Las verbalizaciones tipo regla del terapeuta a lo largo del proceso clínico
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may 22, 2017
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Resumen
Aunque se ha reconocido la importancia del uso de las reglas para el tratamiento de problemas psicológicos, aún se desconoce el papel que juega este tipo de verbalizaciones en el cambio clínico. Con el fin de contribuir al esclarecimiento del rol de las verbalizaciones en forma de regla, proponemos un análisis funcional de este tipo de verbalizaciones a lo largo del proceso clínico. En este estudio se analizaron las verbalizaciones en forma de regla emitidas por 9 terapeutas a lo largo de 19 casos clínicos (92 sesiones). Las verbalizaciones se codificaron de acuerdo a un Sistema de Categorización de las Reglas del Terapeuta (SISC-REGLAS-T). Los resultados mostraron diferencias entre el tipo de verbalizaciones en forma de regla y el objetivo que el terapeuta persigue alcanzar en los distintos momentos de la terapia. Estos resultados pueden ayudar a comprender cómo el terapeuta utiliza las verbalizaciones en forma de reglas, lo que contribuye al esclarecimiento del papel funcional de las reglas que emite el terapeuta para conseguir el cambio clínico.
Keywords
rules, verbalization, therapeutic process, clinical change, therapistreglas, verbalizaciones, proceso terapéutico, cambio clínico, terapeuta
References
Abreu, P. R., Costa Hübner, M. M., & Lucchese, F. (2012). The role of shaping the client’s interpretations in functional analytic psychotherapy. The Analysis of Verbal Behavior, 28(1), 151-157. Recuperado de https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3363406/
Bakeman, R., Quera, V., McArthur, D., & Robinson, B. F. (1997). Detecting sequential patterns and determining their reliability with fallible observers. Psychological Methods, 2(4), 357-370. Recuperado de http://www.ub.edu/gcai/docs/bakeman-quera-97.pdf
Bernaldo-de-Quirós, M., Labrador, F. J., Estupiñá, F. J., & Fernández-Arias, I. (2013). La duración de los tratamientos psicológicos: diferencias entre los casos de corta, media y larga duración. Universitas Psychologica, 12(1), 21-30. Recuperado de http://www.scielo.org.co/pdf/rups/v12n1/v12n1a03.pdf
Baruch, D. E., Kanter, J. W., Busch, A. M., Richardson, J. V., & Barnes-Holmes, D. (2007). The differential effect of instructions on dysphoric and nondysphoric persons. The Psychological Record, 57(4), 543-554. Recuperado de https://contextualscience.org/Baruch_2007
Callaghan, G.M., Summers, C.J., & Weidman, M. (2003). The treatment of histrionic and narcissistic personality disorder behaviors: A singlesubject demonstration of clinical effectiveness using Functional Analytic Psychotherapy. Journal of Contemporary Psychotherapy, 33(4), 321-339. http://dx.doi.org/10.1023/B:JOCP.0000004502.55597.81
Connolly, M. B., Crits-Christoph, P., Shappell, S., Barber, J. P., & Luborsky, L. (1998). Therapist interventions in early sessions of brief supportive-expressive psychotherapy for depression. The Journal of psychotherapy practice and research, 7(4), 290-300. Recuperado de https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3330510/
Cuper, P., Merwin, R., & Lynch, T. (2007). Personality disorders. In P. Sturmey (Ed.), Functional analysis in clinical treatment (pp. 403-427). San Diego, CA, US: Elsevier Academic Press. http://dx.doi.org/10.1016/B978-012372544-8/50021-5
Elliott, R., Hill, C. E., Stiles, W. B., Friedlander, M. L., Mahrer, A. R., & Margison, F. R. (1987). Primary therapist response modes: Comparison of six rating systems. Journal of Consulting and Clinical Psychology, 55(2), 218-223. Recuperado de http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=1987-28771-001
Froján-Parga, M. X., Ruiz-Sancho, E. M., & Calero-Elvira, A. (2014). A theoretical and methodological proposal for the descriptive assessment of therapeutic interactions. PsychotherapyResearch, (ahead-of-print), 1-22. http://dx.doi.org/10.1080/10503307.2014.935518
Guinther, P. M., & Dougher, M. J. (2013). From behavioral research to clinical therapy. En G. Madden, W. V. Dube, T. D. Hackenberg, G. P. Hanley & K. A. Lattal. (Eds.), APA handbook of behavior analysis, Vol. 2: Translating principles into practice (pp. 3-32). Washington, DC, US: American Psychological Association. http://dx.doi.org/10.1037/13938-001
Gumz, A., Lucklum, J., Herrmann, A., Geyer, M., & Brähler, E. (2011). Verbal expression of emotions in the stage-wise progress of a case of long-term psychodynamic therapy. Counselling and Psychotherapy Research, 11(1), 67-77. http://dx.doi.org/10.1080/14733145.2011.546208
Hayes, S. C., Barnes-Holmes, D., & Roche, B. (2001). Relational frame theory: A post-Skinnerian account of human language and cognition. New York: Plenum Press. Recuperado de http://espaciovirtualctd.weebly.com/uploads/3/0/7/7/30779661/rft.pdf
Hayes, S. F., Zettle, D., R., & Rosenfarb, I. (1989). Rule-following. In S. F. Hayes (Ed.), Rule Governed Behavior: Cognition, Contingencies and Instructional Control (pp. 191-220). Nueva York: Plenum Press.
