Avaliação de processo de protocolo de psicoterapia para mulheres com histórico de violência conjugal

Abstract

(Estudo I : Cognitive behavioral therapy for women in domestic violence situation : systematic review) This article aims to perform a systematic review of the literature about cognitive behavioral therapy protocols (CBT) for psychological treatment of women in situations of domestic violence. Method: A search was conducted on those data bases: Scielo, Pepsic, PubMed, PsycINFO, Scopus and Web of Science with the following descriptors: "clinical trial" or "therapy" or "psychotherapy" or "psychological treatment" AND "violence" or "mistreatment "or" domestic violence "or" conjugal violence "AND" women". There were identified 1.329 articles in the initial search and after application of inclusion and exclusion criterias, remained 11 articles. Those were analyzed from those methodological aspects, those technical elements and the results. Results: Nine articles reported randomized clinical trials. All studies focused on symptoms of trauma, anxiety and depression. Conclusions: The articles focused on the avaliation of the results. It was identified the need for studies that detail the psychotherapeutic process, mainly in the national context, to promote practices based on evidences. (Estudo II : Avaliação de processo de protocolo de psicoterapia para mulheres com histórico de violência conjugal : estudo de casos clínicos) Violence against women is a complex phenomenon and generates negative consequences for mental health (WHO, 2016). The present study aimed to evaluate the process of a psychotherapy protocol for women with a history of conjugal violence. The design was case studies, and the sample consisted of three cases. For the analysis of the process, the Working Alliance Inventory (WAI-O) and Psychotherapy Process Q-Set (PQS) instruments were used, which evaluate, respectively, the therapeutic alliance and the more and less characteristic items of psychotherapy. The analysis of the sessions was performed through the evaluation of two independent judges and the results between the evaluators (Pearson's correlation) were compared, and agreement between the pairs ≥ 0.50 was accepted. The results indicated a good therapeutic alliance, a good connection between sessions and pointed out that the protocol is correlated with the expected prototype of cognitive-behavioral psychotherapy. In addition, the symptoms of anxiety, depression and PTSD decreased in the women attended, as well as increased levels of satisfaction with life and self-esteem. Most of the characteristic and non-characteristic items of the sessions are repeated in all three cases, which corroborates with the positive results of the protocol impact. The results compose initial evidence of intervention effectiveness. Protocols with evidence of effectiveness are needed to qualify the care of women in services that make up the network.