Análise de contingências de orientações e auto-orientações em intervenções clínicas comportamentais / Contingency analysis of orientation and self-orientation in behavioral clinical interventions

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Mechanisms responsible for changes that occur in psychotherapy are subject to debate. The question is whether specific techniques or variables of the therapeutic relationship promote the effects of the therapy. Another question is whether behavioral changesproduced by therapy are shaped by contingencies of the therapeutic relationship or ifthey are governed by new rules produced in therapy. In researches about emission of rules (orientation) and self emitted rules (self-orientation) prior to this research, novariables responsible for their emission were found. The use of the orientation strategy seemed to be determined either by the client, or by the therapist, sometimes by neither, and at times by the theme, and possibly by a complex combination of these and other variables. A detailed study of orientations and self-orientations in 81 sessions of behavior analytic therapy was carried out in this research to ascertain which variables were responsible for the emission of orientation and self-orientation in behavioralclinical interventions. The findings indicated that each therapist issued an average of 40to 60 orientations during their nine sessions. The clients of both experienced and inexperienced therapists presented few self-orientations. The number of orientationsdecreased to less than half when only rules with different contents and functions were counted, indicating that therapists tend to functionally repeatthe rule. The self-orientations decreased one quarter when those with different content and function were considered. The group of therapists issued more orientations for specific and generic action; similarly, the clients of these therapists issued more self-orientations for specific and generic action. Episodes of orientation/self-orientation were identified in the 81 sessions, occupying an average of one third of the sessions of experienced therapists, and one quarter of the sessions of inexperienced therapists. These episodes involved several types of intervention by the therapist besides orientation. Orientations were generally issued within the following context: clients report a situation they have experienced and the therapist makes some interventions. When clients show difficulty in assuming responsibility, facing and evaluating their behavior, the therapist providesrules. Clients usually agree with the rules they receive, but on one quarter of occasions they oppose them and, and in one sixth of occasions they receive new orientations. Two thirds of self-orientations were approved by the therapist, but there were alsodisapprovals. There was little correlation between the theme and the presence of orientation/self-orientation. Motivated clients received more orientation than unmotivated and resistant clients; the higher the clients level of education the greaterthe number of self-orientation. Ten percent of the sessions were evaluated by a judge, with satisfactory indices of judge-researcher agreement indicating external validity. Future researches should be conducted to correlate the use of rules and the results of behavioral clinical interventions.

ASSUNTO(S)

behavior therapy contingency analysis aconselhamento rules governed behavior análise de contingências comportamento governado por regras terapia comportamental counselling

ACESSO AO ARTIGO

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