{"id":14614,"date":"2019-06-27T10:47:53","date_gmt":"2019-06-27T09:47:53","guid":{"rendered":"https:\/\/www.fsyc.org\/actualitat\/avanzando-desde-el-modelo-cognitivo-conductual-a-las-terapias-de-3a-generacion-en-el-centro-de-acogida-de-menores-de-ateca-gestionado-por-fsc\/"},"modified":"2019-06-27T11:04:51","modified_gmt":"2019-06-27T10:04:51","slug":"avancant-des-del-model-cognitiu-conductual-a-les-terapies-de-3a-generacio-al-centre-dacollida-de-menors-de-ateca-gestionat-per-fsc","status":"publish","type":"post","link":"https:\/\/www.fsyc.org\/ca\/actualitat\/avancant-des-del-model-cognitiu-conductual-a-les-terapies-de-3a-generacio-al-centre-dacollida-de-menors-de-ateca-gestionat-per-fsc\/","title":{"rendered":"Avan\u00e7ant des del model cognitiu-conductual a les \u00abter\u00e0pies de 3a generaci\u00f3\u00bb al Centre d’Acollida de Menors de Ateca gestionat per FSC"},"content":{"rendered":"
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Tradicionalment, en els centres d’acolliment residencial per a menors, s’ha treballat majorit\u00e0riament des d’un model cognitiu-conductual, ent\u00e8s com una progressi\u00f3 natural i un complement a l’enfocament conductual que es fa servir principalment en la intervenci\u00f3 educativa, a trav\u00e9s de les diferents estrat\u00e8gies de modificaci\u00f3 de la conducta.<\/strong><\/span>\u00a0Actualment, dins de les t\u00e8cniques que poden emprar-se, tamb\u00e9 estan obtenint bons resultats les \u00abter\u00e0pies de 3a generaci\u00f3\u00bb que aporten noves solucions i que resulten senzilles d’adaptar a la intervenci\u00f3 en el context residencial de menors.<\/strong><\/span><\/p>\n<\/blockquote>\n

En aquesta ocasi\u00f3, el nostre company Daniel Urbina, director del Centre d’Acollida de Menors (CAM) d’Ateca, a Saragossa, dirigit i gestionat per la\u00a0Fundaci\u00f3 Salut i Comunitat (FSC),<\/strong>\u00a0ens trasllada una s\u00e8rie d’idees sobre un dels models que major \u00e8xit est\u00e0 tenint actualment en el marc de les \u00abter\u00e0pies de 3a generaci\u00f3\u00bb, sent una ter\u00e0pia de primera elecci\u00f3 en el cas d’alguns trastorns psicopatol\u00f2gics.<\/span>\u00a0Concretament, ens referim al model dial\u00e8ctic-conductual, que s’est\u00e0 utilitzant en el servei adaptant-lo a la intervenci\u00f3 residencial i que s’est\u00e0 implementant a nivell general en els centres de menors que gestionem.<\/span><\/p>\n

El CAM d’Ateca \u00e9s un servei dirigit a nens\/es i adolescents que presenten conductes disruptives recurrents que suposen un risc per a si mateixos o per a tercers i que mostrin grans d\u00e8ficits quant a la seva adaptaci\u00f3 social i\/o familiar, posant en risc el seu desenvolupament .<\/span><\/p>\n

Per aix\u00f2, el programa d’intervenci\u00f3 del centre, de car\u00e0cter intensiu, multidisciplinar i integral, est\u00e0 enfocat cap a la modificaci\u00f3 de conductes disruptives, la regulaci\u00f3 d’emocions, l’abordatge terap\u00e8utic de la hist\u00f2ria pr\u00e8via disfuncional, la prevenci\u00f3 del consum de drogues i la recerca l’aprenentatge de normes socials que ajudin a la transici\u00f3 a la vida adulta.<\/span><\/p>\n

Aquest recurs t\u00e9 conveniades un total de 20 places amb l’Institut Aragon\u00e8s de Serveis Socials (IASS).<\/span>\u00a0Aix\u00ed mateix, mant\u00e9 acords de col\u00b7laboraci\u00f3 amb altres administracions p\u00fabliques, en concret amb la Diputaci\u00f3 Foral de Biscaia i la Diputaci\u00f3 Foral de Guip\u00fascoa.<\/span><\/p>\n

