor, V., Spiegel, S. B., O’Grady, K. E., & Perry, E. S. (1988). The effects of therapist response modes in the effects of therapist response modes in brief psychotherapy. Journal of Counseling Psychology, 36, 222–233.

Lambert, M. J., Burlingame, G. M., Umphress, V. J., Hansen, N. B., Vermeersch, D., Clouse, G., & Yanchar, S. (1996). The relicapacity and validity of the Outcome Questionnaire. Clinical psychology and Psychotherapy, 3, 106–116.

Levitt, H. M., & Rennie, D. L. (2004). Narrative activity: Clients’ and therapists’ intentions in the process of narration. In L. E. Angus & J. McLeod (Eds.), The handbook of narrative and psychotherapy: Practice, theory, and research (pp. 247-262). Thousand Oaks, CA: Sage.

Llewelyn, S. P., Elliott, R., Shapiro, D. A., Hardy, O., & Firth-Cozens, J. (1988). Client perceptions of significant events in prescriptive and exploratory periods of individual therapy. British Journal of Clinical Psychology, 27, 105-114

Machado, P. P, & Fassnacht, D. (2014). The Portuguese version of the Outcome Questionnaire (OQ-45): Normative data, reliability and clinical significance cut-offs scores. Psychology and Psychotherapy: Theory, Research and Practice. doi:10.1111/papt.12048.

Paulson, B., Truscott, D., & Stuart, J. (1999). Clients’ perceptions of helpful experiences in counseling. Journal of Counseling Psychology, 46, 317-324.

Rhodes, R. H., Hill, C. E., Thompson, B. J., & Elliott, R. (1994). Client retrospective recall of resolved and unresolved misunderstanding events. Journal of Counseling Psychology, 41, 473-483.

Sales, C. M.D., & Alves, P. C. G. (2014). Quality of care through the eyes of the patient: Personalised routine measurement systems in mental health. Transcultural, 6(1), 115-127.

Timulak, L. (2007). Identifying core categories of client-identified impact of helpful events in psychotherapy: A qualitative meta-analysis. Psychotherapy Research, 17, 310–320.

Timulak, L., & Elliott, R. (2003). Empowerment events in process-experiential psychotherapy of depression: A qualitative analysis. Psychotherapy Research, 13, 443-460.

Timulak, L., & Lietaer, G. (2001), Moments of empowerment: A qualitative analysis of positively experienced episodes in brief person-centred counselling. Counselling and Psychotherapy Research. doi: 10.1080/14733140112331385268.

Timulak, L., & McElvaney, R. (2013) Qualitative meta-analysis of insight events in psychotherapy, Counselling Psychology Quarterly, 26:2, 131-150. doi: 10.1080/09515070.2013.792997.

Wiseman, H., & Rice, L. N. (1989). Sequential analyses of therapist-client interaction during change events: A task focused approach. Journal of Consulting and Clinical Psychology, 57, 281-2.




DOI: https://doi.org/10.14417/ap.1088

Refbacks

  • There are currently no refbacks.


Nº ERC: 107494 | ISSN (in print): 0870-8231 | ISSN (online): 1646-6020 | Copyright © ISPA - CRL, 2012 | Rua Jardim do Tabaco, 34, 1149-041 Lisboa | NIF: 501313672 | The portal and metadata are licensed under the license Creative Commons CC BY-NC