Servicios psicológicos afirmativos para personas LGTBIQA+ en Ecuador: cambios en el malestar psicológico  <span class="so-article-trans-title" dir="auto"> Translated title: Affirmative psychological services for LGTBIQA+ persons in Ecuador: changes in psychological distress </span>

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Abstract

Resumen: Antecedentes: Aunque en el mundo anglosajón la Terapia Afirmativa tiene un amplio recorrido con un respaldo empírico contundente, en Iberoamérica su desarrollo es reciente. Objetivo: Analizar la Evidencia Basada en la Práctica de una red de servicios de psicología afirmativa para personas LGTBIQA+ en Ecuador. Método: Estudio naturalístico en el que se analiza la Evidencia Basada en la Práctica generada usando el Clinical Outcomes in Routine Evaluation - Outcome Measure como herramienta de evaluación rutinaria para monitorizar los resultados de 101 consultantes que recibieron Terapia Afirmativa entre 2018 y 2020 en una red de servicios de psicología afirmativa para personas LGTBIQA+. Se evaluó el cambio estadísticamente significativo y el cambio confiable y clínicamente significativo. Resultados: Lxs participantes tenían en promedio 27.14 años. La mediana de sesiones fue seis. Hubo cambios estadísticamentes significativos para quienes completaron el cuestionario al menos dos veces. Se encontró un tamaño del efecto grande para el puntaje total y todas las dimensiones, a excepción de Riesgo. El 68% de los participantes presentaron mejoría. Conclusiones: Los resultados sugieren que la Terapia Afirmativa minimiza el riesgo que trae consigo el estrés de minorías. Se invita a estudiantes, terapeutas y usuarios a aprender, adoptar y acudir a Terapia Afirmativa, respectivamente.

Translated abstract

Abstract: Background: Although in the Anglo-Saxon world Affirmative Therapy has a long history with strong empirical support, in Ibero-America its development is recent. Objective: To analyze the Practice-Based Evidence of a network of affirmative psychology services for LGTBIQA+ persons in Ecuador. Methods: This is a naturalistic study analyzing Practice-Based Evidence generated using the Clinical Outcomes in Routine Evaluation - Outcome Measure as a routine evaluation tool to monitor the outcomes of 101 clients who received Affirmative Therapy between 2018 and 2020 in a network of affirmative psychology services for LGTBIQA+ people. Statistically significant change and reliable, clinically meaningful change were assessed. Results: Participants were on average 27.14 years old. The median number of sessions was six. There were statistically significant changes for those who completed the questionnaire at least twice. A large effect size was found for the total score and all dimensions except for Risk. Sixty-eigth percent participants showed improvement. Conclusions: The results suggest that Affirmative Therapy minimizes the risk brought on by minority stress. Students, therapists, and clients are encouraged to learn, adopt, and use Affirmative Therapy, respectively.

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Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence.

Ilan Meyer (2003)

In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress--explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.

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Clinical significance: A statistical approach to defining meaningful change in psychotherapy research.

Neil Jacobson, Paula A. Truax (1991)

In 1984, Jacobson, Follette, and Revenstorf defined clinically significant change as the extent to which therapy moves someone outside the range of the dysfunctional population or within the range of the functional population. In the present article, ways of operationalizing this definition are described, and examples are used to show how clients can be categorized on the basis of this definition. A reliable change index (RC) is also proposed to determine whether the magnitude of change for a given client is statistically reliable. The inclusion of the RC leads to a twofold criterion for clinically significant change.