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- Assessing coping, emotional regulation, and psychosocial perceptions of academic stress in undergraduatesPublication . Teixeira, Ricardo J.; Dores, Artemisa Rocha; Barreto, João Francisco; Sucena, Ana; Martins, Helena; Magalhães, AndreiaLiterature suggests most college students appear to lack the knowledge and skills to effectively cope with stressful academic experiences (Gall, Evans, & Bellrose, 2000). Ineffective coping strategies may increase students’ health problems, demand for health services, and attrition rates (Morrison & O’Connor, 2005). This study aims to examine the associations, and processes between psychosocial variables deemed important in academic transitions.
- Does attachment predict psychotherapists' mentalization with real patients?Publication . Barreto, João Francisco; Saraiva, Luísa; Matos, Paula MenaElaboration of countertransference experience (ECE): implicit and explicit psychological work to which therapists submit experiences with patients (Barreto & Matos, 2016) • Mentalizing process of a particular kind (therapists’ self-oriented mentalizing) through which therapists’ experiences acquire and increase in mental quality (ibd.) • Research addressing psychotherapists’ mentalization is extremely scarce, and very few studies within this field involved real patients as participants • Preliminary findings suggest that therapist mentalization processes benefit therapeutic work (Cologon et al., 2017; Rizq & Target, 2010; Reading, 2013) • Despite established association between the constructs, no studies to our knowledge have yet investigated the impact of attachment on therapist mentalizing processes • Evidence that patients’ attachment dimensions affect therapeutic process (e.g., Diener & Monroe, 2012) • Mixed results concerning the impact of therapist attachment and therapistpatient attachment match on therapy (e.g., Degnan et al., 2016) • Therapist attachment dimensions may impact psychotherapy in interaction with patients variables (Bucci et al., 2015; Schauenburg et al., 2010) • Relational similarity may benefit initial alliance, but dissimilarity may disconfirm transference expectations and facilitate transforming experiences (Bernier & Dozier, 2002; Mallinckrodt et al., 2009)
- Dyadic attachment determinants of session quality in early psychotherapyPublication . Barreto, João Francisco; Matos, Paula MenaIt is sometimes assumed that a counter-complementary stance towards the relational pull exerted by clients plays an important role in the change process (Bernier & Dozier, 2002; Mallinckrodt, 2000). Initial evidence suggests that this can be facilitated by a dissimilar or non-complementary match between relational preferences within the therapeutic dyad and by attachment security in therapists (see Daniel, 2006). In both cases, ‘out of style’/’against type’ responses are more likely to occur, which may help disconfirm clients’ problematic working models of relationships and thus facilitate change (Bowlby, 1988). Presumably, client and therapist attachment dimensions and their combinations will have an effect on session quality (Goodman, 2000). Research in the field is scarce, but tends to support this hypothesis (Bruck et al., 2006; Mohr et al., 2005; Romano et al., 2008). Meanwhile, even less is known concerning the variation of session evaluation over time.
- Inventory of personality organization: Preliminary validation of the European Portuguese versionPublication . Barreto, João Francisco; Matos, Paula MenaPersonality pathology is often organized in two orthogonal axes representing variations in type and severity (Westen et al., 2006). The psychoanalytic model developed by Otto F. Kernberg and colleagues (e.g., Kernberg & Caligor, 2005) is an example of the second trend, consisting of a dimensional approach describing personality organization (PO) in a continuum ranging from normal-neurotic (NPO), through high and low borderline (BPO), to psychotic (PPO) levels. • In this model, borderline-level PO underlies most of the personality disorders considered in the categorical-typological approach held in DSM-IV-TR (APA, 2000). Kernberg’s approach is clinically useful in identifying subthreshold/higher level personality pathology poorly covered by DSM-IV-TR Axis II, and understanding different meanings in common symptoms according to underlying levels of PO (Caligor et al., 2007). • As an effort at operationalization, Kernberg and Clarkin (1995) created the Inventory of Personality Organization (IPO), a self-report questionnaire including 3 primary scales (57 items): Identity Diffusion, Primitive Defenses, and Reality Testing. IPO has been used to investigate the relationship of PO to psychopathology and measure structural change as a psychotherapy outcome (cf. Ellison & Levy, 2011). • IPO has been translated into several languages and latent structure has been tested with clinical and nonclinical population (Berghuis et al., 2008; Iragashi et al., 2009; Lenzenweger et al., 2001; Normandin et al., 2002; Smits et al., 2009), yielding 2- or 3-factor solutions for the 3 primary scales. However, a recent study of the original English-language version conducted with a large nonclinical sample suggests that a 4-factor solution provides a better fit, with factors representing Instability of Self and Others, Instability of Goals, Psychosis, and Instability of Behavior (Ellison & Levy, 2011).