Hill, C. E. (1978). The development of a system for classifying counselor responses. Journal of Counseling Psychology, 25, 461-468.
Hung, L. (2006). The use of verbal response tokens in psychotherapy. Dessertation Abstracts International: Section B: The Sciences and Engineering, 66(9-B), 5090.
Kanter, J. W., Cautilli, J. D., Busch, A. M., & Baruch, D. E. (2011). Toward a comprehensive functional analysis of depressive behavior: five environmental factors and possible sixth and seventh. The International Journal of Behavioral Consultation and Therapy, 7(1), 5-14. Recuperado de http://files.eric.ed.gov/fulltext/EJ959658.pdf
Kensche, M., & Schweiger, U. (2015). Relational Frame Theory-A Theoretical Framework for Contextual Behavioral Science. Psychotherapie, Psychosomatik, Medicinische Psychologie, 65(7), 273-84. http://dx.doi.org/10.1055/s-0034-1399897 .
Kohlenberg, R. J., & Tsai, M. (1991). Functional analytic psychotherapy: Creating intense and curative therapeutic relationships. Nueva York: Plenum Press.
López, C. A., Muñoz, A., & Ballesteros, B. P. (2005). Cambio del contexto social-verbal desde la teoría de marcos relacionales en mujeres en riesgo de problemas alimentarios. Revista Latinoamericana de Psicología, 37(2), 359-378. Recuperado de http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S0120-05342005000200009
Martínez, H., & Tamayo, R. (2005). Interactions of contingencies, instructional accuracy, and instructional history in conditional discrimination. The Psychological Record, 55, 633-646. Recuperado de http://opensiuc.lib.siu.edu/cgi/viewcontent.cgi?article=1205&context=tpr
Merwin, R. M., Timko, C. A., Moskovich, A. A., Ingle, K. K., Bulik, C. M., & Zucker, N. L. (2010). Psychological inflexibility and symptom expression in Anorexia Nervosa. The Journal of Treatment & Prevention, 19(1), 62-82. http://dx.doi.org/10.1080/10640266.2011.533606
Palmer, D. C. (2012). The Role of Atomic Repertoires in Complex Behavior. The Behavior Analyst, 35(1), 59-73. Recuperado de https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3359856/
Parga, M. X. F., Cebrián, R. P., de la Cruz, I. V., & Carmona, F. L. (2011). Análisis de las reglas en el contexto clínico. EduPsykhé: Revista de psicología y psicopedagogía, 10(1), 135-154. https://dialnet.unirioja.es/servlet/articulo?codigo=3749683
Plaud, J. J., & Newberry, D. E. (1996). Rule-governed behavior and pedophilia. Sexual Abuse: Journal of Research and Treatment, 8(2), 143-159. http://dx.doi.org/10.1007/BF02258007
Plaud, J. J., & Plaud, D. (1998). Clinical Behavior Therapy and the experimental analysis of behavior. Journal of Clinical Psychology, 54(7), 905-921. http://dx.doi.org/10.1002/(SICI)1097-4679(199811)54:7<905::AID-JCLP5>3.0.CO;2-D
Ruiz-Sancho, E. M., Froján-Parga, M. X., & Calero-Elvira, A. (2013). Análisis de la conducta verbal del cliente durante el proceso terapéutico. Anales de Psicología, 29(3), 779-790. http://dx.doi.org/10.6018/analesps.29.3.135401
Schlinger, H. D. (1990). A reply to behavior analysts writing about rules and rule-governed behavior. The Analysis of Verbal Behavior, 8, 77-82. Recuperado de https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2748605/
Skinner, B. F. (1957). Conducta Verbal. México: Trillas. Recuperado de http://www.conductitlan.org.mx/02_bfskinner/skinner/3.%20b_f_skinner_conducta_verbal.pdf
Skinner, B. F. (1966). An operant analysis of problem solving. En B. Kleinmuntz (Ed.), Problem solving: research, metho and theory (pp.225-257). Nueva York: John Wiley y Sons.
