Além das abordagens: tendências na Psicologia Clínica que transcendem barreiras teóricas
DOI:
https://doi.org/10.18046/retf.i11.2684Palavras-chave:
Integración en psicoterapia, Transdiagnóstico, Epistemología compleja, Enfoques teóricos, Revisión.Resumo
El ejercicio de la Psicología Clínica se encuentra en medio de la pluralidad y la diversidad, tanto de prácticas como de teorías. Este artículo presenta el marco en el que transcurre el desarrollo contemporáneo de esta disciplina, enfatizando en que las barreras de
enfoque se han intentado desdibujar casi tan pronto como aparecieron. Por lo anterior, supone un desacierto formar a los estudiantes en la mutua exclusión de los enfoques teóricos (a saber: psicodinámico, conductual, cognitivo, cognitivo-conductual, humanista/existencial, sistémico, etc.). Se brinda una introducción acerca del ‘problema de los enfoques’ y algunas consideraciones acerca de la amenaza de la pseudociencia, para luego realizar una revisión de algunas tendencias que, en el marco de la ciencia, trascienden las barreras teóricas en las que muchas veces son formados los estudiantes de psicología. Se revisan los conceptos de lo transteórico, lo transdiagnóstico, los tratamientos y la práctica basados en la evidencia (EBTs y EBP) y algunos modelos y técnicas que cumplen con éstas características. También se trata brevemente la aplicación de las teorías de la complejidad y de la epistemología compleja a la psicología clínica.
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Referências
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APA Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practice in psychology. American Psychologist, 61, 271–285. http://doi.org/10.1002/jclp.20384
Boswell, J. F. (2017). Psychotherapy Integration: Research, Practice, and Training at the Leading Edge. Journal of Psychotherapy Integration, 27(2), 225–235. http://doi.org/10.1037/int0000055
Brown, J. (2015). Specific techniques vs. Common factors? Psychotherapy integration and its role in ethical practice. American Journal of Psychotherapy, 69(3), 301–316.
Castro, L. (2011). Modelo integrador en psicopatología: un enfoque transdiagnóstico. In V. E. Caballo, I. C. Salazar, & J. A. Carrobles (Eds.), Manual de psicopatología y trastornos psicológicos. Madrid: Ediciones Pirámide.
Chorpita, B. F., Miranda, J., & Bernstein, A. (2011). Creating Public Health Policy: The Dissemination of Evidenced Based Psychological Interventions. In D. H. Barlow (Ed.), The Oxford Handbook of Clinical Psychology (pp. 210–220). New York: Oxford University Press.
Downing, J. N. (2004). Psychotherapy practice in a pluralistic world: Philosophical and moral dilemmas. Journal of Psychotherapy Integration, 14(2), 123–148. http://doi.org/10.1037/1053-0479.14.2.123
Follette, V. M., & Hazlett-Stevens, H. (2016). Mindfulness and acceptance theories. In J. C. Norcross, G. R. VandenBos, & D. K. Freedheim (Eds.), APA handbook of Clinical psychology: Theory and research (Vol. 2, pp. 273–302). American Psychological Association. http://doi.org/10.1037/14773-010
Hayes, S. C. (2016). Acceptance and Commitment Therapy, Relational Frame Theory, and the Third Wave of Behavioral and Cognitive Therapies – Republished Article. Behavior Therapy, 47(6), 869–885. http://doi.org/10.1016/j.beth.2016.11.006
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: The Guilford Press.
Herbert, J. D., Lilienfeld, S. O., Lohr, J. M., Montgomery, R. W., O’Donohue, W. T., Rosen, G. M., & Tolin, D. F. (2000). Science and pseudoscience in the development of eye movement desensitization and reprocessing: Implications for clinical psychology. Clinical Psychology Review, 20(8), 945–971. http://doi.org/10.1016/S0272-7358(99)00017-3
Hofmann, S. G. (2013). Bridging the theory-practice gap by getting even bolder with the boulder model. Behavior Therapy, 44(4), 603–608. http://doi.org/10.1016/j.beth.2013.04.006
Ilardi, S. S., & Feldman, D. (2001). The Cognitive Neuroscience Paradigm: A Unifying Metatheoretical Framework for the Science and Practice of Clinical Psychology. Journal of Clinical Psychology, 57(9), 1067–1088.
