Browsing by Author "Calero Elvira, Ana"
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Item Homework assignment and compliance review from a behavioural perspective: the verbal sequences between therapist and client.(Behavioral Psychology, 2023) Marchena Giráldez, Carlos Alberto; Froxán Parga, María Xesús; Calero Elvira, AnaTherapeutic (homework) tasks are a characteristic strategy in behavioral psychology to achieve clinical change. The aim of the present study is to determine how behavioural therapists assign therapeutic tasks and review their compliance. Observational methodology was used to analyse the verbal interaction of therapists and clients in 211 recorded sessions (19 complete successful cases) using a validated coding system (SIST-INTER-INSTR). The values for inter- and intra-judge reliability were from good to excellent. The study shows that behavioural psychologists offer motivating verbalisations when assigning therapeutic tasks. During the review of task compliance, therapists frequently provide positive reinforcement when clients report complete compliance with the assigned task but stop the review of tasks when clients report non-compliance or only partial compliance with the task. These sequences provide information about how behavioural therapists provide instructions for therapeutic tasks and review their compliance. This is a first step to study how these verbal sequences favour the establishment of TC and the effectiveness of treatment.Item Homework Instructions and Compliance Assessing in the Therapeutic Process: An Analysis of Therapists’ Verbal Behavior.(Universitas Psychologica, 2020) Marchena Giráldez, Carlos Alberto; Froxán Parga, María Xesús; Calero Elvira, AnaInstructions are a common resource used by behavioral therapists to assign therapeutic homework. However, understanding how clients learn with instructions is better known in laboratory research than in clinical research. The present study aims to explore changes in the way of instructing and reviewing the client’s compliance throughout the therapeutic process. We analyzed the therapist’s verbal behavior during 211 recorded sessions corresponding to 19 cases treated by 11 behavioral therapists (53% male and 47% female). The sessions were divided into four stages according to the timing of the intervention and coded by using a previously validated coding system (SYST-INTER-INSTR). Results show that instructions become less specific towards the last stage of the intervention. However, therapists assess task compliance in the same way towards the end of the therapeutic process. The change in specificity suggests that the client’s behavior changes from being controlled by instructions to being controlled by natural contingencies. However, to make sure the clinical change remains; therapists assess and reinforce the client’s compliance until the end of the intervention. Although clinical implications of the results, some limitations (i.e., not considering the type of task instructed) should be addressed in future studies.Item Internet-based cognitive behavioural therapy programme with and without videoconference guidance sessions: A randomized controlled trial to treat work-related symptoms of anxiety and depression.(Clinical Psychology and Psychotherapy, 2021) Calero Elvira, Ana; Santacreu Ivars, Marta; Marchena Giráldez, Carlos Alberto; Shih, Pei-ChunThis study provides the results from the implementation of a highly structured therapist-guided iCBT program for people with work-related anxiety and depression, in terms of program efficacy, participants’ adherence and satisfaction. Seventy-seven national police-workers were randomly allocated to one of two groups: without additional videoconference sessions (web platform with guidance of therapist), and with additional videoconference sessions (same intervention as the previous group, plus two videoconference guidance sessions with a psychologist). The intervention was comprised of 12 sessions and took place for 17-20 weeks. We found an adherence rate of 36.4%, with no differences between groups. All participants endorsed lower depression [BDI-II F(1) = 36.98, ρ < .001; ATQ F(1) = 24.22, ρ < .001], and anxiety [STAI-State F(1) = 76.62, ρ < .001] after the program. As a variable related to anxiety and depression in workplace, participants also showed higher assertiveness levels [RAS F(1) = 8.96, ρ < .001]. A significant reduction of the mean level of anxiety perceived by participants as the intervention program progressed was observed in both groups (F(2)=7.44; p=.003). Participants were satisfied with the therapists’ intervention and with the program. No significant group effects were found for any of the measures. Reduction in depression levels was maintained in the 12 months follow-up, but levels of anxiety increased. This study is innovative, as it is the first controlled trial to analyze the effect of two added videoconference sessions, and it includes short and long term measures, which is not usual. The results are discussed to clarify the role of the contact with the therapist to improve treatment adherence.