Stiles, W. B. (1992). Describing talk: A taxonomy of verbal response modes. Newbury Park: Sage Publications.
Stiles, W. B., & Shapiro, D. A. (1995). Verbal exchange structure of brief psychodynamic-interpersonal and cognitive-behavioral psychotherapy. Journal of Consulting and Clinical Psychology, 63(1), 15-27. http://dx.doi.org/10.1037/0022-006X.63.1.15
Sturmey, P., Ward-Horner, J., Marroquin, M., & Doran, E. (2007). Advanced concepts and methods of intervention in behavioral approaches to psychopathology. En P. Sturmey (Ed.), Functional analysis in clinical treatment (51-64). San Diego: Academic Press. http://dx.doi.org/10.1016/B978-012372544-8/50004-5
Törneke, N., Luciano, C., & Valdivia, S. (2008). Rule-governed behavior and psychological problems. International Journal of Psychology and Psychological Therapy, 8(2), 141-156. Recuperado de http://www.ijpsy.com/volumen8/num2/191/rule-governed-behavior-and-psychological-EN.pdf
Tryon, G. S. (2003). A therapist's use of verbal response categories in engagement and nonengagement interviews. Counselling Psychology Quarterly, 16(1), 29-36. http://dx.doi.org/10.1080/0951507021000050168
Vargas de la Cruz, I., & Pardo Cebrian, R. (2014). El papel de la experiencia del cliente en la aplicación de reglas en el contexto clínico. Conductual, 2(3), 36-51. Recuperado de http://www.conductual.com/sites/default/files/pdf-articles/El%20papel%20de%20la%20experiencia%20del%20terapeuta%20en%20la%20aplicaci%C3%B3n%20de%20reglas%20en%20el%20contexto%20cl%C3%ADnico_Vargas%20y%20Pardo.pdf
Zamignani, D., & Meyer, B. (2011). Therapist verbal behavior in the multidimensional system for coding behaviors in therapeutic interaction (SiMCCIT). Revista Perspectivas, 2(01), 25-45. Recuperado de http://pepsic.bvsalud.org/pdf/pac/v2n1/en_v2n1a04.pdf
Zettle, R. D., & Hayes, S. C. (1983). Effect of social context on the impact of coping self- statements. Psychological Reports, 52, 391-401. Recuperado de https://contextualscience.org/zettle_hayes_1983
Bakeman, R., Quera, V., McArthur, D., & Robinson, B. F. (1997). Detecting sequential patterns and determining their reliability with fallible observers. Psychological Methods, 2(4), 357-370. Recuperado de http://www.ub.edu/gcai/docs/bakeman-quera-97.pdf
Bernaldo-de-Quirós, M., Labrador, F. J., Estupiñá, F. J., & Fernández-Arias, I. (2013). La duración de los tratamientos psicológicos: diferencias entre los casos de corta, media y larga duración. Universitas Psychologica, 12(1), 21-30. Recuperado de http://www.scielo.org.co/pdf/rups/v12n1/v12n1a03.pdf
Baruch, D. E., Kanter, J. W., Busch, A. M., Richardson, J. V., & Barnes-Holmes, D. (2007). The differential effect of instructions on dysphoric and nondysphoric persons. The Psychological Record, 57(4), 543-554. Recuperado de https://contextualscience.org/Baruch_2007
Callaghan, G.M., Summers, C.J., & Weidman, M. (2003). The treatment of histrionic and narcissistic personality disorder behaviors: A singlesubject demonstration of clinical effectiveness using Functional Analytic Psychotherapy. Journal of Contemporary Psychotherapy, 33(4), 321-339. http://dx.doi.org/10.1023/B:JOCP.0000004502.55597.81