Jaramillo, J. C. (2009). Consideraciones identitarias para una psicología fundada en la epistemología compleja. International Journal of Psychological Research, 2(2), 158–166.
Jaramillo, J. C., Escobar, A., & Sandoval, C. (2015). Aproximaciones a una clínica psicológica y su método , fundamentada en la epistemología compleja y adecuada a contextos postmodernos. Revista CES Psicología, 8(1), 134–154.
Johnson, P., & Cassell, C. (2001). Epistemology and work psychology: new agendas. Journal of Occupational and Organizational Psychology, 74(2), 125–143. http://doi.org/10.1348/096317901167280
Kabat-Zinn, J. (2003). Mindfulness-based stress reduction (MBSR). Constructivism in the Human Sciences, 8(2), 73–107. Retrieved from http://lcproxy.shu.ac.uk/login?url=https://search.proquest.com/docview/620535552?accountid=13827%0Ahttp://shulinks.shu.ac.uk/?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&genre=article&sid=ProQ:ProQ%3Apsycinfo&atitle=Mindfulness-based+stre
Katsikis, D. (2014). Evidence-based research: the importance for the present and future of evidence-based practice. Journal of Evidence-Based Psychotherapies, 14(2), 259–270. Retrieved from http://library.gcu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=98776731&site=eds-live&scope=site
Kazdin, A. E. (2008). Evidence-based treatment and practice: New opportunities to bridge clinical research and practice, enhance the knowledge base, and improve patient care. American Psychologist, 63(3), 146–159. http://doi.org/10.1037/0003-066X.63.3.146
Kim, H., & Eaton, N. R. (2015). The hierarchical structure of common mental disorders: Connecting multiple levels of comorbidity, bifactor models, and predictive validity. Journal of Abnormal Psychology, 124(4), 1064–1078. http://doi.org/10.1037/abn0000113
Lilienfeld, S. O., Lynn, S. J., & Lohr, J. M. (2015). Science and Pseudoscience in Clinical Psychology. New York: The Guilford Press.
Lilienfeld, S. O., Ritschel, L. A., Lynn, S. J., Cautin, R. L., & Latzman, R. D. (2013). Why many clinical psychologists are resistant to evidence-based practice: Root causes and constructive remedies. Clinical Psychology Review, 33(7), 883–900. http://doi.org/10.1016/j.cpr.2012.09.008
Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: The Guilford Press.
Linehan, M. M. (2015). DBT Skills Training Manual (Second Edition). New York: The Guilford Press. http://doi.org/10.1093/alcalc/agv004
Maldonado, C. E. (2009). La complejidad es un problema, no una cosmovisión. UCM Revista de Investigación, (13), 42–54.
Maldonado, C. E., & Gómez, N. A. (2010). El mundo de las ciencias de la complejidad. Un estado del arte. Bogotá: Editorial Universidad del Rosario.
Mariñelarena-Dondena, L. (2008). Psicología positiva y modelos integrativos en psicoterapia. Fundamentos En Humanidades, 9(28), 55–69.
Morin, E. (1996). A New Way of Thinking. The Unesco Courier. Secrets of Complexity, 2, 10–14.
Munné, F. (2005). ¿Qué es la complejidad? Encuentros de Psicología Social, 3(2), 6–17.
Norcross, J. C., Goldfried, M. R., & Arigo, D. (2016). Integrative Theories. In J. C. Norcross, G. R. VandenBos, & D. K. Freedheim (Eds.), APA Handbook of Clinical Psychology: Theory and Research (Vol. 2, pp. 303–332). American Psychological Association.
