Authors:Jordan Bate, Angelica Tsakas Abstract: One of the consistent findings from psychotherapy process research has been the impact of therapist effects on patient change and the therapeutic alliance. The Facilitative Interpersonal Skills (FIS) paradigm is a task in which participants respond to standardized videos of actors playing patients in interpersonally challenging moments as if they were the therapist, which was designed to assess therapist effects. Participants’ video recorded responses are coded for eight skills: verbal fluency, emotional expressiveness, warmth/acceptance/ understanding, empathy, persuasiveness, hope/positive expectations, alliance-bond capacity, and rupture-repair responsiveness. Performance-based procedures like the FIS minimize self-report bias and systematically control for client-related variability while maintaining strong clinical relevance. Research has shown that therapist FIS predicts the quality of the therapeutic alliance and outcome in adult psychotherapy. This paper describes the development and first adaptation of the FIS task using child and adolescent patients as the stimuli, and reports findings from a pilot study testing the reliability. The FIS-Child (FIS-C) task was administered to 10 therapists with a range of clinical backgrounds. Participants also completed the original FIS task and self-report measures of their empathy, social skills, and playfulness. Adequate interrater reliability was achieved on the FIS-C. There were no significant differences between participants’ ratings on the FIS-C compared to the original FIS, although there were minor differences in the correlations between the FISC and self-report measures compared to the original FIS. Findings support moving forward with utilizing the FIS-C to empirically study therapist effects that may be common factors across treatment models. PubDate: 2022-05-09 DOI: 10.4081/ripppo.2022.595 Issue No:Vol. 25, No. 1 (2022)
Authors:Elham Qanbari Alaee, Omid Saed, Sahel Khakpoor, Reza Ahmadi, Mahsa Ali Mohammadi, Majid Yoosefi Afrashteh, Zekrolah Morovati Abstract: In response to the high rate of comorbidity among different types of emotional disorders in children, Transdiagnostic Unified Protocol of Emotional disorder in children (UP-C) was developed to address common underlying mechanisms in the development and maintenance of emotional disorders using empirically supported cognitive and behavioural strategies. Although, studies supported the effectiveness of this protocol in the treatment of wide range of emotional disorders, further studies are needed to examine its effect on transdiagnostic factors. The present study aimed to investigate the efficacy of the UP-C on negative affect, anxiety sensitivity and perceived control in children with emotional disorders. During this randomized controlled trial, 34 children aged 7 to 13 with emotional disorders were randomly assigned to treatment (n=18) and control (n=16) groups. The treatment group and their parents received 15 sessions of UP-C. Negative Affect Schedule for Children (PANASNA- C), Children’s Anxiety Sensitivity Index (CASI), Anxiety Control Questionnaire-Children (ACQ-C) were carried out in all phases (pre-treatment, post-treatment, 3 and 8 months follow- up). The results showed that following UP-C, negative affect (hedges’g=2.01) and anxiety sensitivity (hedges’g=1.05) were significantly reduced, and perceived control (hedges’g= –2.36) was significantly improved. The results remained relatively constant during the follow-ups. Findings provide evidence that the UP-C has significant effect on negative affect, anxiety sensitivity and perceived control as roots of emotional disorders. PubDate: 2022-05-09 DOI: 10.4081/ripppo.2022.588 Issue No:Vol. 25, No. 1 (2022)
Authors:Lindsey Myers, Howard Steele, Miriam Steele, Anne Murphy Abstract: The current study examined 20 participants from group attachment based intervention (GABI), who completed the adult attachment interviews (AAI; George, et al., 1985) as part of a RCT to test the efficacy of GABI compared with treatment as usual, in order to explore the possible benefits higher RF for treatment outcome in terms of interactive mother and child behaviour. Mothers’ AAIs were analyzed using the reflective functioning (RF) rating scale (Fonagy, et al., 1998), yielding overall RF scores, prompted/demand RF scores, and spontaneous RF scores, and parent-child dyadic interactive behaviour was coded utilizing the coding interactive behaviour (CIB: Feldman, 1998) manual. Children’s age ranged from 2-25 months, mean=14 months. 86.7% of the sample identified English as their primary language, with 13.3% identified speaking both Spanish and English. RF in AAIs obtained at intake from some GABI mothers was expected to be linked to the quality of the parent-child interaction (observed with the CIB), at intake (T1), at end-of treatment T2), and at sixmonth follow-up (T3). Results confirmed this impression insofar as lower overall RF was linked to T1 levels of higher intrusiveness from mothers. At end of treatment (T2), mothers’ higher spontaneous RF scores were significantly linked to maternal praising (of the child), child positive affect, child alertness. At 6-month follow up (T3), mother’s spontaneous RF scores correlated significantly and positively with maternal elaborating with child positive affect. Discussion focuses on the importance of assessing RF in parents entering therapy with their children as it may provide insight into what parent or child behaviours may be targeted. And the RF scores will highlight which mothers need special attention to stimulate their interest and attention to attachment-related processes in themselves, and in their children. PubDate: 2022-04-27 DOI: 10.4081/ripppo.2022.594 Issue No:Vol. 25, No. 1 (2022)
