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Avaliação da eficácia de uma intervenção cognitivo-comportamental em grupo para adultos com perturbação de ansiedade: um estudo exploratório em contexto hospitalar
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Abstract(s)
A investigação tem vindo a salientar a eficácia da intervenção cognitivo-comportamental em grupo na diminuição da sintomatologia ansiosa. Em sistemas de saúde primários e contextos hospitalares, a intervenção psicológica em grupo pode proporcionar uma poupança ao nível económico e de tempo, uma vez que, nestes contextos os recursos disponíveis para a terapia individual são reduzidos, diminuindo por vezes a eficácia da intervenção (Bieling et. al., 2006).
Neste contexto, desenvolvemos um estudo de investigação-ação junto de participantes que recorreram a acompanhamento psicológico em contexto hospitalar e que apresentavam diagnóstico de ansiedade com os seguintes objetivos: (i) avaliar a eficácia de um programa de intervenção cognitivo-comportamental em grupo (TCCG) junto de participantes de idade adulta com perturbação de ansiedade (intra-sujeitos); (ii) avaliar a eficácia de um programa de intervenção cognitivo-comportamental individual (TCCI) junto de participantes de idade adulta com perturbação de ansiedade (intra-sujeitos) e (iii) comparar a eficácia diferencial entre a intervenção cognitvo-comportamental em grupo (TCCG) e a intervenção cognitivo-comportamental individual (TCCI) junto de participantes de idade adulta com perturbação de ansiedade (inter-sujeitos). No estudo participaram 14 clientes de idade adulta, sendo que 7 integraram a intervenção cognitivo-comportamental em grupo (TCCG) e 7 foram acompanhados em intervenção individual de orientação cognitivo-comportamental (TCCI). Todos os participantes foram avaliados antes da intervenção (1ª. sessão) e no final da mesma (8ª. sessão) através de uma escala para avaliação da ansiedade (Self Anxiety Scale, SAS, Zung, 1971) e de um inventário de avaliação psicopatológica (Symptom Checklist-90-Revised, SCL-90-R, Derrogatis, 1975).
Da avaliação intra-sujeitos (comparação entre pré e pós-intervenção em ambos os grupos), verificamos que no grupo TCCG, na pós intervenção constatou-se, uma diminuição estatisticamente significativa da sintomatologia ansiosa, já no grupo TCCI, não foi verificada uma diminuição estatisticamente significativa da sintomatologia ansiosa. A avaliação inter-sujeitos (comparação entre TCCG e TCCI em ambos os momentos) permite concluir que no momento pré-intervenção, o grupo TCCG apresentava um nível mais elevado da sintomatologia ansiosa no que concerne o SCL-90-R, nomeadamente nos itens Ansiedade Fóbica e Psicoticismo comparativamente ao grupo TCCI, já no pós-intervenção não foi verificada diferenças estatisticamente significativas entre ambos os grupos TCCG e TCCI.
Os resultados encontrados estão de acordo com a literatura consultada, permitindo-nos concluir que a intervenção cognitivo-comportamental em grupo é eficaz na redução da sintomatologia ansiosa e que parece revelar-se mais eficaz que a intervenção cognitivo-comportamental individual ao fim de 8 sessões.