Connolly, M. B., Crits-Christoph, P., Shappell, S., Barber, J. P., & Luborsky, L. (1998). Therapist interventions in early sessions of brief supportive-expressive psychotherapy for depression. The Journal of psychotherapy practice and research, 7(4), 290-300. Recuperado de https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3330510/
Cuper, P., Merwin, R., & Lynch, T. (2007). Personality disorders. In P. Sturmey (Ed.), Functional analysis in clinical treatment (pp. 403-427). San Diego, CA, US: Elsevier Academic Press. http://dx.doi.org/10.1016/B978-012372544-8/50021-5
Elliott, R., Hill, C. E., Stiles, W. B., Friedlander, M. L., Mahrer, A. R., & Margison, F. R. (1987). Primary therapist response modes: Comparison of six rating systems. Journal of Consulting and Clinical Psychology, 55(2), 218-223. Recuperado de http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=1987-28771-001
Froján-Parga, M. X., Ruiz-Sancho, E. M., & Calero-Elvira, A. (2014). A theoretical and methodological proposal for the descriptive assessment of therapeutic interactions. PsychotherapyResearch, (ahead-of-print), 1-22. http://dx.doi.org/10.1080/10503307.2014.935518
Guinther, P. M., & Dougher, M. J. (2013). From behavioral research to clinical therapy. En G. Madden, W. V. Dube, T. D. Hackenberg, G. P. Hanley & K. A. Lattal. (Eds.), APA handbook of behavior analysis, Vol. 2: Translating principles into practice (pp. 3-32). Washington, DC, US: American Psychological Association. http://dx.doi.org/10.1037/13938-001
Gumz, A., Lucklum, J., Herrmann, A., Geyer, M., & Brähler, E. (2011). Verbal expression of emotions in the stage-wise progress of a case of long-term psychodynamic therapy. Counselling and Psychotherapy Research, 11(1), 67-77. http://dx.doi.org/10.1080/14733145.2011.546208
Hayes, S. C., Barnes-Holmes, D., & Roche, B. (2001). Relational frame theory: A post-Skinnerian account of human language and cognition. New York: Plenum Press. Recuperado de http://espaciovirtualctd.weebly.com/uploads/3/0/7/7/30779661/rft.pdf
Hayes, S. F., Zettle, D., R., & Rosenfarb, I. (1989). Rule-following. In S. F. Hayes (Ed.), Rule Governed Behavior: Cognition, Contingencies and Instructional Control (pp. 191-220). Nueva York: Plenum Press.
Hill, C. E. (1978). The development of a system for classifying counselor responses. Journal of Counseling Psychology, 25, 461-468.
Hung, L. (2006). The use of verbal response tokens in psychotherapy. Dessertation Abstracts International: Section B: The Sciences and Engineering, 66(9-B), 5090.
Kanter, J. W., Cautilli, J. D., Busch, A. M., & Baruch, D. E. (2011). Toward a comprehensive functional analysis of depressive behavior: five environmental factors and possible sixth and seventh. The International Journal of Behavioral Consultation and Therapy, 7(1), 5-14. Recuperado de http://files.eric.ed.gov/fulltext/EJ959658.pdf
Kensche, M., & Schweiger, U. (2015). Relational Frame Theory-A Theoretical Framework for Contextual Behavioral Science. Psychotherapie, Psychosomatik, Medicinische Psychologie, 65(7), 273-84. http://dx.doi.org/10.1055/s-0034-1399897 .
Kohlenberg, R. J., & Tsai, M. (1991). Functional analytic psychotherapy: Creating intense and curative therapeutic relationships. Nueva York: Plenum Press.