- Lidar com o sofrimento em Fisioterapia: a experiência formativa na ESTSP-IPPPublication . Barreto, João Francisco; Dores, Artemisa RochaA comunicação e a relação terapêutica são reconhecidamente domínios de competência dos profissionais de saúde cujas funções impliquem o contacto com doentes (Corney, 2000; Grilo & Pedro, 2005; Pio Abreu, 1998). Além do seu papel determinante na adesão terapêutica, a qualidade da comunicação e da relação terapêutica estabelecida tem particular impacto no sofrimento da pessoa, tomado como constructo multidimensional (McIntyre, 2004). Tradicionalmente descurados na formação académica, estes temas tendem actualmente a ganhar expressão nos currículos, para o que contribuíram, no espaço europeu, as recomendações para a adequação a Bolonha (Lopes, 2004). Neste trabalho, descrevemos a metodologia de formação adoptada para estes domínios na licenciatura em Fisioterapia da ESTSP-IPP, a funcionar segundo o modelo pedagógico designado Problem-Based Learning (Walsh, 2005; Macedo, 2009). Além dos conhecimentos disseminados ao longo de toda a estrutura curricular, temas como a comunicação (Watzlawick, Bavelas & Jackson, 1967/1993), a escuta activa (Gordon & Edwards, 1997), a relação terapêutica (Rogers, 1957/1992, 1980, 1985), as competências e microcompetências/técnicas de atendimento e de observação (Ivey, 1983; Ivey & Downing, 1990; Ivey, Gluckstern & Ivey, 2006) ou as comunicações difíceis (Faulkner, Maguire & Regnard, 1994; Maguire, 2000) são alvo de formação mais intensiva ao longo de cerca de 16 semanas consecutivas do 1º ciclo de estudos, com recurso a diferentes tipologias de aula visando desenvolver, além dos conhecimentos, atitudes e habilidades nestes domínios.
- A mentalization model for the elaboration of countertransference experiencePublication . Barreto, João Francisco; Matos, Paula MenaImplicit and explicit psychological work to which therapists’ experiences are submitted (in and between sessions) • “something more” than managing CT – recognizing, regulating, and deriving meaning from experience • “something more” than dealing with resistances – elaboration includes both working out/working over (psychische Verarbeitung) and working through (Durcharbeitung) (McDougall, 1985) • therapists’ raw experience acquires (and increases in) mental quality and becomes available for meaning-making and judicious clinical use, involving a close interconnection and integration between implicit-spontaneous and explicit-reflective psychological processes • dialectic, transformative, integrative, contextual, and agency-enhancing process of making “clinically relevant” sense of experience leading to emergence of new meaning and new experience • countertransference (CT) understood as joint creation (Gabbard, 2001) and comprising diverse experiential components (subjective CT, objective CT, therapeutic attitude, emerging experience) (Barreto & Matos, 2016)
- Objectivos académicos e variáveis psicológicas em estudantes da ESTSP-IPP: o papel do coping e da regulação emocional na experiência com diferentes modelos pedagógicosPublication . Martins, Helena; Teixeira, Ricardo J.; Dores, Artemisa Rocha; Barreto, João Francisco; Sucena, Ana; Magalhães, AndreiaO domínio académico é uma área fundamental para a aquisição de competências auto-regulatórias adaptativas, susceptíveis de potenciar o bem-estar e o desenvolvimento humano. Este estudo pretende investigar variáveis psicológicas que dificultam/facilitam a percepção de concretização de objetivos académicos, comparando grupos de estudantes do 1º ano no modelo de ensino-aprendizagem baseada em problemas (PBLProblem Based Learning) com estudantes de modelos pedagógicos mais tradicionais da ESTSP-IPP. O PBL é um método instrutivo centrado no aluno, dirigido por um problema mal-estruturado mas realista, em que os estudantes colaboram para o desenvolvimento de soluções viáveis. Este modelo pedagógico promove um processo de ensino-aprendizagem onde os estudantes são activos no processo de aprendizagem, ou seja, propõem questões investigativas, exploram e pesquisam informações relevantes, e sugerem soluções (Lambros, 2004). O professor assume o papel de facilitador/guia, ajudando os estudantes através do processo de aprendizagem com estímulo, orientação e recursos (Savin-Baden, 2003).
