A aliança terapêutica: um estudo de processo de uma paciente diagnosticada com transtorno de personalidade borderline

Abstract

Psychotherapy research have contributed for the study of therapeutic alliance, its development and maintenance during the treatment of patients diagnosed with many disorders. By thorough exploration of the actions of the process, including patient, interaction and therapist variables, it is possible understand what happens in a therapeutic setting and how the Therapeutic Alliance develops in psychotherapy. Few studies directed their research to patients diagnosed with Borderline Personality Disorder, especially in the description of processes and therapeutic results. This Master's dissertation aimed to evaluate the Therapeutic Alliance in the psychotherapy process of a young woman diagnosed with Borderline Personality Disorder. For such, 12 psychoanalytic psychotherapy sessions were coded by two instruments, one that evaluates the Therapeutic Alliance and the second focusing on the study of the therapeutic process. The Working Alliance Inventory Observer Form (WAI-O) seeks to assess the Therapeutic Alliance through 36 items, investigating the three subscales present in the treatment: the Objectives, the Tasks, and the Bond. The Psychotherapy Process (PQS) aims to assess the psychotherapy sessions through 100 items describing the therapist, the attitudes, the behavior of the patient and the therapist/patient interactions. The first study is the analysis and description of the Therapeutic Alliance in psychotherapy, during the six months of treatment, to understand the qualities of this relationship during these sessions, and later in the three stages of treatment. The second one investigates in depth the process of the Therapeutic Alliance of psychotherapy through the integration of clinical notes, narratives made through the five most typical items and five less typical items of the process, and the correlation of the categories of the Psychotherapy Process Q-Set (PQS) with the subscales of the Working Alliance Inventory Observer Form (WAI-O). Therefore, this dissertation points out that the Therapeutic Alliance is a factor of great importance in the process of psychotherapy, especially in the treatment of critically ill patients and the bond, as well as the empathic and sensitive attitude of the therapist are essential components in this process.