O adolescente institucionalizado em processo psicoterapêutico: um estudo de caso
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2014-03-11
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A autoestima, o autoconceito e a resiliência são áreas que se encontram diretamente
relacionadas com a qualidade das ligações afetivas estabelecidas e com o processo de
ajustamento psicossocial, no período da adolescência, e nomeadamente quando nos referimos
a adolescentes institucionalizados. A medida de institucionalização surge de histórias de
desenvolvimento familiar marcadas por separações relacionais, violência, vínculos
fragilizados, negligência, circunstâncias que colocam em causa a integridade física e
psicológica do jovem.
A manifestação de sintomas comportamentais e emocionais no adolescente
institucionalizado reflete a vivência de um percurso de vida disfuncional e ausente de relações
de vinculação organizadas e seguras. O envolvimento do jovem institucionalizado em
processo psicoterapêutico, sugere a possibilidade de adaptação e de aceitação ao contexto
institucional; a continuidade do seu desenvolvimento; e a sua reintegração social, numa nova
rede de apoio social (grupo de pares, funcionários da instituição, funcionários da escola e
professores).
Os objetivos do presente estudo de caso estruturam-se pela observação e
compreensão da problemática de uma adolescente institucionalizada, com marcado
sofrimento psicológico e em acompanhamento psicoterapêutico. A dificuldade de adaptação
ao contexto institucional e o conflito continuado que mantém com as figuras institucionais
define-se como o foco problemático a trabalhar no contexto psicoterapêutico. Objetivamos
para o contexto psicoterapêutico, pautado pela empatia, aceitação incondicional e escuta ativa,
a envolvência numa nova experiência emocional que promova uma mudança psicológica na
adolescente.
Os instrumentos de avaliação selecionados surgem neste estudo apenas como uma
medida de interpretação subjetiva, destacando-se primordialmente, o processo
psicoterapêutico como impulsionador do bem-estar psicossocial da adolescente. A escolha
dos mesmos vai de encontro às características clínicas do presente estudo de caso. Utilizamos
a Rosenberg Self-Esteem de Rosenberg (1965) aferida para a população portuguesa por Rocha
e Matos (2003), o Inventário Clínico de Autoconceito de Vaz Serra (1986), a Resilience Scale
de Wagnild e Young (1993), adaptada por Felgueiras (2008), o Questionário de Ligação a
Professores e Funcionários e o Questionário de Ligação a Figuras Significativas
desenvolvidos por Mota e Matos (2005a,b), o Inventory of Peer and Parental Attachment de
Armsden e Greenberg (1987), validado por Ferreira e Costa (1989) e o Brief Symptom
Inventory desenvolvido por Derogatis (1982/ 1993), adaptado por Canavarro (1999).
A interpretação qualitativa realizada leva-nos a concluir que a (des) organização das
primeiras relações de vinculação pontua o estabelecimento de relações afetivas dependentes
de amor, de aceitação e de valorização, como o desenvolvimento de uma organização
patológica. Contudo, a qualidade de ligação a figuras significativas e a envolvência em
processo psicoterapêutico são fatores relevantes na autoestima, no autoconceito e no
desenvolvimento de processos resilientes.