Olatunji, B. O., Parker, L. M., & Lohr, J. M. (2005). Pseudoscience in contemporary psychology: Professional issues and implications. The Scientific Review of Mental Health Practice, 4(2), 19–36. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2008-00021-006&site=ehost-live%5Cnoolatun@mail.uark.edu
Opazo, R. (1997). In the Hurricane’s Eye: A Supraparadigmatic Integrative Model. Journal of Psychotherapy Integration, 7(1), 17–54. http://doi.org/10.1037/h0101136
Paris, J. (2013). How the history of psychotherapy interferes with integration. Journal of Psychotherapy Integration, 23(2), 99–106. http://doi.org/10.1037/a0031419
Ritschel, L. A., Lim, N. E., & Stewart, L. M. (2015). Transdiagnostic applications of DBT for adolescents and adults. American Journal of Psychotherapy, 69(2), 111–128. http://doi.org/http://dx.doi.org/10.1108/17506200710779521
Ruiz, F. (2010). A review of acceptance and commitment therapy (ACT) empirical evidence: Correlation, experimental, psychopathology, component and outcome studies. International Journal of Psychology and Psychological Therapy, 10, 125–162. http://doi.org/10.1080/028457199439937
Sexton, T. L., & Stanton, M. (2016). Systems Theories. In J. C. Norcross, G. R. VandenBos, & D. K. Freedheim (Eds.), APA Handbook of Clinical Psychology: Theory and Research (Vol. 2, pp. 213–239). American Psychological Association. http://doi.org/10.4135/9781412958479
Shapiro, S. L. (2009). The Integration of Mindfulness and Psychology. Journal of Clinical Psychology, 65(6), 555–560. http://doi.org/10.1002/jclp
Siegel, R. D. (2011). La Solución Mindfulness. Prácticas cotidianas para problemas cotidianos. (B. Moreno, Ed.). Bilbao: Desclée De Brouwer, S. A.
Siegel, R. D., Germer, C. K., & Olendzki, A. (2008). Mindfulness: What is it? Where Does It Come From? In F. Didonna (Ed.), Clinical Handbook of Mindfulness (pp. 17–35). New York: Springer. http://doi.org/10.1080/14639947.2011.564813
Simón, V. (2010). Mindfulness y psicología: presente y futuro. Informació Psicològica, 100, 162–170. Retrieved from http://dialnet.unirioja.es/descarga/articulo/3642934.pdf%5Cnhttp://dialnet.unirioja.es/servlet/extart?codigo=3642934
Skinner, B. F. (1971). Beyond Freedom & Dignity. Indianapolis: Hackett Publishing Company.
Stoddard, J. A., & Afari, N. (2014). The Big Book of ACT Metaphors. A practitioner’s Guide to Experiential Exercises & Metaphors in Acceptance & Commitment Therapy. Oakland: New Harbinger Publications.
Tryon, W. W. (2014). Cognitive neuroscience and psychotherapy: Network principles for a unified theory. New York: Academic Press.
Tryon, W. W. (2016a). Psychotherapy Integration via Theoretical Unification. International Journal of Integrative Psychotherapy, 7, 1–26. Retrieved from http://integrative-journal.com/index.php/ijip/article/view/106
Tryon, W. W. (2016b). Transtheoretic transdiagnostic psychotherapy. Journal of Psychotherapy Integration, 26(3), 273–287. http://doi.org/10.1037/a0040041
Wachtel, P. L. (1982). What can dynamic therapies contribute to behavior therapy? Behavior Therapy, 13(5), 594–609.
Wachtel, P. L. (1991). From electicism to synthesis toward a more seamless psychotherapeutic integration. Journal of Psychotherapy Integration, 1(1), 43–54. http://doi.org/1053-0479/91/0300-0043506.500
Wachtel, P. L. (2014). On the limits of theoretical fundamentalism. Journal of Psychotherapy Integration, 24(2), 95–98. http://doi.org/10.1037/a0036973
Wachtel, P. L. (2017). Pathways to Progress for Integrative Psychotherapy: Perspectives on Practice and Research. Journal of Psychotherapy Integration. Advance online publication. http://dx.doi.org/10.1037/int0000089
Wilson, K. G., & Luciano, M. C. (2002). Terapia de Aceptación y Compromiso (ACT). Un tratamiento conductual orientado a los valores. Madrid: Ediciones Pirámide.
