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Envolvimento de crianças num programa grupal de terapia cognitivo-comportamental para perturbações emocionais – Caracterização e correlatos do envolvimento
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Enquadramento: As perturbações de ansiedade e as perturbações depressivas apresentam a maior prevalência a nível mundial entre crianças e jovens. Tendo em conta o impacto destas perturbações no funcionamento das crianças e jovens, torna-se importante o estudo de intervenções e a sua eficácia. As terapias cognitivo-comportamentais são consideradas a primeira linha de intervenção, demonstrando ser eficazes no tratamento de uma variedade de perturbações mentais, incluindo as perturbações de ansiedade. As terapias cognitivo-comportamentais em formato de grupo têm sido igualmente identificadas como eficazes no tratamento de perturbações de internalização. O envolvimento é uma componente bastante relevante em intervenções em formato de grupo, sendo importante perceber como evolui ao longo do tratamento e quais os seus correlatos. As variáveis sociodemográficas, as características clínicas e a motivação para a mudança têm sido analisadas enquanto preditores do envolvimento, embora os estudos sejam ainda escassos.
Objetivo: Este estudo analisou o envolvimento da criança ao longo de um programa terapêutico de grupo dirigido às perturbações emocionais, considerando o envolvimento dentro e fora das sessões. Analisou também os correlatos deste envolvimento, nomeadamente as variáveis sociodemográficas, as características clínicas e a motivação para a mudança.
Método: A amostra é constituída por crianças dos sete aos 12 anos com queixas de ansiedade que participam num programa cognitivo-comportamental grupal dirigido às perturbações emocionais. O envolvimento na sessão foi avaliado, ao longo de várias sessões, através de uma medida observacional, a Child Involvement Rating Scale e o envolvimento fora da sessão foi avaliado através de um indicador relativo à adesão às atividades para casa. Para obter os dados referentes aos correlatos foram recolhidos
dados sociodemográficos, dados de intensidade da sintomatologia, com recurso à Revised Child Anxiety and Depression Scale, e a uma medida de motivação para a mudança.
Resultados: Os resultados deste estudo indicam que não existiram diferenças estatisticamente significativas no envolvimento da criança observado entre o primeiro segmento da intervenção e o segundo segmento. No que concerne ao envolvimento fora das sessões, os resultados apontam para um declínio na adesão às atividades para casa no segundo segmento da intervenção.
No que diz respeito aos correlatos de envolvimento dentro e fora das sessões, não se observaram associações estatisticamente significativas com a idade e a motivação para a mudança. Por sua vez, observaram-se diferenças no envolvimento nas sessões em relação ao sexo da criança: crianças do sexo masculino revelaram-se mais envolvidas nas sessões. Também a intensidade da sintomatologia se revelou negativa e significativamente associada ao envolvimento dentro e fora das sessões, nomeadamente crianças com níveis elevados de ansiedade social e sintomatologia depressiva envolveram-se menos nas sessões e revelaram menor adesão às atividades para casa.
Conclusões: Os resultados deste estudo contribuem para o conhecimento de quais os fatores que devem ser mais trabalhados, de forma a aumentar o envolvimento das crianças e, por conseguinte, obter melhores resultados no tratamento de perturbações emocionais.
