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Behavior-analytic objectives and intervention strategies on interactions with child in sessions of two renowned child therapists

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Author(s):
Giovana Del Prette
Total Authors: 1
Document type: Doctoral Thesis
Press: São Paulo.
Institution: Universidade de São Paulo (USP). Instituto de Psicologia (IP/SBD)
Defense date:
Examining board members:
Sonia Beatriz Meyer; Fatima Cristina Souza Conte; Jaide Aparecida Gomes Regra; Emmanuel Zagury Tourinho; Denis Roberto Zamignani
Advisor: Sonia Beatriz Meyer
Abstract

Research process in psychotherapy use categorization of sessions as a way of understanding the therapist-client relationship in the clinical setting, systematizing description of the therapeutic practice and identifying critical process variables and the impact on their effectiveness. This research related the results of a molar categorization of behavior-analytic objectives, a molar system of strategies for treating the child, and therapist and client behaviors (molecular) for analysis of interaction in behavior analytic sessions. Filming was done in eight sessions of Dyad Alice-Alex and six of Dyad Bertha-Bia and of interviews with therapists, doctors in behavior analysis with more than 30 years of clinical experience with children. The sessions were categorized according to four systems, the first two developed in this research: (1) Categorization System for Therapeutic Objectives (SICOT) (2) System of Strategies of Conversations and Activities (SECAT), (3) Functional Analytic Psychotherapy Rating Scale (FAPRS) and (4) Categories of Therapist and Client Behavior (SMCCIT), besides the categorization of the focus of conversation (in or out of session). Satisfactory Kappa rates of agreement were obtained between observers ((K>0,630 in three of those, with p<0,05 in every system)) and correlation analysis was carried out among nominal categories (Chi-square), within and between systems, as well as qualitative analysis on the data, relating them to reports of therapists during the interviews. Results indicated that therapists have emphasized different strategies, but consistent with the profile of children and their therapeutic goals. In Alex case the therapist attempted to teach him to report, engage and follow instructions as an alternative to opposing and distracting himself. In case Bias case the therapist aimed to teach her to express herself assertively and improve analysis. Alices strategies were based primarily on: (1) assigning therapeutic tasks, managing behavior in the session for teaching to read and write, and (2) deriving conversations from fantasy and games, managing verbal control to teach him to report. The strategies with Bertha were: (1) using fantasy, managing the behavior of Bia in the session for teaching other forms of relationships with family and (2) talking derived from or parallel to playing and make believe, managing verbal control so that the analysis of B would supplement the contingencies out of the session. The two treatments had the highest percentage of interactions with focus on the session, an emphasis on different activities to promote adhesion, to manage behavior directly and converse with children. Conclusions: (a) the use of different systems, molecular and molar, was essential to achieve different levels of analysis and combine them together, (b) the use of activities is not therapeutic in itself, but helps interventions with a population whose verbal development - and its control by rules is still incipient. The activities are important for the management of behaviors in session and conversation for enhancing verbal control. Some research questions are raised considering the experience of participating therapists, and practical implications for professional training in child behavior analytic therapy are discussed (AU)