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Nelise de Paula Araujo C, MendonçA Corradi-Webster C, Gonçalves Correia-Zanini MR, M Yurasek A. Quasi-randomized trial of solution-focused brief therapy intervention for readiness to change and alcohol and other drug use in a Brazilian community-based treatment center. Psychother Res 2024:1-13. [PMID: 38642394 DOI: 10.1080/10503307.2024.2336192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 03/24/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVE Strategies to increase readiness to change may enhance community-based substance use treatment outcomes. This study evaluated the effect of solution-focused brief therapy (SFBT) on readiness to change and substance use compared to treatment as usual (TAU) in a Brazilian community-based substance use treatment center. METHODS One hundred two adults (M = 36.79, SD = 10.29) were quasi-randomized into SFBT or TAU groups. Assessments were completed at baseline, post-test, and 1-month follow-up. The primary outcome was the changes in readiness to change at post-test and 1-month follow-up. The secondary outcome was the change in substance use at 1-month follow-up. RESULTS Through Quade non-parametric analysis of covariance (ANCOVA), both groups decreased tobacco, alcohol, and cocaine/crack use at 1-month follow-up, but SFBT had greater reductions in alcohol use (p = .05). ANCOVA analysis demonstrated no differences between groups on readiness to change at any time point. However, among participants who used multiple substances (n = 59), SFBT showed higher readiness to change at post-test (p = .05). CONCLUSIONS These findings strengthen the evidence that SFBT holds promise for positive community-based substance use treatment outcomes.
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Affiliation(s)
| | | | | | - Ali M Yurasek
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
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Santos CGB, Lopes RDCT, Oliveira JTTDC, Gonçalves MM, Sartes LMA. Propriedades Psicométricas da Versão Brasileira do Questionário de Ambivalência em Psicoterapia - QAP. PSICO-USF 2022. [DOI: 10.1590/1413-82712022270402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Resumo Níveis elevados de ambivalência estão associados a piores resultados e abandono terapêutico. Este estudo teve como objetivo a adaptação transcultural e avaliação das propriedades psicométricas do Questionário de Ambivalência em Psicoterapia (QAP). Após adaptação cultural do instrumento, foram avaliados 181 indivíduos em psicoterapia de diversas abordagens, em clínicas-escola e consultórios particulares. O QAP foi avaliado quanto à estrutura interna e relação com variáveis externas. Na análise fatorial confirmatória, o modelo com melhor ajuste foi composto por três dimensões: duas de primeira ordem - Desmoralização e Alternância - e uma de segunda ordem - Ambivalência. A consistência interna foi 0,86. Na relação com variáveis externas, o QAP se correlacionou moderadamente com medidas de desconforto psicológico (OQ-45- Outcome Questionnaire) (r = 0,65) e motivação para mudança (URICA - University of Rhode Island Change Assessment): contemplação (r = 0,36) e manutenção (r = 0,37). A versão brasileira do QAP demonstrou ser um instrumento com boas características psicométricas, de aplicação rápida e fácil.
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Xavier ACM, de Souza CMB, Flores LHF, Bermudez MB, Silva RMF, de Oliveira AC, Dreher CB. Skin picking treatment with the Rothbaum cognitive behavioral therapy protocol: a randomized clinical trial. ACTA ACUST UNITED AC 2020; 42:510-518. [PMID: 32401873 PMCID: PMC7524420 DOI: 10.1590/1516-4446-2019-0636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 01/15/2020] [Indexed: 11/22/2022]
Abstract
Introduction: Although behavioral therapies can effectively treat skin picking disorder (SPD), there is no standardized treatment for improving SPD and its comorbidities and there is no group intervention option. This trial aimed to adapt the Rothbaum trichotillomania protocol to SPD (Study 1) and test its efficacy for treating SPD and comorbidities in individual and group formats (Study 2). Methods: The adapted protocol was applied to 16 SPD patients, who were allocated to group or individual treatment (Study 1). Afterwards, 54 patients were randomly allocated to treatment in an individual (n=27) or group format (n=27) (Study 2). In both studies, assessments of SPD severity, anxiety, depression, clinical status and skin lesion severity were performed at baseline and the endpoint. Results: The adapted protocol was feasible in both treatment modalities (Study 1) and led to high SPD remission rates (individual 63%; group 52%), with no significant difference between intervention types (p = 0.4) (Study 2). SPD, anxiety, and depression symptoms and objective patient lesion measures improved after treatment. There was large effect size for SPD symptom improvement in both treatment types (Cohen’s d: group = 0.88; individual = 1.15) (Study 2). Conclusion: The adapted Rothbaum protocol was effective for SPD remission, comorbidities, and skin lesions, both in individual and group formats. Clinical trial registration: NCT03182478
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Affiliation(s)
- Alice C M Xavier
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Camila M B de Souza
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Luís H F Flores
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Mariane B Bermudez
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Renata M F Silva
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Ariadne C de Oliveira
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Carolina B Dreher
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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Zencke da Silva K, Bello JZ, Cassol M. Motivational Stage Analysis of Patients with Behavioral Dysphonia. Folia Phoniatr Logop 2019; 72:267-272. [PMID: 31189167 DOI: 10.1159/000500403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 04/12/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To analyze the applicability of the University of Rhode Island Change Assessment (URICA)-VOICE scale before and after a therapeutic program for functional balance in voice production. PATIENTS AND METHODS The sample comprised 26 adult participants (18 female) from the -Brazilian Public Healthcare System. The URICA-VOICE scale was applied prior to the intervention and after 10 sessions of a therapeutic program. RESULTS The motivational stage values were significantly increased after the intervention compared with the first application of the scale. Precontemplation and action were the stages most commonly reported by the participants. Significant differences were found in 6 statements of the URICA-VOICE scale after voice therapy. CONCLUSIONS The motivational stage of the participants improved after voice therapy. Being motivated is important for adherence to behavioral changes regarding the voice, and this study shows that using the URICA-VOICE scale in clinical practice is essential to measure patient performance in the voice therapy process, as well as to determine the ideal moment of discharge.