Tornant al model dial\u00e8ctic-conductual, cal assenyalar que t\u00e9 grans avantatges pel que fa a la seva validesa, demostrada en innombrables ocasions en la investigaci\u00f3, que avala la seva utilitat cl\u00ednica en m\u00faltiples quadres psicopatol\u00f2gics i que ha donat com a resultat una infinitat de programes d’intervenci\u00f3 basats en l’evid\u00e8ncia que ens permeten fer intervencions eficients i sistem\u00e0tiques, com assenyalen alguns autors.<\/span><\/p>\n

Tenint en compte aquest panorama general, ens plantegem la seg\u00fcent pregunta: per a qu\u00e8 intervenim amb aquests nens i nenes?<\/span>\u00a0El model cognitiu-conductual respondria a aquesta pregunta afirmant que per eliminar o reduir certs problemes i s\u00edmptomes psicopatol\u00f2gics, aix\u00ed com el malestar, la incapacitat i\/o el patiment associats als mateixos.<\/span>\u00a0Aix\u00ed ent\u00e8s, podem simplificar aquest model entenent-lo com una intervenci\u00f3 encaminada a l’eliminaci\u00f3 del malestar.<\/span><\/p>\n

En contraposici\u00f3 a aquest model, fent els ulls enrere, en les \u00faltimes d\u00e8cades estan sorgint noves aproximacions, tamb\u00e9 del nostre especial inter\u00e8s de cara a la intervenci\u00f3, que posen el seu focus d’atenci\u00f3 m\u00e9s enll\u00e0 de la mera eliminaci\u00f3 de s\u00edmptomes, i se centren m\u00e9s en la promoci\u00f3 de la salut, tenint en compte tant el paper del comportament com de les variables psicol\u00f2giques i psicosocials sobre el benestar i la qualitat de vida.<\/span><\/p>\n

Aquests nous models s’agrupen sota un moviment que es denomina \u00abtercera generaci\u00f3\u00bb o \u00abtercera onada de psicologia\u00bb que neix amb la finalitat de superar les limitacions de models anteriors.<\/span>\u00a0Cal assenyalar que, entre les limitacions m\u00e9s rellevants de les ter\u00e0pies cognitiu-conductuals destaca l’evid\u00e8ncia experimental que d\u00f3na suport a la idea que precisament aquests intents de control, reducci\u00f3 o eliminaci\u00f3 del malestar, com a objecte d’intervenci\u00f3 d’aquestes ter\u00e0pies, produeixen en molts de casos i paradoxalment, efectes contraris o de rebot.<\/span><\/p>\n

No obstant aix\u00f2, aquesta nova generaci\u00f3 no s’ha d’entendre com una ruptura o una negaci\u00f3 dels models anteriors, reconeixent la seva evident validesa, sin\u00f3 m\u00e9s aviat com una evoluci\u00f3 l\u00f2gica, o, dit d’una altra manera, com \u00abun moviment que reformula i sintetitza els postulats de les generacions anteriors, q\u00fcestionant aquestes tradicions per aconseguir millors resultats\u00bb (Hayes, 2004a).<\/span><\/p>\n

Per tant, entenem aquesta \u00abtercera generaci\u00f3\u00bb com una nova forma de fer ter\u00e0pia cognitiu-conductual, aportant una visi\u00f3 renovada al que ja existia pr\u00e8viament i posant \u00e8mfasi en determinats aspectes marginals fins a la data, com poden ser el concepte del jo, la intervenci\u00f3 centrada en la persona, el viure en el present, l’atenci\u00f3 plena, la import\u00e0ncia del context o la consecuci\u00f3 d’objectius.<\/span><\/p>\n

En aquest sentit, cal destacar que, tot i que des del CAM d’Ateca s’est\u00e0 treballant per fer una adaptaci\u00f3 pr\u00f2pia i espec\u00edfica a l’entorn residencial, actualment per a la posada en pr\u00e0ctica d’aquest model, un dels manuals que s’empren \u00e9s el programa atrapa (accions per al Tractament de la Personalitat en l’Adolesc\u00e8ncia), desenvolupat amb molt bons resultats en aquest servei a Saragossa, ja sigui a trav\u00e9s de la intervenci\u00f3 grupal com en la individual.<\/span><\/p>\n

