Psicoterapia Psicodinámica de Niños y Embarazo de Terapeuta: Estudio de Caso Sistemático

Schmidt, Fernanda Munhoz Driemeier; Gastaud, Marina Bento; Ramires, Vera Regina Röhnelt

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Sumário

Psychology of Health • Paidéia (Ribeirão Preto) 28 • 2018 • https://doi.org/10.1590/1982-4327e2836 copiar

Psicoterapia Psicodinámica de Niños y Embarazo de Terapeuta: Estudio de Caso Sistemático

Autoría SCIMAGO INSTITUTIONS RANKINGS

Resumen

El presente estudio buscó describir las características del proceso psicoterápico psicodinámico de una niña con una terapeuta embarazada e identificar posibles repercusiones de ese embarazo en el tratamiento. Se realizó un estudio descriptivo, longitudinal, basado en el procedimiento de estudio de caso único sistemático. Participaron una niña de ocho años de edad y su terapeuta que se quedó embarazada durante el tratamiento. Se analizaron 40 sesiones de la psicoterapia a través del Child Psychotherapy Q-Set. El proceso terapéutico se dividió en cuatro períodos de acuerdo con el embarazo de la terapeuta: (1) terapeuta no estaba embarazada; (2) terapeuta sabía de su gestación, pero el asunto no había sido verbalizado; (3) tema fue tratado en el setting terapéutico; (4) retorno de la licencia por maternidad. Los resultados demostraron una disminución de la neutralidad y de la colocación de límites, y discusión de pausas e interrupciones en el tratamiento. Se concluyó que el embarazo de la terapeuta influye en el setting terapéutico de forma acentuada.

Palabras clave:
psicoterapia psicoanalítica; psicoterapia del niño; proceso psicoterapéutico

Items	Overall average	Average time 1	Average time 2	Average time 3	Average time 4
Most characteristic items
31 - T asks for more information or elaboration.	8.28	8.25	8.20	8.32	8,36
6 - T is sensitive to C’s feelings.	8.20	8.08	8.20	8.26	8.29
28 - T accurately perceives the therapeutic process.	8.06	7.67	7.95	8.18	8.14
3 - T’s remarks are aimed at encouraging C’s speech.	7.70	8.17	7.95	7.65	7.07
88 - Material of the hour is meaningful and relevant to C’s conflicts.	7.56	7.58	7.20	7.79	7.50
76 - T makes links between C’s feelings and experience.	7.45	7.17	7.75	7.32	7.57
77 - T’s interaction with C is sensitive to the C’s level of development.	7.35	7.42	7.65	7.35	-
23 - Therapy session has a specific focus or theme.	7.25	7.25	7.10	7.26	7.43
86 - T is confident, self-assured [vs; uncertain or unsure].	7.25	7.92	7.35	7.03	-
82 - T helps C manage feelings.	7.16	7.00	7.50	7.18	-
38 - T and C demonstrate a shared vocabulary or understanding when referring to events or feelings.	7.15	-	7.30	7.09	7.36
67 - T interprets warded-off or unconscious wishes, feelings, or ideas.	7.10	-	7.30	7.38	7.36
97 - T emphasizes verbalization of internal states and affects.	7.10	7.33	-	7.18	-
64 - C draws T into play.	7.07	6.92	7.40	7.15	-
69 - C’s current or recent life situation is emphasized.	7.06	8.17	-	-	7.36
81 - T emphasizes feelings to help C experience them more deeply.	-	7.25	-	-	-
65 - T clarifies, restates, or rephrases C’s communication.	-	7.08	-	-	-
62 - T points out a recurrent theme in the C’s experience or conduct.	-	-	7.30	-	7.07
78 - C is compliant.	-	-	6.90	-	-
72 - C is active.	-	-	-	7.03	7.36
75 - Interruptions, breaks in the treatment, or termination of therapy are discussed.	-	-	-	-	7.93
46 - T interprets the meaning of C’s play.	-	-	-	-	7.07
53 - C conveys awareness of own internal difficulties	-	-	-	-	7.50
Least characteristic items
1 - C expresses negative feelings (e.g., criticism, hostility) towards T [vs. express approval or admiration].	2.86	2.92	2.50	-	-
20 - C is provocative; challenges the T or rules and boundaries of the therapy hour.	2.85	2.83	2.80	2.91	2.79
89 - T acts to strengthen existing defenses.	2.65	-	2.55	2.59	2.64
49 - C conveys or expresses mixed or conflicted feelings about the T.	2.62	2.17	2.40	2.85	2.79
95 - C’s play lacks spontaneity.	2.45	2.50	2.35	2.50	2.43
58 - C appears unwilling to examine thoughts, reactions, or motivations related to problems.	2.43	2.50	2.65	2.38	2.21
42 - C ignores or rejects T’s comments and observations.	2.15	2.33	2.25	2.12	1.93
26 - C is socially misattuned or inappropriate.	2.02	2.25	2.10	2.03	1.71
17 - T actively exerts control over the interaction (e.g., structuring, introducing new topics).	1.97	2.25	1.90	1.91	2.00
56 - C is distant from his or her feelings.	1.91	1.58	2.10	1.94	1.86
18 - T is judgmental and conveys lack of acceptance.	1.77	1.67	1.70	1.68	2.21
5 - C has difficulty understanding the T’s comments.	1.73	1.75	1.70	1.76	-
40 - C communicates without affect.	1.72	1.75	1.65	1.71	1.86
41 - C does not feel understood by T.	1.62	1.58	1.55	1.68	1.64
9 - T is nonresponsive [vs; affectively engaged].	1.12	1.25	1.15	1.09	1.07
57 - T attempts to modify distortions in C’s beliefs.	-	2.92	-	-	-
37 - T behaves in a didactic manner.	-	-	-	2.79	2.36
5 - C has difficulty understanding the T’s comments.	-	-	-	-	1.71

