El cliente: el verdadero agente del cambio en psicoterapia

Implicaciones para los psicoterapeutas

Autores/as

  • Elena Gismero-González Universidad Pontificia Comillas

DOI:

https://doi.org/10.14422/mis.v79.i154.y2021.011

Palabras clave:

investigación en psicoterapia, resultados de la psicoterapia, relación terapéutica, factores del cliente, práctica basada en la evidencia

Resumen

Las evidencias científicas no dejan lugar a dudas sobre el papel activo que las personas tienen en la gestión de sus acontecimientos vitales adversos y su capacidad de recuperación. Ocurre lo mismo con su papel protagonista en psicoterapia, donde todas las investigaciones sitúan al mal llamado «paciente» como el verdadero agente de cambio; el papel del terapeuta consiste en adaptar el tratamiento a las necesidades y características de sus clientes, así como crear el clima adecuado para movilizar sus competencias y recursos facilitando el cambio. La evidencia apoya una visión de la psicoterapia más ajustada a un modelo relacional colaborativo.

Citas

Bachelor, A. y Horvath, A. (1999). The therapeutic relationship. En M. A. Hubble, B. L. Duncan y S. D.Miller (Eds.). The heart and soul of change: What works in therapy (pp. 133‑178).Washington, DC: American Psychological Association.

Bandini, J. (2015). The medicalization of bereavement: (Ab)normal grief in the DSM- 5. Death Studies, 39(6), 347‑352. DOI: 10.1080/07481187.2014.951498

Barber, B. K. (2009). Adolescents and war: How youth deal with political violence. New York, NY: Oxford University Press

Bogar, C. B. y Hulse-Killacky, D. (2006). Resiliency determinants and resiliency processes among female adult survivors of childhood sexual abuse. Journal of Counseling and Development, 84, 318‑327. https://doi.org/10.1002/j.1556-6678.2006. tb00411.x

Bohart, A. C. y Tallman, K. (2010). Clients: The neglected common factor in psychotherapy. In B. Duncan, S. Miller, B. Wampold y M. Hubble (Eds), The heart and soul of change: Delivering what works in therapy (2nd ed., pp. 83-111). Washington, DC: American Psychological Association.

Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? The American Psychologist, 59(1), 20‑28. doi: 10.1037/0003-066X.59.1.20.

Bonanno, G. A., Westphal M. y Mancini A. D. (2011). Resilience to loss and potential trauma. Annual Review of Clinical Psychology, 7, 511‑535. doi: 10.1146/annurev- clinpsy-032210-104526.

Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research and Practice, 16(3), 252-260.

Botella, L., Pacheco, M., Herrera, O. y Corbella, S. (2000). Investigación en psicoterapia: el estado de la cuestión. Boletín de Psicología, 69, 19-42.

Cicchetti, D. (2013). Annual research review: Resilient functioning in maltreated children–past, present, and future perspectives. Journal of Child Psychology and Psychiatry, 54, 402‑422. doi: 10.1111/j.1469-7610.2012.02608.x

Corbella, S. y Botella, L. (2003). La alianza terapéutica: historia, investigación y evaluación. Anales de Psicología, 19(2), 205-221.

Duncan, B. L. (2010). On becoming a better therapist. Washington, D.C: American Psychological Association.

Duncan, B. L. y Miller, S. D. (2000). The heroic client: Doing client-directed, outcome- informed therapy. San Francisco, CA: Jossey-Bass.

Duncan, B. L., Miller, S. D. y Sparks, J. (2004). The Heroic Client: A Revolutionary Way to Improve Effectiveness through Client-Directed, Outcome-Informed Therapy (2nd Edition). San Francisco: Jossey-Bass.

Duncan B. L., Miller S. D., Sparks J., Claud D., Reynolds L., Brown J. y Johnson L., (2003). The Session Rating Scale: Preliminary psychometric properties of a «working» alliance measure. Journal of Brief Therapy, 3(1), 3‑12.

Eisenberg, E. y Silver, R. C. (2011). Growing up in the shadow of terrorism. American Psychologist, 66, 468‑481. doi: 10.1037/a0024619

Gismero-González, E., Bermejo-Toro, L., Cagigal, V., Roldán, A., Martínez-Beltrán, M. J. y Halty, L. (2020) Emotional impact of COVID-19 lockdown among the Spanish population. Frontiers in Psychology, 11, 616978. doi: 10.3389/ fpsyg.2020.616978

Hayes, J. A. y Wall, T. N. (1998). What influences clinicians’ responsibility attributions? The role of problem type, theoretical orientation, and cliente attribution. Journal of Social and Clinical Psychology, 17(1), 69-74.