- Personality organization, emotion regulation, and symptom distressPublication . Barreto, João Francisco; Matos, Paula MenaEvidence suggests that the severity of personality difficulties, regardless of their type, may be the most important determinant of current and future dysfunction (Hopwood et al., 2011). Otto F. Kernberg’s model of personality organization (PO) describes severity of personality disturbance as a continuum from normal-neurotic functioning, through borderline, to psychotic personality, along which the predominance of primitive defenses and the concomitant identity disturbance augments, with reality testing compromised in the psychotic pole (e.g., Kernberg & Caligor, 2005). The increasing influence of primitive, intense emotions lacking integration often manifest in affect dysregulation and behavioral correlates such as anger expression and impulsive self-destructive behaviors (Clarkin, Yeomans, & Kernberg, 2006). Still, there is little research into the paths through which PO affects symptoms, in which emotion (dys)regulation must play an important role.
- Predicting early alliance developmentPublication . Barreto, João Francisco; Matos, Paula MenaThere is wide consensus that, in early stages of psychotherapy, a good alliance is an important predictor of positive outcome, particularly if rated by clients and in early stages of psychotherapy (Constantino et al., 2002; Horvath & Bedi, 2002). Both theory and empirical research have been concerned with delineating therapist and client specific contributions to alliance development, with particular emphasis on clinical, relational, and technical dimensions. Still, uncertainty persists and further evidence is needed. Although the relation between client attachment and alliance is relatively well established (e.g., Diener & Monroe, 2012), results seem more ambiguous regarding therapist attachment dimensions. Recent research suggests that the complexity of clients’ problems may work as a moderator, turning therapist attachment relevant as clinical impairment increases (Bucci et al., 2015; Schauenburg et al., 2010). Additionally, therapist and client attachment dimensions may interact in ways that affect alliance, although research addressing this hypothesis is still very scarce (see Degnan et al., 2016). In particular, dissimilar or non-complementary matches of therapist and client relational dimensions may benefit the therapeutic process (Bernier & Dozier, 2002). Dealing with difficulties coming from the relational match and/or clinical severity will probably require therapists to regulate their own reactions, turning countertransference management (CtM; Gelso & Hayes, 2007) into a relevant dimension in the process.
- Predicting early alliance from attachment, personality organization, and countertransference managementPublication . Barreto, João Francisco; Carvalho, Helena Moura; Matos, Paula MenaTherapeutic alliance has been widely recognized as an important predictor of psychotherapy outcome across therapeutic orientations (Horvath et al., 2011). In particular, evidence suggests that client rated alliance and assessment at early stages of the therapeutic process may be especially relevant (Constantino et al., 2002; Horvath & Bedi, 2002). Although several determinants of alliance have been investigated in the last decades, few studies have analyzed the interaction between therapists’ and clients’ attachment orientations for predicting alliance development (see Daniel, 2006). On the other hand, the kind and severity of the clients’ problems pose different challenges on the therapeutic alliance. Presumably, therapists’ capacity to manage countertransference (CT) demands coming from these dimensions will influence the extent to which the alliance is affected.