Winston, C. N. (2015). Points of Convergence and Divergence Between Existential and Humanistic Psychology: A Few Observations. Humanistic Psychologist, 43(1), 40–53. http://doi.org/10.1080/08873267.2014.993067
Wolf, A. W. (2003). Pragmatism, Pluralism, and Psychotherapy Relationships: An Interview with John C. Norcross, Ph.D. Journal of Contemporary Psychotherapy, 33(2), 129–143. http://doi.org/10.1023/A:1022887205178
Anchin, J. C. (2008). Pursuing a unifying paradigm for psychotherapy: Tasks, dialectical considerations, and biopsychosocial systems metatheory. Journal of Psychotherapy Integration, 18(3), 310–349. http://doi.org/10.1037/a0013557
APA Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practice in psychology. American Psychologist, 61, 271–285. http://doi.org/10.1002/jclp.20384
Boswell, J. F. (2017). Psychotherapy Integration: Research, Practice, and Training at the Leading Edge. Journal of Psychotherapy Integration, 27(2), 225–235. http://doi.org/10.1037/int0000055
Brown, J. (2015). Specific techniques vs. Common factors? Psychotherapy integration and its role in ethical practice. American Journal of Psychotherapy, 69(3), 301–316.
Castro, L. (2011). Modelo integrador en psicopatología: un enfoque transdiagnóstico. In V. E. Caballo, I. C. Salazar, & J. A. Carrobles (Eds.), Manual de psicopatología y trastornos psicológicos. Madrid: Ediciones Pirámide.
Chorpita, B. F., Miranda, J., & Bernstein, A. (2011). Creating Public Health Policy: The Dissemination of Evidenced Based Psychological Interventions. In D. H. Barlow (Ed.), The Oxford Handbook of Clinical Psychology (pp. 210–220). New York: Oxford University Press.
Downing, J. N. (2004). Psychotherapy practice in a pluralistic world: Philosophical and moral dilemmas. Journal of Psychotherapy Integration, 14(2), 123–148. http://doi.org/10.1037/1053-0479.14.2.123
Follette, V. M., & Hazlett-Stevens, H. (2016). Mindfulness and acceptance theories. In J. C. Norcross, G. R. VandenBos, & D. K. Freedheim (Eds.), APA handbook of Clinical psychology: Theory and research (Vol. 2, pp. 273–302). American Psychological Association. http://doi.org/10.1037/14773-010
Hayes, S. C. (2016). Acceptance and Commitment Therapy, Relational Frame Theory, and the Third Wave of Behavioral and Cognitive Therapies – Republished Article. Behavior Therapy, 47(6), 869–885. http://doi.org/10.1016/j.beth.2016.11.006
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: The Guilford Press.
Herbert, J. D., Lilienfeld, S. O., Lohr, J. M., Montgomery, R. W., O’Donohue, W. T., Rosen, G. M., & Tolin, D. F. (2000). Science and pseudoscience in the development of eye movement desensitization and reprocessing: Implications for clinical psychology. Clinical Psychology Review, 20(8), 945–971. http://doi.org/10.1016/S0272-7358(99)00017-3
Hofmann, S. G. (2013). Bridging the theory-practice gap by getting even bolder with the boulder model. Behavior Therapy, 44(4), 603–608. http://doi.org/10.1016/j.beth.2013.04.006
Ilardi, S. S., & Feldman, D. (2001). The Cognitive Neuroscience Paradigm: A Unifying Metatheoretical Framework for the Science and Practice of Clinical Psychology. Journal of Clinical Psychology, 57(9), 1067–1088.
Jaramillo, J. C. (2009). Consideraciones identitarias para una psicología fundada en la epistemología compleja. International Journal of Psychological Research, 2(2), 158–166.
Jaramillo, J. C., Escobar, A., & Sandoval, C. (2015). Aproximaciones a una clínica psicológica y su método , fundamentada en la epistemología compleja y adecuada a contextos postmodernos. Revista CES Psicología, 8(1), 134–154.