López, C. A., Muñoz, A., & Ballesteros, B. P. (2005). Cambio del contexto social-verbal desde la teoría de marcos relacionales en mujeres en riesgo de problemas alimentarios. Revista Latinoamericana de Psicología, 37(2), 359-378. Recuperado de http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S0120-05342005000200009
Martínez, H., & Tamayo, R. (2005). Interactions of contingencies, instructional accuracy, and instructional history in conditional discrimination. The Psychological Record, 55, 633-646. Recuperado de http://opensiuc.lib.siu.edu/cgi/viewcontent.cgi?article=1205&context=tpr
Merwin, R. M., Timko, C. A., Moskovich, A. A., Ingle, K. K., Bulik, C. M., & Zucker, N. L. (2010). Psychological inflexibility and symptom expression in Anorexia Nervosa. The Journal of Treatment & Prevention, 19(1), 62-82. http://dx.doi.org/10.1080/10640266.2011.533606
Palmer, D. C. (2012). The Role of Atomic Repertoires in Complex Behavior. The Behavior Analyst, 35(1), 59-73. Recuperado de https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3359856/
Parga, M. X. F., Cebrián, R. P., de la Cruz, I. V., & Carmona, F. L. (2011). Análisis de las reglas en el contexto clínico. EduPsykhé: Revista de psicología y psicopedagogía, 10(1), 135-154. https://dialnet.unirioja.es/servlet/articulo?codigo=3749683
Plaud, J. J., & Newberry, D. E. (1996). Rule-governed behavior and pedophilia. Sexual Abuse: Journal of Research and Treatment, 8(2), 143-159. http://dx.doi.org/10.1007/BF02258007
Plaud, J. J., & Plaud, D. (1998). Clinical Behavior Therapy and the experimental analysis of behavior. Journal of Clinical Psychology, 54(7), 905-921. http://dx.doi.org/10.1002/(SICI)1097-4679(199811)54:7<905::AID-JCLP5>3.0.CO;2-D
Ruiz-Sancho, E. M., Froján-Parga, M. X., & Calero-Elvira, A. (2013). Análisis de la conducta verbal del cliente durante el proceso terapéutico. Anales de Psicología, 29(3), 779-790. http://dx.doi.org/10.6018/analesps.29.3.135401
Schlinger, H. D. (1990). A reply to behavior analysts writing about rules and rule-governed behavior. The Analysis of Verbal Behavior, 8, 77-82. Recuperado de https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2748605/
Skinner, B. F. (1957). Conducta Verbal. México: Trillas. Recuperado de http://www.conductitlan.org.mx/02_bfskinner/skinner/3.%20b_f_skinner_conducta_verbal.pdf
Skinner, B. F. (1966). An operant analysis of problem solving. En B. Kleinmuntz (Ed.), Problem solving: research, metho and theory (pp.225-257). Nueva York: John Wiley y Sons.
Stiles, W. B. (1992). Describing talk: A taxonomy of verbal response modes. Newbury Park: Sage Publications.
Stiles, W. B., & Shapiro, D. A. (1995). Verbal exchange structure of brief psychodynamic-interpersonal and cognitive-behavioral psychotherapy. Journal of Consulting and Clinical Psychology, 63(1), 15-27. http://dx.doi.org/10.1037/0022-006X.63.1.15
Sturmey, P., Ward-Horner, J., Marroquin, M., & Doran, E. (2007). Advanced concepts and methods of intervention in behavioral approaches to psychopathology. En P. Sturmey (Ed.), Functional analysis in clinical treatment (51-64). San Diego: Academic Press. http://dx.doi.org/10.1016/B978-012372544-8/50004-5
Törneke, N., Luciano, C., & Valdivia, S. (2008). Rule-governed behavior and psychological problems. International Journal of Psychology and Psychological Therapy, 8(2), 141-156. Recuperado de http://www.ijpsy.com/volumen8/num2/191/rule-governed-behavior-and-psychological-EN.pdf
Tryon, G. S. (2003). A therapist's use of verbal response categories in engagement and nonengagement interviews. Counselling Psychology Quarterly, 16(1), 29-36. http://dx.doi.org/10.1080/0951507021000050168
Vargas de la Cruz, I., & Pardo Cebrian, R. (2014). El papel de la experiencia del cliente en la aplicación de reglas en el contexto clínico. Conductual, 2(3), 36-51. Recuperado de http://www.conductual.com/sites/default/files/pdf-articles/El%20papel%20de%20la%20experiencia%20del%20terapeuta%20en%20la%20aplicaci%C3%B3n%20de%20reglas%20en%20el%20contexto%20cl%C3%ADnico_Vargas%20y%20Pardo.pdf
Zamignani, D., & Meyer, B. (2011). Therapist verbal behavior in the multidimensional system for coding behaviors in therapeutic interaction (SiMCCIT). Revista Perspectivas, 2(01), 25-45. Recuperado de http://pepsic.bvsalud.org/pdf/pac/v2n1/en_v2n1a04.pdf
Zettle, R. D., & Hayes, S. C. (1983). Effect of social context on the impact of coping self- statements. Psychological Reports, 52, 391-401. Recuperado de https://contextualscience.org/zettle_hayes_1983
Cómo citar
Vargas de la Cruz, I., Pardo Cebrian, R., Martínez, H., & Froján Parga, M. X. (2017). Las verbalizaciones tipo regla del terapeuta a lo largo del proceso clínico. Universitas Psychologica, 16(1). https://doi.org/10.11144/Javeriana.upsy16-1.vtrt
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