Background: Anxiety disorders and depressive disorders are highly prevalent worldwide among children and adolescents. Considering the impact of these disorders on the functioning of children and adolescents, it is vital to study interventions and their effectiveness. Cognitive behavioral therapies are considered the first line of intervention, effectively treating various mental disorders, including anxiety disorders. Cognitive behavioral therapy in a group format has also been identified as effective in treating internalizing disorders. Involvement is a very relevant component in group interventions, and it is essential to understand how it evolves throughout the treatment and what factors are associated with it . Predictors of involvement, such as sociodemographic variables, clinical characteristics and readiness to change, have been analyzed, although studies are still scarce. Objective: This study aimed to analyze the child's involvement throughout a group therapeutic program aimed at emotional disorders, considering involvement inside and outside the sessions. It also aimed to analyze the correlates of this involvement (e.g., sociodemographic variables, clinical characteristics, and readiness to change). Method: The sam ple consist ed of children aged seven to 12 years old with complaints of anxiety who participate in a group cognitive behavioral program for emotional disorders. Engagement in the session was assessed in several sessions using an observational measure, the Child Involvement Rating Scale, and engagement outside the session was assessed using an indicator relating to adherence to home activities. To obtain data regarding correlates, sociodemographic data, and symptom intensity were collected using the Revised Child Anxiety and Depression Scale, and also, a measure of readiness to change. Results: The results indicate no statistically significant differences in child engagement observed between the first segment of the intervention and the second segment. Regarding involvement outside the sessions, the results point to a decline in adherence to home activities in the second segment of the intervention. Regarding the correlates of involvement inside and outside the sessions, no statistically significa nt associations were observed with age and readiness to change. In turn, differences were observed in involvement in the sessions related to the child's sex: male children were more involved in the sessions. The intensity of symptoms was also found to be negatively and significantly associated with involvement inside and outside the sessions specifically, children with high levels of social anxiety and depressive symptoms were less involved in the sessions and showed less adherence to home activities. Conclusions: The results of this study contribute to the knowledge of which factors should be further worked on to increase children's involvement and, therefore, obtain better results in treating emotional disorders.
Background: Anxiety disorders and depressive disorders are highly prevalent worldwide among children and adolescents. Considering the impact of these disorders on the functioning of children and adolescents, it is vital to study interventions and their effectiveness. Cognitive behavioral therapies are considered the first line of intervention, effectively treating various mental disorders, including anxiety disorders. Cognitive behavioral therapy in a group format has also been identified as effective in treating internalizing disorders. Involvement is a very relevant component in group interventions, and it is essential to understand how it evolves throughout the treatment and what factors are associated with it . Predictors of involvement, such as sociodemographic variables, clinical characteristics and readiness to change, have been analyzed, although studies are still scarce. Objective: This study aimed to analyze the child's involvement throughout a group therapeutic program aimed at emotional disorders, considering involvement inside and outside the sessions. It also aimed to analyze the correlates of this involvement (e.g., sociodemographic variables, clinical characteristics, and readiness to change). Method: The sam ple consist ed of children aged seven to 12 years old with complaints of anxiety who participate in a group cognitive behavioral program for emotional disorders. Engagement in the session was assessed in several sessions using an observational measure, the Child Involvement Rating Scale, and engagement outside the session was assessed using an indicator relating to adherence to home activities. To obtain data regarding correlates, sociodemographic data, and symptom intensity were collected using the Revised Child Anxiety and Depression Scale, and also, a measure of readiness to change. Results: The results indicate no statistically significant differences in child engagement observed between the first segment of the intervention and the second segment. Regarding involvement outside the sessions, the results point to a decline in adherence to home activities in the second segment of the intervention. Regarding the correlates of involvement inside and outside the sessions, no statistically significa nt associations were observed with age and readiness to change. In turn, differences were observed in involvement in the sessions related to the child's sex: male children were more involved in the sessions. The intensity of symptoms was also found to be negatively and significantly associated with involvement inside and outside the sessions specifically, children with high levels of social anxiety and depressive symptoms were less involved in the sessions and showed less adherence to home activities. Conclusions: The results of this study contribute to the knowledge of which factors should be further worked on to increase children's involvement and, therefore, obtain better results in treating emotional disorders.
Descrição
Dissertação de mestrado, Psicopatologia do Desenvolvimento da Criança e do Adolescente – Prevenção e Intervenção, 2023, Universidade de Lisboa, Faculdade de Psicologia
Palavras-chave
Ansiedade - Crianças Terapia cognitivo-comportamental Perturbações emocionais Intervenção terapêutica Envolvimento da criança Dissertações de mestrado - 2023