Supervisión clínica de casos complejos de trastornos de la personalidad según la Terapia Interpersonal Metacognitiva

• Antonio Carcione ^[1] ; Ilaria Riccardi ^[1]
  1. [1] Third Centre of Cognitive Psychotherapy - Italian School of Clinical Cognitivism (SICC). Rome, Italy
• Localización: Revista de psicoterapia, ISSN-e 2339-7950, ISSN 1130-5142, Vol. 34, Nº. 126, 2023 (Ejemplar dedicado a: Desafíos de la Supervisión en Psicoterapia), págs. 113-132
• Idioma: español
• DOI: 10.5944/rdp.v34i126.38709
• Enlaces
  • Texto completo (pdf)
• Resumen

  • Tratar con pacientes con Trastornos de la Personalidad (TP) significa enfrentarse a lo que a menudo se denominan casos complejos. La complejidad de los casos deriva de diversas variables y en particular: el alto porcentaje de coocurrencias diagnósticas, la dificultad de los pacientes para reflexionar sobre sus propios estados mentales y los de los demás (es decir, dificultades metacognitivas) y la fuerte presión emocional que experimentan los terapeutas. Todo ello provoca dificultades en la construcción de la alianza terapéutica y altas tasas de abandono. Por estas razones, los terapeutas suelen necesitar supervisión, con un terapeuta más experimentado o incluso entre pares. Este artículo propone un modelo de supervisión estructurada según la Terapia Metacognitiva Interpersonal (TMI), que es un modelo de tratamiento para la TP basado en la evidencia.

