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Publication
Avaliação do pocesso terapêutico numa perspetiva sistémica
Advisor(s)
Abstract(s)
O presente estudo de caso tem como objetivo olhar sistemicamente para a estrutura e comunicação de duas famílias e perceber o impacto destas dimensões na construção da aliança terapêutica, nos recursos e nas dificuldades que evidenciam. Pretende-se ainda avaliar se alguns fatores observáveis no início de um processo terapêutico, tais como a coerência do pedido, a motivação para a mudança e a expectativa face à terapia, poderão influenciar a adesão ao processo terapêutico. A sua pertinência prende-se com a escassez de informação acerca do conhecimento científico na área da psicologia clínica sistémica.
Para tal caracterizou-se e analisou-se um casal para quem a terapia foi considerada com sucesso e uma família que desistiu do seu processo terapêutico. O referencial teórico que sustentou este estudo foi a Teoria Estrutural de Minuchin, a Teoria da Comunicação de Watzlawick e o Modelo Circumplexo dos Sistemas Conjugais e Familiares de David Olson.
Os instrumentos usados foram a Grelha de Caracterização das Famílias, o Genograma, o Systemic Clinical Outcome Routine Evaluation - SCORE-15 e o SOFTA-o Sistema Observação da Aliança em Terapia Familiar - (versão observacional).
Os resultados demonstraram que níveis mais elevados de coesão e flexibilidade familiar potenciam a construção de uma aliança terapêutica e níveis mais baixos de coesão e flexibilidade familiar oferecem grande resistência à construção da mesma. As famílias cuja comunicação seja mais funcional dispõem de mais recursos e superam mais facilmente as dificuldades por oposição a quadros familiares com comunicações mais disfuncionais.
A estrutura e a comunicação são fulcrais no processo terapêutico na medida em que estruturas familiares mais equilibradas, com processos comunicacionais mais funcionais, têm mais facilidade em potenciar os seus recursos, ultrapassar as dificuldades e construir a aliança terapêutica que aumenta a probabilidade de sucesso terapêutico. Sistemas familiares estruturalmente mais desequilibrados, com padrões comunicacionais pouco funcionais, têm mais dificuldade na otimização dos recursos, na superação das dificuldades e na construção da aliança terapêutica potenciando a rutura ou o abandono do processo terapêutico.
The present case study aims to verify the strength of the therapeutic alliance in two families by using a systematic vision of the communication and the structure analysis. A couple and a family were observed, one whose therapy was successfully considered and the other for which the therapy was not concluded (withdrew). It is also intended to assess whether some observable factors at the beginning of a therapeutic process, such as request coherence, the motivation for change and expectation regarding therapy, may influence adherence to the therapeutic process. The motivation to this study was related with lack of scientific knowledge in clinic systemic phsycology. The Minuchin Structural Theory, the Theory of Watzlawick's Communication and the Olson Circumplex Model were used as the theoretical references. The Family Characterization Grid, the Genogram, the Systemic Clinical Outcome Routine Evaluation-SCORE-15 was used as the main chain analysis tools. The Alliance Observation System in Family Therapy-SOFTA-o (observational version) was used to conduct the study. The results showed that higher levels of cohesion and family flexibility promote the therapeutic alliance. In otherwise, lower levels of cohesion and family flexibility offer great resistance to the therapeutic alliance. Families whose communication is more functional tends to have more abilities to easily overcome difficulties as opposed to family groups with more dysfunctional communications. The family structure and their communication skills are both critical factors to achieve the therapeutic process. As more balanced a family is in terms of proximity between their members and his communication skills more likely will be the success of the therapeutic alliance. By the other hand, unbalanced families tend to not achieve the purposes of the therapeutic alliance. These clients are more likely to abandon the therapeutic process.
The present case study aims to verify the strength of the therapeutic alliance in two families by using a systematic vision of the communication and the structure analysis. A couple and a family were observed, one whose therapy was successfully considered and the other for which the therapy was not concluded (withdrew). It is also intended to assess whether some observable factors at the beginning of a therapeutic process, such as request coherence, the motivation for change and expectation regarding therapy, may influence adherence to the therapeutic process. The motivation to this study was related with lack of scientific knowledge in clinic systemic phsycology. The Minuchin Structural Theory, the Theory of Watzlawick's Communication and the Olson Circumplex Model were used as the theoretical references. The Family Characterization Grid, the Genogram, the Systemic Clinical Outcome Routine Evaluation-SCORE-15 was used as the main chain analysis tools. The Alliance Observation System in Family Therapy-SOFTA-o (observational version) was used to conduct the study. The results showed that higher levels of cohesion and family flexibility promote the therapeutic alliance. In otherwise, lower levels of cohesion and family flexibility offer great resistance to the therapeutic alliance. Families whose communication is more functional tends to have more abilities to easily overcome difficulties as opposed to family groups with more dysfunctional communications. The family structure and their communication skills are both critical factors to achieve the therapeutic process. As more balanced a family is in terms of proximity between their members and his communication skills more likely will be the success of the therapeutic alliance. By the other hand, unbalanced families tend to not achieve the purposes of the therapeutic alliance. These clients are more likely to abandon the therapeutic process.
Description
Dissertação de Mestrado apresentada no
ISPA - Instituto Universitário para obtenção do grau de
Mestre na especialidade de Psicologia Clínica.
Keywords
Terapia familiar e conjugal sistémica Aliança terapêutica Coesão Flexibilidade e Comunicação Family and Marital Systemic Therapy Therapeutic Alliance Cohesion Flexibility and Communication