Item	Item description	Manova	Tukey
Item	Item description	F	Times	Difference of averages between periods	Item direction
4	There is discussion of why C is in therapy.	6.64**	1-2	1.66*	↓
			1-3	1.59 *	↓
			2-4	-1.68*	↑
			3-4	-1.60*	↑
32	C achieves a new understanding or insight.	3.95*	1-4	-2.71*	↑
35	C’s self-image is a theme.	3.64*	1-4	-1.52*	↑
43	T suggests the meaning of the behavior of others.	3.60*	2-4	-.79*	↑
43	T suggests the meaning of the behavior of others.	3.60*	3-4	-.67*	↑
46	T interprets the meaning of C’s play.	3.91*	3-4	-1.27*	↑
48	T sets limits.	4.81**	1-3	.72 **	↓
48	T sets limits.	4.81**	1-4	.82**	↓
54	C is clear and organized in verbal expression.	2.94*	1-4	.90*	↓
61	C feels shy and embarrassed [vs; un-self-conscious and assured].	4.25*	1-4	2.08*	↓
61		4.25*	2-4	1.60*	↓
67	T interprets warded-off or unconscious wishes, feelings, or ideas.	3.83*	1-2	-1.63*	↑
			1-3	-1.76*	↑
			1-4	-1.69*	↑
69	C’s current or recent life situation is emphasized.	3.08*	1-3	1.40*	↓
75	Interruptions, breaks in the treatment, or termination of therapy are discussed.	7.12**	1-4	-2.51**	↑
			2-4	-2.38**	↑
			3-4	-2.19**	↑
87	T informs C of the potential impact of his or her behavior on others (not including T).	3.03*	2-3	-.70*	↑
93	T is neutral.	3.66*	1-3	1.34*	↓
94	C feels sad or depressed [vs. cheerful and joyous].	3.64*	1-3	.96*	↓

Universidade de São Paulo, Faculdade de Filosofia Ciências e Letras de Ribeirão Preto, Programa de Pós-Graduação em Psicologia Av.Bandeirantes 3900 - Monte Alegre, 14040-901 Ribeirão Preto - São Paulo - Brasil, Tel.: (55 16) 3315-3829 - Ribeirão Preto - SP - Brazil
E-mail: paideia@usp.br

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[1] Correspondence address: Fernanda Munhoz Driemeier Schmidt. Universidade do Vale do Rio dos Sinos. São Leopoldo-RS, Brazil. CEP 93.022-000. E-mail: fernandadriemeier@hotmail.com