Authors:Fabiola Bizzi, Francesca Locati, Laura Parolin, Shmueli Goetz Yael, Emanuela Brusadelli Abstract: The Child Attachment Interview (CAI) is a well-established semi-structured interview, widely used to identify attachment representations in middle childhood and adolescence. The application of the Child and Adolescent Reflective Functioning Scale (CRFS) to CAI narratives allows for an assessment of child mentalization, considered a strong predictor of attachment security. The 2nd edition of the Psychodynamic Diagnostic Manual (PDM-2) includes CAI and CRFS as valid and reliable assessment measures in order to assess the dominion of the Mental Functioning axis. The aim of the present paper is to investigate the informative power of CAI and CRFS for the overall understanding of mental functioning and personality in a PDM-2 framework. The present report includes the discussion of two clinical cases of school-aged children in applying the Psychodiagnostic Chart-Second Edition (PDC-2) to the CAI transcript. The first case concerns a young male, aged 10, suffering from Oppositional-Provocative Disorder (externalizing disorder), while the second case concerns a young female, aged 15, suffering from Somatic Symptoms Disorder (internalizing disorder). PDC-2 for children and adolescents was used. Data from the scoring of CAI and CRFS were combined with a systematic evaluation of the qualitative contents emerging from CAI transcripts. A detailed analysis suggests that both the CAI and CRFS are useful attachment-oriented measures, able to explore child's mental states, and together with the application of PDC-2 they provide an essential contribution in the understanding of developmental psychopathology. Implications of this innovative approach for clinical assessment, treatment design, and interventions are further discussed. PubDate: 2022-03-04 DOI: 10.4081/ripppo.2022.586 Issue No:Vol. 25, No. 1 (2022)
Authors:Catalina Sieverson, Marcia Olhaberry, Javiera Duarte, Javier Morán, Stefanella Costa, M. José León, Sofía Valenzuela, Fanny Leyton, Carolina Honorato, Antonia Muzard Abstract: The present single case study explored and described the intervention process and therapeutic change expression through the Generic Change Indicators model (GCI) aiming to answer the question of “What changes when you change'”. We reasoned that psychotherapy process research in child and dyadic psychotherapy is scarce, as well as needed because it accounts for the content and mechanisms related to the therapeutic change and its association with interventions’ effectiveness. To explore this possibility, we conducted a single case qualitative study to explore and describe the intervention process through the GCI within a brief intervention mentalization-informed with video-feedback, with a depressive mother and her baby. Specifically, Patient’s ongoing change was determined through the identification of Episodes of Change (EC) and the Moment of Change (MC) that occurs within it. Each MC was then labeled with one of the 19 GCIs. Results of the single case study showed that the GCI model is a feasible model to observe and comprehend dyadic interventions. GCI were observed from the beginning of the intervention, increasing the hierarchical level of the GCI throughout the intervention, and associated with the video-feedback situation. To investigate processes of intervention using the methodology here proposed, allows us to understand the intervention not only from a perspective of effectivity and outcomes but considering the ongoing therapeutic change. In this sense, research like this contributes to the growing body of evidence supporting the training and supervision of psychotherapists. PubDate: 2022-03-04 DOI: 10.4081/ripppo.2022.584 Issue No:Vol. 25, No. 1 (2022)
Authors:Claudia Capella, Estrella Azócar, Loreto Rodríguez, Ximena Lama, Lucía Núñez, Daniela Águila, Camila Gomez, Macarena Espeleta, Vania Vasquez Abstract: Introduction: Change in psychotherapy research in cases of child sexual abuse (CSA) has mainly emerged from a symptomatologic view, which needs to be complemented by a subjective perspective of change. Thus, this article aim is to describe different outcomes and stages of change during psychotherapy in children and adolescents who have been sexually abused, from the subjective perspectives of those involved in the process. Methods: A longitudinal qualitative study was developed. Qualitative interviews were conducted at different moments of the psychotherapeutic process (at around 6 months of therapy, 12 months and at the end of therapy) with 28 children and adolescents aged 6 to 17, with their caregivers and therapists. All children and adolescents attended and then completed psychotherapy due to sexual abuse in natural settings, in public specialized centres in Santiago, Chile. Sexual abuse occurred mainly in an intrafamilial context or by acquaintances. Data analysis was conducted using narrative analysis. Results: Three stages of therapy were identified: (1) settling into therapy, (2) approaching CSA and (3) healing from abuse. Three different outcomes of psychotherapeutic change were also identified: (1) protective and psychosocial changes, (2) changes related to diminishing the effects of abuse and (3) changes related to healing from abuse. Psychosocial characteristics of the cases and features of the therapeutic process are described in each group. Discussion: The outcomes of change and the stages of therapy are interrelated in a dynamic and gradual process where change is linked with the case’s psychosocial characteristics and the features of the therapeutic process. Results allowed the authors to situate the voices of the participants within a proposed model of psychotherapeutic change for CSA, with clinical practical implications. PubDate: 2022-03-04 DOI: 10.4081/ripppo.2022.583 Issue No:Vol. 25, No. 1 (2022)
