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      Tratamientos psicológicos personalizados: orientaciones clínicas Translated title: Personalized psychological treatments: clinical instructions

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          Abstract

          Resumen En la actualidad existe una amplia concienciación para personalizar los tratamientos psicológicos en función de las características individuales del paciente y de la singularidad de su contexto vital. Utilizar el mismo tratamiento para cada paciente y para cada trastorno es una práctica clínica contraindicada y una conducta poco ética. En el presente trabajo se revisan siete factores importantes en este ámbito: el grado de reactancia con respecto al cambio, la fase del cambio en la que se encuentra el cliente, la cultura, el estilo de afrontamiento, el estilo de apego, las preferencias terapéuticas y los sentimientos religiosos y espirituales. Los resultados de diversos estudios metanalíticos sugieren que dichos factores influyen sensiblemente en la eficacia de los tratamientos psicológicos, y que su aplicación deja un amplio margen de mejora para la eficacia de los tratamientos psicológicos.

          Translated abstract

          Abstract Today therapists are more aware of the importance of personalizing psychological treatments according to patients' individual characteristics and the singularity of their life contexts. Using the same treatment for every patient and every disorder is not advisable and it is a poor ethical behavior. In this study, seven important personalizing factors are reviewed: patient reactance level, stage of change phase, culture, coping style, attachment style, therapeutic preferences, and religious and spiritual dimension. Meta-analytic studies suggest that these factors notably affect the efficacy of psychological treatments, and that their application will allow for further improvement in psychotherapy efficacy.

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          Most cited references49

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          Evidence-based practice in psychology.

          (2006)
          The evidence-based practice movement has become an important feature of health care systems and health care policy. Within this context, the APA 2005 Presidential Task Force on Evidence-Based Practice defines and discusses evidence-based practice in psychology (EBPP). In an integration of science and practice, the Task Force's report describes psychology's fundamental commitment to sophisticated EBPP and takes into account the full range of evidence psychologists and policymakers must consider. Research, clinical expertise, and patient characteristics are all supported as relevant to good outcomes. EBPP promotes effective psychological practice and enhances public health by applying empirically supported principles of psychological assessment, case formulation, therapeutic relationship, and intervention. The report provides a rationale for and expanded discussion of the EBPP policy statement that was developed by the Task Force and adopted as association policy by the APA Council of Representatives in August 2005. Copyright 2006 APA, all rights reserved.
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            Comorbidity: a network perspective.

            The pivotal problem of comorbidity research lies in the psychometric foundation it rests on, that is, latent variable theory, in which a mental disorder is viewed as a latent variable that causes a constellation of symptoms. From this perspective, comorbidity is a (bi)directional relationship between multiple latent variables. We argue that such a latent variable perspective encounters serious problems in the study of comorbidity, and offer a radically different conceptualization in terms of a network approach, where comorbidity is hypothesized to arise from direct relations between symptoms of multiple disorders. We propose a method to visualize comorbidity networks and, based on an empirical network for major depression and generalized anxiety, we argue that this approach generates realistic hypotheses about pathways to comorbidity, overlapping symptoms, and diagnostic boundaries, that are not naturally accommodated by latent variable models: Some pathways to comorbidity through the symptom space are more likely than others; those pathways generally have the same direction (i.e., from symptoms of one disorder to symptoms of the other); overlapping symptoms play an important role in comorbidity; and boundaries between diagnostic categories are necessarily fuzzy.
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              The Lancet Psychiatry Commission on psychological treatments research in tomorrow's science

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                Author and article information

                Journal
                pappsicol
                Papeles del Psicólogo
                Pap. Psicol.
                Consejo General de Colegios Oficiales de Psicólogos (Madrid, Madrid, Spain )
                0214-7823
                1886-1415
                April 2020
                : 41
                : 1
                : 16-26
                Affiliations
                [1] País Vasco orgnameUniversidad del País Vasco UPV-EHU España
                Article
                S0214-78232020000100016 S0214-7823(20)04100100016
                10.23923/pap.psicol2020.2915
                65f5d213-8570-4df8-9fce-c08c369b206c

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 16 June 2019
                : 02 September 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 51, Pages: 11
                Product

                SciELO Spain

                Categories
                Artículos

                Personalized treatments,Tratamientos adaptados,Psicoterapia,Revisión-narrativa-de-metanálisis,Práctica-basada-en-la-evidencia,Tratamientos personalizados,Treatment adaptations,Psychotherapy,Narrative review of meta-analysis,Evidence-based practice

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