Es tracta d’un programa assistencial espec\u00edfic per a l’estudi i tractament d’adolescents amb alta inestabilitat emocional i trastorn de la personalitat l\u00edmit que va n\u00e9ixer l’any 2009, en el si de l’equip del servei de psiquiatria del nen i l’adolescent de l’Hospital General Universitari Gregorio Mara\u00f1\u00f3n (HGUGM) de Madrid.<\/span><\/p>\n

Atrapa \u00e9s el resultat de l’adaptaci\u00f3 de la ter\u00e0pia dial\u00e8ctic-conductual, original de la Dra. Marsha Linehan i revisada per poblaci\u00f3 adolescent nord-americana pel Dr. Alec Miller.<\/span>\u00a0\u00c9s interessant a m\u00e9s perqu\u00e8, al llarg del programa, es presenten tant els fonaments te\u00f2rics com el material utilitzat (fitxes, presentacions, acr\u00f2nims, etc.) per al tractament ambulatori intensiu d’adolescents amb inestabilitat emocional greu, que ens serviran com a punt de partida per a adaptar el model a la intervenci\u00f3 residencial, a trav\u00e9s dels diferents materials.<\/span><\/p>\n

Les habilitats de consci\u00e8ncia, treballades a trav\u00e9s de t\u00e8cniques com el\u00a0mindfulness,<\/em>\u00a0aporten un model d’intervenci\u00f3 centrat en l’atenci\u00f3 en el present, acceptant i sense jutjar-lo, entenent el passat com una hist\u00f2ria d’aprenentatge, i atenent al futur des del comprom\u00eds a una s\u00e8rie de valors i metes personals, que en \u00faltim terme determinaran la conducta.<\/span><\/p>\n

A m\u00e9s d’aquesta t\u00e8cnica, aplicada actualment en els tallers que es realitzen en el servei, tamb\u00e9 se li d\u00f3na una especial import\u00e0ncia a una s\u00e8rie d’activitats dissenyades amb la finalitat de reduir el malestar i minimitzar la vulnerabilitat emocional.<\/span>\u00a0Tots dos conceptes s\u00f3n transversals a activitats i tallers duts a terme en el centre, com poden ser l’oci alternatiu, el desenvolupament creatiu i el dibuix, les assemblees, el taller d’esport o el taller de prevenci\u00f3 de consum de drogues, per esmentar alguns exemples.<\/span><\/p>\n

Aix\u00ed mateix, de la m\u00e0 del\u00a0mindfulness,<\/em>\u00a0en els \u00faltims temps, ha sorgit el concepte de la compassi\u00f3 que ens ensenya a relacionar-nos amb les experi\u00e8ncies vitals dif\u00edcils d’una manera amable, atenta i comprensiva, de manera que, com assenyalen alguns autors, es deixi enrere l’autocr\u00edtica i el \u00abautomaltrato\u00bb, treballant sobre conceptes com la bondat, l’empatia i l’acceptaci\u00f3, que tamb\u00e9 estan donant bons resultats en la intervenci\u00f3 que realitzem en els centres de menors gestionats per FSC.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Tradicionalment, en els centres d’acolliment residencial per a menors, s’ha treballat majorit\u00e0riament des d’un model cognitiu-conductual, ent\u00e8s com una progressi\u00f3 […]<\/p>\n","protected":false},"author":1,"featured_media":14608,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[906,1073],"tags":[999,1424,1425],"class_list":["post-14614","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-actualitat","category-infancia-i-families","tag-ateca","tag-centro-de-acogida-de-menores-ca","tag-ateca-2-ca"],"yoast_head":"\nAvan\u00e7ant des del model cognitiu-conductual a les "ter\u00e0pies de 3a generaci\u00f3" al Centre d'Acollida de Menors de Ateca gestionat per FSC - Fundaci\u00f3n Salud y Comunidad<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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