Mentalization adherence and therapeutic alliance in prediction of therapeutic improvement in child psychodynamic therapy during pandemic
Küçük Resim Yok
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İstanbul Bilgi Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
COVID-19 pandemisi, birçok etkisi olan ve psikoterapötik çalışmalarda ve çerçevelerde değişikliklere yol açan travmatik bir yaşam olayı olarak tanımlanabilir. Ancak, terapistler hızlı bir şekilde yeni koşullara uyum sağlamaya çalıştılar ve çevrimiçi platformlarda psikoterapiler yürüttüler. Bu çalışma, pandemi sırasında gerçekleşen çocuk psikoterapisinde terapötik iyileşmeye yol açan faktörleri araştırmak açısından incelemeyi amaçlamıştır. Önceki araştırmalar zihinselleştirme ve terapötik ittifakın terapötik değişimle ilişkili ortak faktörler olduğunu göstermiştir. Bu nedenle, mevcut çalışmada psikodinamik çocuk psikoterapisinde zihinselleştirme uyumu (terapistlerin dikkat kontrolü, duygu düzenleme ve açık sözel zihinselleştirme müdahaleleri olarak kavramsallaştırılır), terapötik ittifak (çocuk ve terapist arasındaki terapötik ilişki olarak tanımlanır) ve terapötik iyileştirme incelenmiştir. Pandemi döneminde psikoterapi hizmetine başvuran 39 çocukla yapılan oturumlar incelenmiştir. Daha spesifik olarak, bu çalışma zihinselleştirme temelli uyumun ve terapötik ittifakın terapötik değişimi öngörüp öngörmediğini ve zihinselleştirme temelli uyumun terapötik ittifakı nasıl öngördüğünü incelemeyi amaçlamıştır. Bu çocukların tedavinin farklı aşamalarından 130 seansı, terapistlerin zihinselleştirme uyumu için Zihinselleştirmeye Dayalı Çocuk Uyum Ölçeği (MBT-CAS) ile, 129 seansı ise terapötik ittifakın kalitesini ölçmek için Gözleme Dayalı Terapötik İttifak Ölçeği (GDTİÖ) ile kodlanmıştır. Ek olarak, çocukların problem düzeylerini değerlendirmek için Tedavi süresince Çocukların Davranış Değerlendirme Ölçeği (ÇDDÖ) ve Kısa Problem İzleme - Ebeveyn (BPM-P) düzenli olarak toplanmıştır. Çok Düzeyli Model Analizleri, dikkat kontrolünün tedavi süresince çocukların problem düzeylerini negatif yönde yordadığını göstermiştir. Ek olarak, duygu düzenleme terapötik ittifakı pozitif olarak yordarken, açık sözel zihinselleştirme terapötik ittifakı negatif olarak yordamıştır. Genel olarak, çalışma, özellikle pandemi gibi travmatik bir dönemde, terapötik değişim ve terapötik ittifak üzerindeki belirli zihinselleştirme temelli müdahalelerin etkinliğini göstererek literatüre katkıda bulunmuştur.
The COVID-19 pandemic was a traumatic life event that had numerous effects and it also led to changes in psychotherapy processes and therapeutic frame. However, the therapists quickly tried to adapt to the new conditions and conducted psychotherapies with online platforms. The present study aimed to examine child psychotherapy that took place during the pandemic and to investigate the factors related to therapeutic improvement. Previous research indicated that mentalization and therapeutic alliance are common factors associated with therapeutic change. Therefore, in the current study, mentalization adherence (conceptualized as attention control, emotion regulation, and explicit mentalization interventions of the therapists), therapeutic alliance (defined as the therapeutic relationship between child and therapist), and therapeutic improvement were examined in psychodynamic child psychotherapy sessions conducted with 39 children who applied for services during the pandemic. More specifically, the present study aimed to examine whether mentalization adherence and therapeutic alliance predicted therapeutic change and the relations between mentalization adherence and therapeutic alliance. 130 sessions of these children from different phases of treatment were coded with the Mentalization-Based Therapy for Children Adherence Scale (MBT-CAS) for mentalization adherence of the therapists, and 129 sessions were coded with Therapy Process Observational Coding System-Alliance (TPOCS-A) to measure the quality of the therapeutic alliance. Additionally, the Children's Behavior Checklist (CBCL) and Brief Problem Monitor-Parent (BPM-P) were regularly collected over the course of treatment in order to assess the problem levels of the children. Multilevel Model Analyses revealed that attention control negatively predicted problem levels of the children over the course of treatment. Additionally, emotion regulation positively predicted therapeutic alliance whereas, explicit mentalization negatively predicted the therapeutic alliance. Overall, the study contributed to the literature by demonstrating the effectiveness of specific mentalization-based interventions on therapeutic change and therapeutic alliance, particularly during a traumatic moment such as a pandemic.
The COVID-19 pandemic was a traumatic life event that had numerous effects and it also led to changes in psychotherapy processes and therapeutic frame. However, the therapists quickly tried to adapt to the new conditions and conducted psychotherapies with online platforms. The present study aimed to examine child psychotherapy that took place during the pandemic and to investigate the factors related to therapeutic improvement. Previous research indicated that mentalization and therapeutic alliance are common factors associated with therapeutic change. Therefore, in the current study, mentalization adherence (conceptualized as attention control, emotion regulation, and explicit mentalization interventions of the therapists), therapeutic alliance (defined as the therapeutic relationship between child and therapist), and therapeutic improvement were examined in psychodynamic child psychotherapy sessions conducted with 39 children who applied for services during the pandemic. More specifically, the present study aimed to examine whether mentalization adherence and therapeutic alliance predicted therapeutic change and the relations between mentalization adherence and therapeutic alliance. 130 sessions of these children from different phases of treatment were coded with the Mentalization-Based Therapy for Children Adherence Scale (MBT-CAS) for mentalization adherence of the therapists, and 129 sessions were coded with Therapy Process Observational Coding System-Alliance (TPOCS-A) to measure the quality of the therapeutic alliance. Additionally, the Children's Behavior Checklist (CBCL) and Brief Problem Monitor-Parent (BPM-P) were regularly collected over the course of treatment in order to assess the problem levels of the children. Multilevel Model Analyses revealed that attention control negatively predicted problem levels of the children over the course of treatment. Additionally, emotion regulation positively predicted therapeutic alliance whereas, explicit mentalization negatively predicted the therapeutic alliance. Overall, the study contributed to the literature by demonstrating the effectiveness of specific mentalization-based interventions on therapeutic change and therapeutic alliance, particularly during a traumatic moment such as a pandemic.
Açıklama
Lisansüstü Programlar Enstitüsü, Klinik Psikoloji Ana Bilim Dalı, Klinik Psikoloji Bilim Dalı
Anahtar Kelimeler
Psikoloji, Psychology