The self-esteem, self-concept and the resilience are areas which we find directly connected with the established quality of affective bonds and the process of psychosocial adjustment in adolescence, and especially when referring to institutionalized adolescents. The measure of institutionalization arises from familiar development histories characterized by relational separations, violence, weakened bonds, negligence and circumstances that jeopardize the physical and psychological integrity of the young. The behavioral and emotional symptomatology in institutionalized adolescent reflects the experience of a life path dysfunctional and absent of organized and safe linking's relations. The involvement of institutionalized young in the psychotherapeutic process implies the possibility of adaptation and admission to institutional context; the continuing of his development; and his social reintegration in a new social support network (peer group, employees of the institution, employees of the school and teachers). The purposes of this case study organize itself by the observation and understanding of the problem of an institutionalized adolescent, with psychological distress and in psychotherapeutic accompaniment. The difficulty in adapting to the institutional context and continuing conflict that they have with institutional figures is defined as the problematic focus to work in the psychotherapeutic context. We aim to the psychotherapeutic context, guided by empathy, unconditional acceptation and active listening, the involvement in a new emotional experience that foments a psychological change in the adolescent. The selected evaluation instruments only appear in this study like a measure of subjective interpretation, highlighting essentially the psychotherapeutic process like a propelling of the psychosocial well-being of the adolescent. The choice of this instruments goes in line with the clinical characteristics of the present study case. We used Rosenberg Self-Esteem of Rosenberg (1965) gauged for the Portuguese population by Rocha and Matos (2003); the Clinical Inventory of Self-concept of Vaz Serra (1986); the Resilience Scale of Wagnild and Young (1993), adapted by Felgueiras (2008); the Questionnaire of Connecting Faculty and Staff and Questionnaire of Connecting Significant Figures developed by Mota and Matos (2005a,b); the Inventory of Peer and Parental Attachment of Armsden and Grrenberg (1987), validated by Ferreira and Costa (1989); and the Brief Symptom Inventory developed by Derogatis (1982/1993), adapted by Canavarro (1999). The realized qualitative interpretation bring us to conclude that the (dis) organization of the first attachment relations point the establishment of affective relations dependents of love, acceptation and valorization like as the development of a pathologic organization. However, the quality of the link to significant figures and to the surroundings in psychotherapeutic process are relevant factors in self-esteem, self-concept and development of resilient processes.
The self-esteem, self-concept and the resilience are areas which we find directly connected with the established quality of affective bonds and the process of psychosocial adjustment in adolescence, and especially when referring to institutionalized adolescents. The measure of institutionalization arises from familiar development histories characterized by relational separations, violence, weakened bonds, negligence and circumstances that jeopardize the physical and psychological integrity of the young. The behavioral and emotional symptomatology in institutionalized adolescent reflects the experience of a life path dysfunctional and absent of organized and safe linking's relations. The involvement of institutionalized young in the psychotherapeutic process implies the possibility of adaptation and admission to institutional context; the continuing of his development; and his social reintegration in a new social support network (peer group, employees of the institution, employees of the school and teachers). The purposes of this case study organize itself by the observation and understanding of the problem of an institutionalized adolescent, with psychological distress and in psychotherapeutic accompaniment. The difficulty in adapting to the institutional context and continuing conflict that they have with institutional figures is defined as the problematic focus to work in the psychotherapeutic context. We aim to the psychotherapeutic context, guided by empathy, unconditional acceptation and active listening, the involvement in a new emotional experience that foments a psychological change in the adolescent. The selected evaluation instruments only appear in this study like a measure of subjective interpretation, highlighting essentially the psychotherapeutic process like a propelling of the psychosocial well-being of the adolescent. The choice of this instruments goes in line with the clinical characteristics of the present study case. We used Rosenberg Self-Esteem of Rosenberg (1965) gauged for the Portuguese population by Rocha and Matos (2003); the Clinical Inventory of Self-concept of Vaz Serra (1986); the Resilience Scale of Wagnild and Young (1993), adapted by Felgueiras (2008); the Questionnaire of Connecting Faculty and Staff and Questionnaire of Connecting Significant Figures developed by Mota and Matos (2005a,b); the Inventory of Peer and Parental Attachment of Armsden and Grrenberg (1987), validated by Ferreira and Costa (1989); and the Brief Symptom Inventory developed by Derogatis (1982/1993), adapted by Canavarro (1999). The realized qualitative interpretation bring us to conclude that the (dis) organization of the first attachment relations point the establishment of affective relations dependents of love, acceptation and valorization like as the development of a pathologic organization. However, the quality of the link to significant figures and to the surroundings in psychotherapeutic process are relevant factors in self-esteem, self-concept and development of resilient processes.
Descrição
Dissertação de Mestrado em Psicologia Clínica
Palavras-chave
Adolescência , Autoestima , Institucionalização , Vinculação , Resiliência , Autoconceito