Hill, C. E., Nutt-Williams, E., Heaton, K., Thompson, B. y Rhodes, R. H. (1996). Therapist retrospective recall of impasses in long-term psychotherapy: A qualitative analysis. Journal of Counseling Psychology, 43, 207‑217. https://psycnet.apa.org/ doi/10.1037/0022-0167.43.2.207

Horvath, A. O. y Greenberg, L. S. (1989). Development and validation of the Working Alliance Inventory. Journal of Counseling Psychology, 36, 223-233. doi:10.1037/0022-0167.36.2.223

Kim-Cohen, J. y Turkewitz, R. (2012). Resilience and measured gene-environment interactions. Development and Psychopathology, 24, 1297‑1306. doi: 10.1017/ S0954579412000715

Luborsky, L., Singer, B. y Luborsky, L. (1975). Comparative studies of psychotherapies: Is it true that «Everyone has won and all must have prizes»? Archives of General Psychiatry, 3(2), 995-1008.

Mackrill, T. (2008). Exploring psychotherapy clients’ independent strategies for change while in therapy. British Journal of Guidance & Counselling, 36(4), 441- 453. doi: http://dx.doi.org/10.1080/03069880802343837

Masten, A. S. y Narayan, A. J. (2012). Child development in the context of disaster, war, and terrorism: Pathways of risk and resilience. Annual Review of Psychology, 63, 227‑257. doi: 10.1146/annurev-psych-120710-100356

Morales Vallejo, P. (2006). Implicaciones para el profesor de una enseñanza centrada en el alumno. Miscelánea Comillas, 64(124), 11-38. http://www.upcomillas.es/Servicios/ serv_publ_revi_misc_revi.aspx

Morrison, A. P., Turkington, D., Pyle, M., Spencer, H., Brabban, A., Dunn, G., Christodoulides, T., Dudley, R., Chapman, N., Callcott, P., Grace, T., Lumley, V., Drage, L., Tully, S., Irving, K., Cummings, A., Byrne, R., Davies, L. M. y Hutton, P. (2014). Cognitive therapy for people with schizophrenia spectrum disorders not taking antipsychotic drugs: a single-blind randomised controlled trial. Lancet (London, England), 383(9926), 1395‑1403. https://doi.org/10.1016/S0140-6736(13)62246-1

Norcross, J. C. y Lambert, M. J. (2018). Psychotherapy relationships that work III. Psychotherapy, 55(4), 303-3015. http://dx.doi.org/10.1037/pst0000193

Ozer, E. J., Best, S. R., Lipsey, T. L. y Weiss, D. S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychological Bulletin, 129, 52-71.

Pietrzak, R. H. y Southwick, S. M. (2011). Psychological resilience in OEF-OIF Veterans: Application of a novel classification approach and examination of demographic and psychosocial correlates. Journal of Affective Disorders, 133(3), 560‑568. DOI: 10.1016/j.jad.2011.04.028

Prieto-Ursúa, M. y Jódar, R. (2020). Finding meaning in hell. The role of meaning, religiosity and spirituality in posttraumatic growth. Frontiers in Psychology, 11, 567836.

Read, J., Cartwright, C. y Gibson, K. (2014). Adverse emotional and interpersonal effects reported by 1829 New Zealanders while taking antidepressants. Psychiatry Research, 216(1), 67-73. https://doi.org/10.1016/j.psychres.2014.01.042.

Rodríguez-Morejón, A. (2016). El cliente en psicoterapia: contribución al resultado terapéutico. Anales de Psicología, 32, 1, 1-8. http://dx.doi.org/10.6018/analesps. 32.1.192551

Smith M., Glass, G. y Miller, T. (1980). The Benefits of Psychotherapy. Baltimore, MD: John Hopkins University Press.

Southwick, S. M., Bonanno, G. A., Masten, A. S., Panter-Brick, C. y Yehuda, R. (2014). Resilience definitions, theory, and challenges: interdisciplinary perspectives. European Journal of Psychotraumatology, 5 (1). DOI: 10.3402/ejpt.v5.25338

Swift, J. K., Callahan, J. L. y Vollmer, B. M. (2011). Preferences. Journal of Clinical Psychology, 67(2), 155-165. doi: 10.1002/jclp.20759

Vázquez, C. et al. (2021). Post-Traumatic Growth and Stress-Related responses during the COVID-19 pandemic in a national representative sample: The role of positive core beliefs about the world and others. Journal of Happiness Studies, https://doi.org/10.1007/s10902-020-00352-3

Wampold, B. E. (2001). The great psychotherapy debate: models, methods, and findings. Mahwah, N.J.: L. Erlbaum Associates.

Wampold, B. E. y Imel, Z. E. (2015). The great psychotherapy debate: Models, methods and findings. Nueva York: Rouledge.

Wampold, B. E., Mondin, G. W., Moody, M., Stich, F., Benson, K. y Ahn, H.-n. (1997). A meta-analysis of outcome studies comparing bona fide psychotherapies: Empirically, «All must have prizes». Psychological Bulletin, 122 (3), 203-215. https:// doi.org/10.1037/0033-2909.122.3.203

Whiteford, H. A., Harris, M. G., McKeon, G., Baxter, A., Pennell, C., Barendregt, J. J. y Wang, J. (2013). Estimating remission from untreated major depression: a systematic review and meta-analysis. Psychological Medicine, 43, 1569-1585. doi:10.1017/S0033291712001717

Descargas

Publicado

2021-07-21