• Referencias bibliográficas
  • Alfonsson, S., Parling, T., Spännargård, Å., Andersson, G., & Lundgren, T. (2018). The effects of clinical supervision on supervisees...
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, (5th Ed.). https://doi.org/10.1176/appi.books.9780890425596
  • Anderson, T., Crowley, M. E. J., Patterson, C. L., & Heckman, B. D. (2012). The influence of supervision on manual adherence and therapeutic...
  • Bateman, A., & Fonagy, P. (2004). Psychotherapy for borderline personality disorder: Mentalization based treatment. Oxford University...
  • Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice,...
  • Bordin, E. S. (1983). A working alliance based model of supervision. The Counseling Psychologist, 11(1), 35-42. https://doi.org/10.1177/0011000083111007
  • Carcione, A., Dimaggio, G., Conti, L., Nicolò, G., Fiore, D., Procacci, M., & Semerari, A. (2010). Metacognition Assessment Scale (MAS)...
  • Carcione, A., & Semerari, A. (2019). I cicli interpersonali problematici nei disturbi di personalità [Problematic interpersonal cycles...
  • Carcione, A., Nicolò, G., & Semerari, A. (2021). Complex cases of personality disorders. Metacognitive interpersonal therapy. Springer....
  • Clark, L. A. (2007). Assessment and diagnosis of personality disorder: Perennial issues and an emerging reconceptualization. Annual Review...
  • Clarkin, J. F., Yeomans, F. E., & Kernberg, O. F. (1999). Psychotherapy for borderline personality. Wiley.
  • Colli, A., Tanzilli, A., Dimaggio, G., & Lingiardi, V. (2014). Patient personality and therapist response: An empirical investigation....
  • Dimaggio, G., & Norcross, J. C. (2008). Treating patients with two or more personality disorders: An introduction. Journal of Clinical...
  • Dimaggio, G., Semerari, A., Carcione, A., Nicolo, G., &Procacci, M. (2007). Psychotherapy of personality disorders: Metacognition, states...
  • Falender, C. A., & Shafranske, E. P. (2010). Psychotherapy-based supervision models in an emerging competency-based era: A commentary....
  • Falender, C. A., Cornish, J. A. E., Goodyear, R., Hatcher, R., Kaslow, N. J., Leventhal, G., Shafranske, E., Sigmon, S. T., Stoltenberg, C.,...
  • Fernández-Álvarez, H., Gómez, B., & García, F. (2015). Bridging the gap between research and practice in a clinical and training network:...
  • Fernández-Álvarez, H., Clarkin, J. F., Salgueiro, M. D. C., & Critchfield, K. L. (2005). Participant factors in treating personality disorders....
  • Gaetano, P., Picardi, A., & Carcione, A. (2022). A cognitive therapy perspective on therapists’ feelings and interpersonal processes....
  • Gamache, D., Savard, C., Lemelin, S., Cote, A., & Villeneuve, E. (2018). Premature psychotherapy termination in an out- patient treatment...
  • Haggerty, G., & Hilsenroth, M. J. (2011). The use of video in psychotherapy supervision. British Journal of Psychotherapy, 27(2), 193-210....
  • Hoffmann, J., & Weinberger, S. (2007). The art and science of psychotherapy. Routledge.
  • Horvath, A. O. (2001). The alliance. Psychotherapy: Theory, Research, Practice, Training, 38(4), 365–372. https://doi.org/10.1037/0033-3204.38.4.365
  • MacDonald, J., & Ellis, P. M. (2012). Supervision in psychiatry: terra incognita? Current Opinion in Psychiatry, 25(4), 322-326. https://doi.org/10.1097/YCO.0b013e3283541ecc
  • Monticelli, F., Imperatori, C., Carcione, A., Pedone, R., & Farina, B. (2018). Cooperation in psychotherapy increases metacognitive abilities:...
  • Norcross, J. C., & Lambert, M. J. (2006). The therapy relationship. In J. C. Norcross, L. E. Beutler, & R. F. Levant (Eds.), Evidence-based...
  • Perris, C. (1993). Psicoterapia del paziente difficile [Psychotherapy of the difficult patient]. Metis.
  • Rossi, R., Corbo, D., Magni, L. R., Pievani, M., Nicolò, G., Semerari, A., Quattrini, G., Riccardi, I., Colle, L., Conti, L., Gasparotti,...
  • Ruggiero, G. M., Caselli, G., & Sassaroli, S. (Eds.). (2021). CBT case formulation as therapeutic process. Springer. https://doi.org/10.1007/978-3-030-63587-9
  • Safran, J. D., & Muran, J. C. (2000). Negotiating the therapeutic alliance: A relational treatment guide. Guilford Press.
  • Safran, J. D., & Segal, Z. V. (1990). Interpersonal process in cognitive therapy. Basic Books.
  • Schofield, M. J., & Grant, J. (2013). Developing psychotherapists’ competence through clinical supervision: protocol for a qualitative...
  • Semerari, A. (2002). Psicoterapia cognitiva del paciente grave. Metacognicion y relacion terapéutica [Cognitive psychotherapy of the seriously...
  • Semerari, A., Pellecchia, G., & Carcione, A. (2021). The therapeutic relationship. In A. Carcione, G. Nicolo, & A. Semerari (Eds.),...
  • Stiles, W. B., Honos-Webb, L., & Surko, M. (1998). Responsiveness in psychotherapy. Clinical Psychology: Science and Practice, 5(4), 439–458....
  • Tanzilli, A., Lingiardi, V., & Carcione A. (2023). Therapist Responsiveness and Metacognition: A patient perspective. Preliminary Study....
  • Watkins, C. E. (2019). What do clinical supervision research reviews tell us? Surveying the last 25 years. Couns Psychother Res, 20(2), 1–19....
  • Watkins, C. E. (2015). The learning alliance in psychoanalytic supervision: A fifty-year retrospective and prospective. Psychoanalytic Psychology,...
  • Wheeler, S., & Richards, K. (2007). The impact of clinical supervision on counsellors and therapists, their practice and their clients....
  • Whipple, J., Hoyt, T., Rousmaniere, T., Swift, J., Pedersen, T., & Worthen, V. (2020). Supervisor variance in psychotherapy outcome in...
  • Zimmerman, M., Rothschild, L. y Chelminski, I. (2005). The prevalence of DSM-IV personality disorders in psychiatric outpatients [La prevalencia...
  • World Health Organization. (2019). International statistical classification of diseases and related health problem (11th ed.). https://icd.who.int/