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Affiliation(s)
| | | | - Mauriceia Cassol
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
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Sant'Anna WT, Mitsuhiro SS, Figlie NB, Diehl A, Pillon SC, Laranjeira R. Relapse in involuntary substance treatment: a transversal study. ACTA ACUST UNITED AC 2019; 49:255-261. [PMID: 33328018 DOI: 10.1016/j.rcp.2019.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 02/17/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the associations between relapse and admissions (voluntary and involuntary) in a sample of patients with substance dependence. METHODS This is a cross-sectional study undertaken at a private medical therapeutic community specialised in treating addiction, located in a rural area of São Paulo, Brazil. Sociodemographic characteristics, the University of Rhode Island Change Assessment Scale (URICA), Stages Readiness and Treatment Eagerness Scale (SOCRATES), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) and Structured Clinical Interview for DSM-IV-SCID were used. RESULTS Relapse was associated with low family income (P=.006) and contemplation motivational stage (P<0.05). Nevertheless, no significant differences between individuals who were admitted involuntarily (64%) and voluntarily (54%) were observed (P=0.683) in terms of relapses. CONCLUSIONS In this sample, the relapse outcome in involuntary admissions was no different from the voluntary ones.
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Affiliation(s)
| | | | | | - Alessandra Diehl
- Psychiatric Department, Federal University of São Paulo (UNIFESP), Brazil
| | - Sandra Cristina Pillon
- Psychiatric Nursing and Human Science Department, Faculty of Nursing at Ribeirão Preto, University of São Paulo (USP), Brazil; PAHO/WHO Collaborating Centre for Nursing Research Development
| | - Ronaldo Laranjeira
- Psychiatric Department, Federal University of São Paulo (UNIFESP), Brazil
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Pawlina MMC, Rondina RDC, Espinosa MM, Botelho C. Depression, anxiety, stress, and motivation over the course of smoking cessation treatment. J Bras Pneumol 2016; 41:433-9. [PMID: 26578135 PMCID: PMC4635090 DOI: 10.1590/s1806-37132015000004527] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 04/08/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate changes in the levels of patient anxiety, depression, motivation, and stress over the course of smoking cessation treatment. METHODS This cohort study involved patients enrolled in a smoking cessation program in Cuiabá, Brazil. We selected patients who completed the program in six months or less (n = 142). Patient evaluations were conducted at enrollment (evaluation 1 [E1]); after 45 days of treatment with medication and cognitive-behavioral therapy (E2); and at the end of the six-month study period (E3). Patients were evaluated with a standardized questionnaire (to collect sociodemographic data and determine smoking status), as well as with the University of Rhode Island Change Assessment scale, Beck Anxiety Inventory, Beck Depression Inventory, and Lipp Inventory of Stress Symptoms for Adults. The data were analyzed with the nonparametric Wilcoxon test for paired comparisons. To compare treatment success (smoking cessation) with treatment failure, the test for two proportions was used. RESULTS Among the 142 patients evaluated, there were improvements, in terms of the levels of anxiety, depression, motivation, and stress, between E1 and E2, as well as between E1 and E3. In addition, treatment success correlated significantly with the levels of motivation and anxiety throughout the study period, whereas it correlated significantly with the level of depression only at E2 and E3. CONCLUSIONS We conclude that there are in fact changes in the levels of patient anxiety, depression, motivation, and stress over the course of smoking cessation treatment. Those changes appear to be more pronounced in patients in whom the treatment succeeded.
