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关于与一群自闭症儿童兄弟姐妹共同治疗关系的精神分析视角:对沟通行为模式的观察研究

A Psychoanalytical Perspective on the Co-therapeutic Relationship With a Group of Siblings of Children With Autism: An Observational Study of Communicative Behavior Patterns.

作者信息

Venturella Mariella, Carbonell Xavier, Cabré Víctor, Arias-Pujol Eulàlia

机构信息

FPCEE Blanquerna, Ramon Llull University, Barcelona, Spain.

Training and Research Center, Carrilet, Barcelona, Spain.

出版信息

Front Psychol. 2019 Aug 8;10:1832. doi: 10.3389/fpsyg.2019.01832. eCollection 2019.

Abstract

A child diagnosed with autism may have a negative psychological and behavioral impact on their siblings, whose participation in a group with children in the same situation is a preventive measure. Our group study was conducted by two therapists (T1 and T2) assigned to co-therapy (CT) work. Both therapists shared the theoretical bases and understanding of the group and the needs of the individual subjects, and complemented each other in terms of the direction of their interventions, given that shared impressions and continuous exchanges that integrate countertransference aspects are essential to successful co-therapy. The objectives of this study were as follows: (a) to detect patterns of clarification, confrontation, and interpretation interventions by T1 and T2 in the group; and (b) to detect patterns of clarification, confrontation and interpretation interventions considering T1 and T2 as the only focal subject of the CT. Design was mixed-methods based on systematic observation, for which we developed a qualitative instrument that combined a field format and a categorizing system. Interobserver agreement was analyzed quantitatively using Cohen's kappa and Krippendorf's canonical concordance. Once data reliability was confirmed, lag sequential analysis using GSEQ5 software was performed to search for behavior patterns. The results show (a) different behavior patterns in the clarification, confrontation, and interpretation interventions by T1 and T2; and (b) different behavior patterns when T1 and T2 are considered as the focal subject (CT). Our study offers a new perspective on the impact of therapist interventions on participants in this kind of group.

摘要

被诊断患有自闭症的儿童可能会对其兄弟姐妹产生负面的心理和行为影响,让这些兄弟姐妹与处于相同情况的儿童一起参加小组活动是一种预防措施。我们的小组研究由两名被分配进行联合治疗(CT)工作的治疗师(T1和T2)开展。两位治疗师共享小组的理论基础以及对个体受试者需求的理解,并且在干预方向上相互补充,因为整合了反移情方面的共同印象和持续交流对于成功的联合治疗至关重要。本研究的目标如下:(a)检测T1和T2在小组中进行澄清、对峙和解释干预的模式;(b)将T1和T2视为联合治疗的唯一焦点受试者,检测澄清、对峙和解释干预的模式。研究设计基于系统观察的混合方法,为此我们开发了一种结合了现场格式和分类系统的定性工具。使用科恩kappa系数和克里彭多夫典型一致性对观察者间一致性进行定量分析。一旦确认数据可靠性,就使用GSEQ5软件进行滞后序列分析以寻找行为模式。结果显示:(a)T1和T2在澄清、对峙和解释干预方面存在不同的行为模式;(b)将T1和T2视为焦点受试者(联合治疗)时存在不同的行为模式。我们的研究为治疗师干预对这类小组参与者的影响提供了新的视角。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce89/6694756/e5ebaf0ef00c/fpsyg-10-01832-g001.jpg

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