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Co-construindo problemas e soluções num passo de mágica? : o processo de mudança em sessões únicas de terapia
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Este estudo é uma exploração qualitativa do processo de mudança em sessões únicas de terapia situações de terminação do tratamento que ocorrem quando, face aos resultados satisfatórios alcançados, cliente e terapeuta acordam sobre a suficiência do encontro único , particularmente no equacionar da interacção, mediatizada pela comunicação, que se estabelece entre os participantes no decorrer da sessão e das acções comunicativas do terapeuta. Foram analisados os padrões de comunicação de dois casos típicos de sessões únicas, ilustrativos da utilização de duas abordagens de intervenção sistémica, a terapia breve orientada para as soluções e a abordagem da escola de Milão, com recurso a duas ferramentas de análise, o Modelo Comunicacional da Gestão Coordenada de Significações (CMM; Pearce Associates, 1999) e a microanálise da comunicação (Tomori & Bavelas, 2007). Os resultados mostram que o processo terapêutico nas sessões únicas envolve um diálogo colaborativo, permanentemente recursivo e co-construtivo, que se entretece na interacção singular entre terapeuta e cliente/ família. A intervenção das terapeutas durante a sessão foi pautada pela utilização predominante de perguntas, face a um menor número de formulações, uma tendência que se inverteu na conclusão, caracterizada pelo uso apenas de formulações. As questões colocadas foram, em grande parte, orientadoras, embora se denote o recurso a questões reflexivas, sugerindo que as terapeutas não pretenderam somente obter informação sobre a situação dos clientes, mas procuraram, pontualmente, fomentar uma mudança terapêutica. As questões e formulações das terapeutas focadas na solução centraram-se em aspectos positivos, recursos e soluções da cliente, enquanto as da terapeuta sistémica da escola de Milão abordaram sobretudo problemas. As formulações que caracterizaram o final da sessão em ambos os casos focaram as potencialidades dos clientes. Foi realizado um importante trabalho terapêutico com os clientes nos dois casos durante a sessão, que se repercutiu no seu comportamento depois da finalização do encontro único. São discutidas implicações destes resultados para a intervenção terapêutica e limitações do estudo.
This study is a qualitative exploration concerning the changing process in single therapysessions situations relating to the end of treatment that occur when client and therapist agreeabout the need of a single encounter, due to the satisfactory results' achieved mainly inrelationship to the interaction established among participants, based on communicative activities,which takes place during the session, and the therapist communicative actions. Communicationpatterns of two typical cases of single sessions were studied, representative of the use of twosystemic intervention approaches, namely the Solution-Focused Therapy and the Milan Approach, using two analytic tools, The Coordinated Management of Meaning (CMM; Pearce Associates,1999) and Microanalysis of Communication (Tomori & Bavelas, 2007). The results reveal that thetherapeutic process in single sessions implies a collaborative dialogue, constantly recursive andco-constructive, that it is thereby established due to the singular interaction between therapist andclient/ family. Therapists' intervention during the session was ruled by the use of a series ofquestions, and a minor number of formulations, a tendency that was reversed at the end of thesession, characterized by the single use of formulations. The questions asked were mainlyorienting questions, although it is denoted the use of reflexive questions, suggesting that therapistsdo not only intend to search for information about clients' situation but also seek to implement atherapeutic change. The solution focused therapists' questions and formulations center on positiveactions and clients' resources and solutions, while the systemic therapist of Milan Approachfocuses mainly on problems. In both cases, the formulations that took place at the end of thesession focused clients' potential. Thus, it was done an important therapeutic work with bothclients, during the session, which influenced their behavior, after the ending of the singleencounter. Implications of these results for therapeutic intervention and study limitations are muchdiscussed.
This study is a qualitative exploration concerning the changing process in single therapysessions situations relating to the end of treatment that occur when client and therapist agreeabout the need of a single encounter, due to the satisfactory results' achieved mainly inrelationship to the interaction established among participants, based on communicative activities,which takes place during the session, and the therapist communicative actions. Communicationpatterns of two typical cases of single sessions were studied, representative of the use of twosystemic intervention approaches, namely the Solution-Focused Therapy and the Milan Approach, using two analytic tools, The Coordinated Management of Meaning (CMM; Pearce Associates,1999) and Microanalysis of Communication (Tomori & Bavelas, 2007). The results reveal that thetherapeutic process in single sessions implies a collaborative dialogue, constantly recursive andco-constructive, that it is thereby established due to the singular interaction between therapist andclient/ family. Therapists' intervention during the session was ruled by the use of a series ofquestions, and a minor number of formulations, a tendency that was reversed at the end of thesession, characterized by the single use of formulations. The questions asked were mainlyorienting questions, although it is denoted the use of reflexive questions, suggesting that therapistsdo not only intend to search for information about clients' situation but also seek to implement atherapeutic change. The solution focused therapists' questions and formulations center on positiveactions and clients' resources and solutions, while the systemic therapist of Milan Approachfocuses mainly on problems. In both cases, the formulations that took place at the end of thesession focused clients' potential. Thus, it was done an important therapeutic work with bothclients, during the session, which influenced their behavior, after the ending of the singleencounter. Implications of these results for therapeutic intervention and study limitations are muchdiscussed.
Descrição
Tese de Mestrado Integrado em Psicologia (Psicologia Clínica e da Saúde/Núcleo de Psicologia Clínica Sistémica), apresentada à Universidade de Lisboa através da Faculdade de Psicologia e de Ciências da Educação, 2008
Palavras-chave
Psicoterapia Relação terapêutica Teses de mestrado