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Affiliation(s)
| | | | | | - Clóvis Botelho
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, Cuiabá, MT, Brasil
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LessaHorta R, Schäfer JL, Coelho LRM, Rodrigues VS, Oliveira MSD, Teixeira VA. [Conditions associated with impaired social skills in a convenience sample of crack users]. CAD SAUDE PUBLICA 2016; 32:e00010715. [PMID: 27096296 DOI: 10.1590/0102-311x00010715] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 08/27/2015] [Indexed: 11/21/2022] Open
Abstract
The article analyzes conditions associated with low scores on the Social Skills Inventory (SSI) among crack users in Greater Metropolitan Porto Alegre, Rio Grande do Sul State, Brazil, based on a cross-sectional study in a convenience sample of 519 individuals interviewed in 2011. Low SSI scores occurred in 52.8% of the sample, and there were no differences according to currently active use of crack (yes/no) or current addiction treatment. Higher likelihood of low SSI was associated with crack users in pre-contemplation or contemplation in University of Rhode Island Change Assessment - URICA (p = 0.031), high Beck Depression Inventory - BDI scores (p = 0.037), mourning a deceased child (p = 0.001), and having committed armed robbery to obtain crack (p = 0/020). Lower likelihood of low SSI was associated with 9 or more years of schooling (p = 0.001), high social support (p < 0.001), high resilience (p < 0.001), having lost contact with parents (p = 0.032), history of hospitalization due to crack (p = 0.009), and history of sex to obtain crack (p = 0.009). The findings are clinically useful and highlight the issue's importance.
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Teixeira LC, Rodrigues ALV, Silva AFGD, Azevedo R, Gama ACC, Behlau M. The use of the URICA-VOICE questionnaire to identify the stages of adherence to voice treatment. Codas 2014; 25:8-15. [PMID: 24408164 DOI: 10.1590/s2317-17822013000100003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2011] [Accepted: 12/12/2011] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To adapt the URICA questionnaire to assess the motivational stages of patients undergoing voice treatment, and to determine the association between these stages with age, type of dysphonia, level of education, profession, and number of voice therapy sessions. METHODS A cross-sectional study design was employed, using a convenience sample composed of 66 dysphonic patients--women and eight men--aged from 18 to 68 years, who were enrolled in outpatient care at two federal universities. As an exploratory tool, the URICA questionnaire was adapted to the area of voice, based on specific situations related to vocal behaviors. This questionnaire was named URICA-VOICE. It was administered individually and subjected to analyses. RESULTS Most patients, 38 (57.6%), were in the contemplation stage, 20 (30.3%) were in the pre-contemplation, and only eight (12.1%) in the action stage, which is ideal to voice therapy. There was no association between adherence stages and the variables age, type of dysphonia, level of education, and number of voice therapy sessions. The variable profession was associated with the action stage of the URICA-VOICE. CONCLUSION The URICA-VOICE showed that most dysphonic patients undergoing treatment are still in the contemplation stage, which may limit therapy outcomes. There was no relationship between the other variables and the adherence stages of the URICA-VOICE questionnaire.
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Rodrigues VS, Horta RL, Szupszynski KPDR, Souza MCD, Oliveira MDS. Revisão sistemática sobre tratamentos psicológicos para problemas relacionados ao crack. JORNAL BRASILEIRO DE PSIQUIATRIA 2013. [DOI: 10.1590/s0047-20852013000300005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: O objetivo deste artigo é apresentar uma revisão sistemática da literatura sobre tratamentos psicológicos oferecidos para usuários de crack. MÉTODOS: Foi realizada uma revisão sistemática por meio de uma busca na literatura internacional e nacional, indexada nas bases de dados Medline, SciELO, Lilacs e Web of Science. Os descritores utilizados foram: crack or crack cocaine or cocaine smokers (crack) and psychosocial treatment or psycotherapy or psychosocial treatment (tratamento psicológico) e a busca incluiu artigos publicados no período de 2001 a 2011. RESULTADOS: No total foram encontrados 155 artigos por meio dos descritores utilizados. Os artigos foram agrupados em três dimensões: tratamentos psicossociais na internação e cuidados continuados, relaxamento respiratório e outras técnicas comportamentais e abordagens fundamentadas na Entrevista Motivacional, Cognitivo-Comportamental e Modelo Transteórico de Mudança. CONCLUSÃO: Com base nos estudos examinados, pode ser formulado um elenco de algumas intervenções que estão sendo estudadas para o tratamento de usuários de crack e algumas apresentam resultados satisfatórios. Os poucos esforços de comparação entre técnicas resultaram em evidências de pouca ou nenhuma diferença, ainda que se registre o benefício para os usuários na aplicação de qualquer delas. Não existe consenso acerca da efetividade no tratamento de usuários de crack. Parece oportuno e necessário o aprofundamento dos estudos nesse campo.
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Bittencourt SA, Santos PLD, Oliveira MDS. Motivação para mudança: análise fatorial da URICA para hábitos alimentares. PSICO-USF 2012. [DOI: 10.1590/s1413-82712012000300016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O presente estudo objetivou realizar a adaptação da URICA para avaliação da motivação para a mudança de hábitos alimentares e posterior redução da versão de 32 para a de 24 itens, mediante análise fatorial exploratória e de índices de fidedignidade. Trata-se de um estudo de cunho instrumental, realizado com 175 participantes de programas de redução de peso do sul do Brasil. A análise fatorial apontou uma solução de 4 fatores, referentes aos 4 estágios de motivação para a mudança e apresentou um alpha de Cronbach total de 0,842, que variou de 0,813 a 0,940 entre os 4 domínios.
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