Resumen de Relações entre uma supervisão em Psicoterapia Analítica Funcional e as respostas de uma terapeuta e sua cliente em sessão

Alisson Ferreira Lepienski, Jocelaine Silveira

• português

  O objetivo do presente estudo é avaliar relações entre a supervisão em Psicoterapia Analítico Funcional (FAP) e respostas de uma díade terapeuta-cliente em sessão. Analisam-se 12 sessões de psicoterapia com a Functional Analytic Psychotherapy Rating Scale (FAPRS) e os Códigos de Comportamentos Relevantes do Terapeuta (criados para a pesquisa). Categorizam-se oito sessões de supervisão com uma versão modificada da FAPRS. Calculam-se a Frequência Relativa (Fr) dos códigos e a correlação de Spearman entre elas. Após o início da supervisão, a terapeuta diminui a Fr de respostas inadequadas em sessão (T1), e aumenta a de adequadas (T2) e aderência à FAP. A cliente emite mais Comportamentos Clinicamente Relevantes (CRBs 1 e 2), relatos sobre dificuldades (O1) e progressos (O2) no cotidiano. Na supervisão, a terapeuta demonstra maior frequência de comportamentos adequados (TRB2) do que inadequados (TRB1s). Não são encontradas correlações entre TRB1 e T1, TRB2 e T2, e entre a resposta do supervisor a TRBs e T1 ou T2. A supervisão em FAP apresenta correlação negativa com a perda de respostas a CRBs (M) e T1. A Supervisão Não-FAP apresenta correlações positivas com Respostas a O1s e T2. Os dados corroboram parcialmente a literatura sobre supervisão em FAP.

• English

  The aim of the study is to assess the relationship between Functional Analytic Psychotherapy (FAP) Supervision and client-therapist`s within-session responses. Twelve sessions were examined by using the Functional Analytic Psychotherapy Rating Scale (FAPRS) and the Therapist’s Relevant Behavioral Codes (CCRT, an instrument created for the study). Eight supervision meetings were coded by using a FAPRS adapted version (SFAPRS). Codes’ relative frequencies (RF) were calculated for each session. Then, FAP-specific codes were summed to identify those interactions in which therapist did or did not used FAP strategies. Relative frequency of FAP specific and non-specific interventions during supervision meetings were summed independently. The effects of supervision on therapist’s responses in subsequent sessions were assessed by visual inspection of graphics and by Spearman’s Correlation (ρ), considering code’s relative frequency (CCRT, SFAPRS, and FAPRS). Correlations greater than 0.15 were assumed as indicative of significance. FAP interventions within supervision meetings showed relation with therapist’s inadequate responses (CCRT-T1) decrease, therapist`s adequate responses (CCRT-T2) increase and FAP adherence increase. In addition, FAP interventions within supervision meetings showed relations with increased client’s Clinical Relevant Behaviors (CRB) and with increased reports about daily life behaviors. Within supervision meetings, therapist showed larger RF of adequate responses than inadequate responses. The method didn`t allow measuring supervision’s specific effect on therapy progress. There wasn’t significant correlation between therapist’s adequate or inadequate relevant behavior during supervision meetings and therapist`s in-session behavior as measured by CCRT. Supervisor’s response to therapist’s in-session relevant behaviors had no correlation with T1 (ρ = -0,40, p = 0,33) or T2 (ρ = -0,16, p = 0,72). Therapist’s report about her within session progress and within supervision meetings relevant behavior (TRB2) had negative correlation with missing opportunities to respond to client`s behavior (ρ = 0,73, p = 0,04; ρ =-0,64, p=0,08, respectively). FAP Supervision’s RF presented negative correlation with therapist’s inadequate response to CRBs (M, ρ = -0.5952, p = 0,12) and T1s (ρ = -0.6905, p = 0.058). This suggests that general FAP supervision reduced therapist`s inadequate responses.

  There was no correlation between FAP supervision and FAP adherence (ρ = 0,37, p = 0,37). Non- FAP supervision had positive correlations with Therapist’s Responses to client’s report of daily life behavior problems (RO1, ρ = 0.6667, p = 0.07) and T2 (ρ = 0.8095, p = 0.01), and negative correlations with Therapist’s Positive Session Progression (TPR, ρ = -0.7381, p = 0.04). Non- FAP supervision seemed to hold relation with therapist`s adequate responses increase and with therapist`s inadequate responses decrease. In sum, present data suggests that FAP interventions within supervision may be important to reduce therapist’s problem behaviors, however, it seems not enough to promote therapist’s within-session adequate behavior. Further studies may be performed to investigate different client-therapist dyads and to isolate FAP supervision interventions as independent variable.