Psychological Intervention in Psychotic Crisis: a person-centered approach

Guilherme Wykrota Tostes,Vera Engler Cury

doi:10.1590/1982-0275202138e200106

Guilherme Wykrota Tostes, Vera Engler Cury

Open Access

https://doi.org/10.1590/1982-0275202138e200106

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Abstract

Abstract This article describes, theoretically analyzes, and exemplifies, through a fictitious vignette, a psychological intervention of a clinical nature, developed by psychologists in a tertiary mental health care hospital, as an alternative to conventional physical restraint in situations of acute psychotic crises. The theoretical framework adopted is Person-Centered Approach, developed by the North American psychologist Carl Rogers. The psychological intervention reveals the importance of an interpersonal relationship in the care of patients who are going through a psychotic crisis. The psychologist’s therapeutic posture includes the three attitudes advocated by Carl Rogers as necessary and sufficient to facilitate the process of resuming personal autonomy (congruence or authenticity, unconditional positive regard, and empathic understanding), in addition to confidence in the patient’s own actualizing tendency. The therapeutic strategy presented is a possible resource to be used to stabilize the person in crisis. These attitudes were initially proposed by Rogers and his team to develop and maintain a psychotherapeutic intervention process, but they also proved to be effective in the experience of Brazilian psychologists in relation to patients with severe mental disorders in acute crises.

Highlights

Este artigo descreve, analisa teoricamente e exemplifica por meio de uma vinheta fictícia uma intervenção psicológica de natureza clínica, desenvolvida por psicólogos num serviço de atenção terciária em saúde mental, como alternativa à contenção física convencional em situações de crises psicóticas agudas
The present article aims to present a theoretical analysis about psychological intervention in the case of patients in acute psychotic crisis based on the assumptions of the Person-Centered Approach, developed by the North American psychologist Carl Rogers in the context of Client-Centered Therapy
It is noteworthy that a standard operational protocol was developed in this hospital institution, given the therapeutic efficacy provided by the active presence of professional psychologists in the manifestations of mental suffering of patients in crisis situations; the objective of this document was to ensure the presence of a member of the psychology team to carry out the first interventions in these cases

Summary

Introduction

Analisa teoricamente e exemplifica por meio de uma vinheta fictícia uma intervenção psicológica de natureza clínica, desenvolvida por psicólogos num serviço de atenção terciária em saúde mental, como alternativa à contenção física convencional em situações de crises psicóticas agudas. The present article aims to present a theoretical analysis about psychological intervention in the case of patients in acute psychotic crisis based on the assumptions of the Person-Centered Approach, developed by the North American psychologist Carl Rogers in the context of Client-Centered Therapy This type of intervention was carried out by one of the authors with fellow psychologists in a tertiary mental health care hospital, as an alternative to conventional physical restraint in situations of an acute psychotic crisis. It is noteworthy that a standard operational protocol was developed in this hospital institution, given the therapeutic efficacy provided by the active presence of professional psychologists in the manifestations of mental suffering of patients in crisis situations; the objective of this document was to ensure the presence of a member of the psychology team to carry out the first interventions in these cases The scope of this institutional protocol was the humanization of professional practices aimed at coping with crisis situations in patients in hospital custody. In preparation of this protocol, the experience of the psychology team played a central role, as the presence of a psychologist became mandatory in any case of acute crisis and prior to any attempt at physical or chemical restraints by the other teams, medical or nursing

Objectives

Conclusion