Authors:Alexandro Fortunato, Annalisa Tanzilli, Vittorio Lingiardi, Anna Maria Speranza Abstract: Background: Reliable clinical-diagnostic evaluation is crucial in childhood. The present research sought to examine the validity of the Psychodiagnostic Chart – Child (PDC–C) in assessing children’s mental functioning and personality organization according to the Psychodynamic Diagnostic Manual- Second Edition (PDM–2)’s framework. Method: A sample of 209 clinicians completed the PDC-C to assess 209 children between the age of 4 and 11 who had been in their care for a time range between 2 and 12 months. Each clinician completed a clinical questionnaire to collect demographic information, as well as the Child Behavior Checklist (CBCL) to evaluate the presence of behavioral problems and the attainment of social competences, and the Childhood Personality Assessment Q-Sort (CPAP–Q) to assess emerging personality patterns. Results: The findings confirmed that the PDC–C is a valid tool able to provide a comprehensive diagnosis considering the child’s full range of functioning. Moreover, this measure showed good levels of sensitivity and appears clinically useful in distinguishing some psychological characteristic in different clinical populations. Conclusions: PDC–C could be a useful measure in promoting an accurate assessment in developmental stage and to tailor individualized therapeutic interventions. One of the PDC–C’s advantages is its ability to capture variations in the child’s functioning even within the same diagnostic category, illuminating strengths and psychological vulnerabilities. Noteworthy, additional research is needed to establish the utility of PDC–C derived ratings in predicting clinically relevant constructs and to monitor both the process and the outcome of interventions. PubDate: 2022-03-01 DOI: 10.4081/ripppo.2022.591 Issue No:Vol. 24, No. 3 (2022)
Authors:Jessica L. Borelli, Lyric N. Russo, Jose Arreola, Breana R. Cervantes, Christina M. Marquez, Gloria Montiel, Vanessa Avalos, Jacqueline Carballo, Jackie Garcia, Isha Bhatt, Gina Torres, Francisca Leal, Nancy Guerra Abstract: Evidence for the effectiveness of attachment-based interventions in improving youth’s socioemotional health increases each year, yet potential for scalability of existing programs is limited. Available programs may have lower acceptability within low-income immigrant communities. Co-designing and implementing interventions with trained community workers (promotores) offers an appealing solution to multiple challenges, but community workers must have high investment in the program for this to be a workable solution. This study examines the experiences of promotores involved in the co-creation and delivery of an attachment-based intervention program for low-income Latinx youth (ages 8 to 17) and their mothers. Promotores (N=8) completed surveys, reporting on the experiences of each therapy group in terms of group dynamic (e.g., promotores’ connectedness to each group, perceived program relevance). Following the completion of the intervention study, promotores participated in interviews in which they described their experiences in co-creating the intervention, delivering the intervention to the community, and their recommendations for improving the intervention. Overall, promotores perceived group dynamics as positive, though the mother groups were evaluated as significantly higher in quality (e.g., lower conflict) than the youth groups. Interviews revealed that promotores enjoyed the co-creation process and identified important areas for improvements for the intervention (incorporation of more visuals, creation of age-limited groups, reducing number of youth sessions) and evaluation (reduction in length, modification of language). Integrating input from promotores in the process of co-creating and implementing an intervention can benefit every member of the community from the program participants to the providers themselves. PubDate: 2022-02-04 DOI: 10.4081/ripppo.2022.598 Issue No:Vol. 24, No. 3 (2022)
Authors:Mariagrazia Di Giuseppe, Tracy A. Prout, Lauren Ammar, Thomas Kui, Ciro Conversano Abstract: Defense mechanisms are unconscious and automatic psychological processes that serve to protect the individual from painful emotions and thoughts. There is ample evidence from the adult psychotherapy and mental health literature suggesting the salience of defenses in the maintenance and amelioration of psychological distress. Although several tools for the assessment of children’s defenses exist, most rely on projective and self-report tools, and none are based on the empirically derived hierarchy of defenses. This paper outlines the development of the defense mechanisms rating scale Q-sort for children (DMRS-Q-C), a 60-item, observer-rated tool for coding the use of defenses in child psychotherapy sessions. Modifications to the Defense Mechanisms Rating Scale Q-Sort for adults to create a developmentally relevant measure and the process by which expert child psychotherapists collaborated to develop the DMRS-Q-C are discussed. A clinical vignette describing the child’s defensive functioning as assessed by the innovative DMRS-Q-C method is also reported. Finally, we provide an overview of forthcoming research evaluating the validity of the DMRS-Q-C. PubDate: 2021-12-21 DOI: 10.4081/ripppo.2021.590 Issue No:Vol. 24, No. 3 (2021)
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