The research has highlighted the effectiveness of the group cognitive-behavioral intervention in reducing anxiety symptoms. In primary health care and hospital setting systems, the psychological group intervention can provide savings to the economic level and time, and in these contexts the available resources to individual therapy are reduced, decreasing sometimes the intervention effectiveness (Bieling et.al 2006). In this context, we developed an action-research study with participants who resorted to psychological counseling in a hospital context and who had a diagnosis of anxiety with the following objectives : (i) to evaluate the effectiveness of a group cognitive-behavioral intervention program (TCCG) with adults with anxiety disorder (intra-subjects) ; (ii) to evaluate the effectiveness of an individual cognitive-behavioral intervention (TCCI) program with adults with anxiety disorder (intra-subjects) and (iii) to compare the differential effectiveness between the group cognitive-behavioral intervention (TCCG) and individual cognitive-behavioral intervention (TCCI) among adults with anxiety disorder. In the study, 14 adult’s clients have been participated, which 7 of them were part of the group cognitive-behavioral intervention (TCCG) and 7 were followed in an individual cognitive-behavioral intervention (TCCI). All participants were evaluated before the intervention (1st session) and at the end of it (8th session) using a scale for assessing anxiety (Self Anxiety Scale, SAS, Zung, 1971) and a psychopathological assessment inventory (Symptom Checklist – 90 Revised, SCL-90-R, Derrogatis, 1975). From the intra-subject evaluation (comparison between pre and post-intervention in both groups), we found that in the TCCG group, in the post-intervention period, there was a statistically significant decrease in anxious symptoms, whereas in the TCCI group, there was no decrease statistically significant difference in anxious symptoms. The inter-subject’s assessment (comparison between TCCG and TCCI at both moments) allows us to conclude that, at the pre-intervention moment, the TCCG group had a higher level of anxious symptoms regarding the SCL-90-R, mainly in the items Phobic Anxiety and Psychoticism compared to the TCCI group, but in the post-intervention there were no statistically significant differences between both the TCCG and the TCCI groups. The results found are in agreement with the consulted literature, allowing us to conclude that the group cognitive-behavioral intervention is effective in reducing anxious symptoms and that it seems to be more effective than the individual cognitive-behavioral intervention after 8 sessions.
The research has highlighted the effectiveness of the group cognitive-behavioral intervention in reducing anxiety symptoms. In primary health care and hospital setting systems, the psychological group intervention can provide savings to the economic level and time, and in these contexts the available resources to individual therapy are reduced, decreasing sometimes the intervention effectiveness (Bieling et.al 2006). In this context, we developed an action-research study with participants who resorted to psychological counseling in a hospital context and who had a diagnosis of anxiety with the following objectives : (i) to evaluate the effectiveness of a group cognitive-behavioral intervention program (TCCG) with adults with anxiety disorder (intra-subjects) ; (ii) to evaluate the effectiveness of an individual cognitive-behavioral intervention (TCCI) program with adults with anxiety disorder (intra-subjects) and (iii) to compare the differential effectiveness between the group cognitive-behavioral intervention (TCCG) and individual cognitive-behavioral intervention (TCCI) among adults with anxiety disorder. In the study, 14 adult’s clients have been participated, which 7 of them were part of the group cognitive-behavioral intervention (TCCG) and 7 were followed in an individual cognitive-behavioral intervention (TCCI). All participants were evaluated before the intervention (1st session) and at the end of it (8th session) using a scale for assessing anxiety (Self Anxiety Scale, SAS, Zung, 1971) and a psychopathological assessment inventory (Symptom Checklist – 90 Revised, SCL-90-R, Derrogatis, 1975). From the intra-subject evaluation (comparison between pre and post-intervention in both groups), we found that in the TCCG group, in the post-intervention period, there was a statistically significant decrease in anxious symptoms, whereas in the TCCI group, there was no decrease statistically significant difference in anxious symptoms. The inter-subject’s assessment (comparison between TCCG and TCCI at both moments) allows us to conclude that, at the pre-intervention moment, the TCCG group had a higher level of anxious symptoms regarding the SCL-90-R, mainly in the items Phobic Anxiety and Psychoticism compared to the TCCI group, but in the post-intervention there were no statistically significant differences between both the TCCG and the TCCI groups. The results found are in agreement with the consulted literature, allowing us to conclude that the group cognitive-behavioral intervention is effective in reducing anxious symptoms and that it seems to be more effective than the individual cognitive-behavioral intervention after 8 sessions.
Description
Keywords
Ansiedade Terapia cognitivo-comportamental Intervenção em grupo Anxiety Cognitive-behavioral therapy Group intervention