Johnson, P., & Cassell, C. (2001). Epistemology and work psychology: new agendas. Journal of Occupational and Organizational Psychology, 74(2), 125–143. http://doi.org/10.1348/096317901167280
Kabat-Zinn, J. (2003). Mindfulness-based stress reduction (MBSR). Constructivism in the Human Sciences, 8(2), 73–107. Retrieved from http://lcproxy.shu.ac.uk/login?url=https://search.proquest.com/docview/620535552?accountid=13827%0Ahttp://shulinks.shu.ac.uk/?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&genre=article&sid=ProQ:ProQ%3Apsycinfo&atitle=Mindfulness-based+stre
Katsikis, D. (2014). Evidence-based research: the importance for the present and future of evidence-based practice. Journal of Evidence-Based Psychotherapies, 14(2), 259–270. Retrieved from http://library.gcu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=98776731&site=eds-live&scope=site
Kazdin, A. E. (2008). Evidence-based treatment and practice: New opportunities to bridge clinical research and practice, enhance the knowledge base, and improve patient care. American Psychologist, 63(3), 146–159. http://doi.org/10.1037/0003-066X.63.3.146
Kim, H., & Eaton, N. R. (2015). The hierarchical structure of common mental disorders: Connecting multiple levels of comorbidity, bifactor models, and predictive validity. Journal of Abnormal Psychology, 124(4), 1064–1078. http://doi.org/10.1037/abn0000113
Lilienfeld, S. O., Lynn, S. J., & Lohr, J. M. (2015). Science and Pseudoscience in Clinical Psychology. New York: The Guilford Press.
Lilienfeld, S. O., Ritschel, L. A., Lynn, S. J., Cautin, R. L., & Latzman, R. D. (2013). Why many clinical psychologists are resistant to evidence-based practice: Root causes and constructive remedies. Clinical Psychology Review, 33(7), 883–900. http://doi.org/10.1016/j.cpr.2012.09.008
Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: The Guilford Press.
Linehan, M. M. (2015). DBT Skills Training Manual (Second Edition). New York: The Guilford Press. http://doi.org/10.1093/alcalc/agv004
Maldonado, C. E. (2009). La complejidad es un problema, no una cosmovisión. UCM Revista de Investigación, (13), 42–54.
Maldonado, C. E., & Gómez, N. A. (2010). El mundo de las ciencias de la complejidad. Un estado del arte. Bogotá: Editorial Universidad del Rosario.
Mariñelarena-Dondena, L. (2008). Psicología positiva y modelos integrativos en psicoterapia. Fundamentos En Humanidades, 9(28), 55–69.
Morin, E. (1996). A New Way of Thinking. The Unesco Courier. Secrets of Complexity, 2, 10–14.
Munné, F. (2005). ¿Qué es la complejidad? Encuentros de Psicología Social, 3(2), 6–17.
Norcross, J. C., Goldfried, M. R., & Arigo, D. (2016). Integrative Theories. In J. C. Norcross, G. R. VandenBos, & D. K. Freedheim (Eds.), APA Handbook of Clinical Psychology: Theory and Research (Vol. 2, pp. 303–332). American Psychological Association.
Olatunji, B. O., Parker, L. M., & Lohr, J. M. (2005). Pseudoscience in contemporary psychology: Professional issues and implications. The Scientific Review of Mental Health Practice, 4(2), 19–36. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2008-00021-006&site=ehost-live%5Cnoolatun@mail.uark.edu
Opazo, R. (1997). In the Hurricane’s Eye: A Supraparadigmatic Integrative Model. Journal of Psychotherapy Integration, 7(1), 17–54. http://doi.org/10.1037/h0101136
Paris, J. (2013). How the history of psychotherapy interferes with integration. Journal of Psychotherapy Integration, 23(2), 99–106. http://doi.org/10.1037/a0031419
Ritschel, L. A., Lim, N. E., & Stewart, L. M. (2015). Transdiagnostic applications of DBT for adolescents and adults. American Journal of Psychotherapy, 69(2), 111–128. http://doi.org/http://dx.doi.org/10.1108/17506200710779521
Ruiz, F. (2010). A review of acceptance and commitment therapy (ACT) empirical evidence: Correlation, experimental, psychopathology, component and outcome studies. International Journal of Psychology and Psychological Therapy, 10, 125–162. http://doi.org/10.1080/028457199439937
Sexton, T. L., & Stanton, M. (2016). Systems Theories. In J. C. Norcross, G. R. VandenBos, & D. K. Freedheim (Eds.), APA Handbook of Clinical Psychology: Theory and Research (Vol. 2, pp. 213–239). American Psychological Association. http://doi.org/10.4135/9781412958479
Shapiro, S. L. (2009). The Integration of Mindfulness and Psychology. Journal of Clinical Psychology, 65(6), 555–560. http://doi.org/10.1002/jclp
Siegel, R. D. (2011). La Solución Mindfulness. Prácticas cotidianas para problemas cotidianos. (B. Moreno, Ed.). Bilbao: Desclée De Brouwer, S. A.
