Evaluación de la efectividad de la terapia de grupo multifamiliar en el abordaje de la problemática conductual y emocional del adolescente

Résumé

Title: Assessment of the effectiveness of the multi-family group therapy when addressing behavior and emotional problems in adolescence. Aims: In the wake of the high demand for care as a consequence of problematic behavior during adolescence at an outpatient clinic, with limited healthcare resources, a multi-family group therapy (MFGT) is suggested as a therapeutic alternative of easy implementation, economically worthwhile and potentially effective with respect to other frequently utilized treatments or tratment as usual (TAU) in this center. As there are few documented studies which prove the efficiency and/ or effectiveness of similar therapy models to the one discussed here, we will try to demonstrate that MFGT is no less effective than TAU in problematic behavior modification in adolescents. Method: An experimental design study is carried out on selected incidental cases (adolescents aged 12-15) who attend the child-youth mental health care clinic in the IX area of the Region of Murcia from January 2013 to April 2014. A registry at basal time of personal, social-family characteristics and problematic behavior in adolescents by means of YSR and parents' attitude towards upbringing by means of PCRI is proceeded to. Later, a random assignation of two groups of intervention, MFGT (fortnightly sessions) and TAU, which includes individual therapy (with monthly or bimonthly sessions) is carried out. Finally, the results and variations obtained in the aforementioned groups of intervention after 6 months and with respect to basal time are analyzed, to which effect results in subsequent questionnaires for parents and adolescents in said period are assessed. In order to perform the analysis, the statistics software program SPSS, version 15 for Windows was implemented, by means of the appropriate contrast tests, both for related and independent samples. Results: the majority of incidental cases were 13 year old boys whose family nucleus was composed of their parents and 2 siblings. Apart from that, they had more than 3 close friends and perceived themselves as similar to other teenagers of the same age with regard to their relationship with friends, parents and siblings and to the ability to be self-sufficient. The study sample scored higher than other samples of general population in most of the problem behavior scales. Differences were also observed in connection with gender at basal time, with girls featuring more internalizing problem behaviors than boys, but also with higher marks in verbal aggressiveness, a externalizing factor subscale. The parents' participation in the study, but also the perceived support scale in PCRI, turned out significantly higher in the case of male teenagers. Besides, fathers' and mothers' educational styles were noticeably different. After six months of intervention, there was a significant increase in the self-perception of the improvement of the quality of the friendships in both types of treatment. Moreover, there was a notable increase in verbal aggressiveness on the whole and also in the socially desirable behavior in teenagers taking part in MFGT. On the contrary, there was a significant decrease in the scores in the majority of scales of internalizing patterns and thinking problems in boys and girls partaking in TAU, obtaining better results in the average grade of the last term. There weren't notable differences between both types of intervention with regard to parents' participation after 6 months. Likewise, parents taking part in TAU showed a tendency to feature higher marks in discipline than those taking part in MFGT. Conclusions: Therapy, both in individual and multi-family group formats, with or without combined psychopharmacological treatment has proven effective in the reduction of behavioral and/or emotional problems in adolescents. Both treatment types enable a decrease in the average scoring in behavioral and emotional problem scales in adolescents, albeit in different ways.