Siegel, R. D., Germer, C. K., & Olendzki, A. (2008). Mindfulness: What is it? Where Does It Come From? In F. Didonna (Ed.), Clinical Handbook of Mindfulness (pp. 17–35). New York: Springer. http://doi.org/10.1080/14639947.2011.564813
Simón, V. (2010). Mindfulness y psicología: presente y futuro. Informació Psicològica, 100, 162–170. Retrieved from http://dialnet.unirioja.es/descarga/articulo/3642934.pdf%5Cnhttp://dialnet.unirioja.es/servlet/extart?codigo=3642934
Skinner, B. F. (1971). Beyond Freedom & Dignity. Indianapolis: Hackett Publishing Company.
Stoddard, J. A., & Afari, N. (2014). The Big Book of ACT Metaphors. A practitioner’s Guide to Experiential Exercises & Metaphors in Acceptance & Commitment Therapy. Oakland: New Harbinger Publications.
Tryon, W. W. (2014). Cognitive neuroscience and psychotherapy: Network principles for a unified theory. New York: Academic Press.
Tryon, W. W. (2016a). Psychotherapy Integration via Theoretical Unification. International Journal of Integrative Psychotherapy, 7, 1–26. Retrieved from http://integrative-journal.com/index.php/ijip/article/view/106
Tryon, W. W. (2016b). Transtheoretic transdiagnostic psychotherapy. Journal of Psychotherapy Integration, 26(3), 273–287. http://doi.org/10.1037/a0040041
Wachtel, P. L. (1982). What can dynamic therapies contribute to behavior therapy? Behavior Therapy, 13(5), 594–609.
Wachtel, P. L. (1991). From electicism to synthesis toward a more seamless psychotherapeutic integration. Journal of Psychotherapy Integration, 1(1), 43–54. http://doi.org/1053-0479/91/0300-0043506.500
Wachtel, P. L. (2014). On the limits of theoretical fundamentalism. Journal of Psychotherapy Integration, 24(2), 95–98. http://doi.org/10.1037/a0036973
Wachtel, P. L. (2017). Pathways to Progress for Integrative Psychotherapy: Perspectives on Practice and Research. Journal of Psychotherapy Integration. Advance online publication. http://dx.doi.org/10.1037/int0000089
Wilson, K. G., & Luciano, M. C. (2002). Terapia de Aceptación y Compromiso (ACT). Un tratamiento conductual orientado a los valores. Madrid: Ediciones Pirámide.
Winston, C. N. (2015). Points of Convergence and Divergence Between Existential and Humanistic Psychology: A Few Observations. Humanistic Psychologist, 43(1), 40–53. http://doi.org/10.1080/08873267.2014.993067
Wolf, A. W. (2003). Pragmatism, Pluralism, and Psychotherapy Relationships: An Interview with John C. Norcross, Ph.D. Journal of Contemporary Psychotherapy, 33(2), 129–143. http://doi.org/10.1023/A:1022887205178
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2018-03-24
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Além das abordagens: tendências na Psicologia Clínica que transcendem barreiras teóricas. (2018). Trans-Pasando Fronteras, (11). https://doi.org/10.18046/retf.i11.2684
