Guía para el manejo de las rupturas en la alianza terapéutica

dc.contributor.advisorNavia Arroyo, Carmen Elvira
dc.contributor.authorDelgado Merchan, Laura Valentina
dc.contributor.researchgroupEstilo de Vida y Desarrollo Humano
dc.date.accessioned2026-03-26T16:38:19Z
dc.date.available2026-03-26T16:38:19Z
dc.date.issued2023
dc.description.abstractEl manejo de las rupturas en la alianza terapéutica se reconoce como una habilidad que beneficia de manera positiva el cambio en los procesos de psicoterapia, presentándose como una necesidad para los terapeutas el poder contar con orientaciones para dicho manejo. La presente guía busca responder a esta necesidad mediante la construcción de una guía que ofrezca parámetros generales y recomendaciones para el manejo de las rupturas. Se hizo una revisión de la literatura, se obtuvieron 129 artículos teóricos y empíricos desde diversos enfoques de psicoterapia. Se realizó un análisis de contenido por medio del programa NVIVO 14, obteniendo las categorías: aspectos teóricos, identificación de rupturas, estrategias de resolución, habilidades clínicas y manejo de factores que influencian la alianza. Con base en los resultados del análisis de estas categorías se construye la guía la cual está dividida en dos secciones: aspectos teóricos, donde se establecen los conceptos generales para la comprensión del manejo de las rupturas y aspectos procedimentales donde se plantean el procedimiento de resolución de las rupturas, los indicadores de ruptura, las estrategias de resolución, habilidades transversales y los factores que afectan la alianza. Estos resultados se presentan con ejemplos y recomendaciones para favorecer la toma de decisiones en el manejo de las rupturas según las necesidades del consultante y el estilo del terapeuta. Finalmente se resalta que la guía obtenida es un instrumento útil para la práctica clínica de terapias y terapeutas en formación, ofreciendo de manera integrada y sintetizada la información obtenida en la literatura y sirviendo de base como una guía para el trabajo clínico. (Texto tomado de la fuente)spa
dc.description.abstractRupture management in the therapeutic alliance is recognized as a skill that positively benefits change in psychotherapy processes, presenting a need for therapists to have guidance on how to handle them. This guide aims to address this need by creating a resource that offers general parameters and recommendations for managing ruptures. A literature review was conducted, obtaining 129 theoretical and empirical articles from various psychotherapy approaches. Content analysis was performed using NVIVO 14 software, resulting in the following categories: theoretical aspects, identification of ruptures, resolution strategies, clinical skills, and management of factors influencing the alliance. Based on the analysis of these categories, the guide was constructed and divided into two sections: theoretical aspects, which establish general concepts for understanding rupture management, and procedural aspects, which outline the resolution process, rupture indicators, resolution strategies, transversal skills, and factors affecting the alliance. These results are presented with examples and recommendations to support decision-making in rupture management according to the client’s needs and the therapist’s style. Finally, it is emphasized that the guide is a useful tool for clinical practice for therapists and trainees, offering integrated and synthesized information from the literature and serving as a baseline for clinical work.eng
dc.description.degreelevelMaestríaspa
dc.description.degreenameMaestría en Psicología
dc.description.methodsPara el desarrollo de esta guía, se utilizaron como referencia algunos procedimientos propuestos en la Guía Metodológica para la elaboración de Guías de Atención Integral en el Sistema General de Seguridad Social en Salud Colombiano (Ministerio de la Protección Social - Colciencias, 2010), los cuales se llaman: Etapa 1: Formulación de una Guía de Práctica Clínica, Etapa 2: Desarrollo o adaptación de una Guía de Práctica Clínica y la Etapa 3: Preparación de una Guía de Práctica Clínica. Se tomaron de referencia estas etapas y se describe a continuación los pasos utilizados en la realización de la presente guia. Para la primera etapa se hizo una formulación de la guía, que consistió en varios pasos que incluyeron establecer la priorización y selección del foco, definir el alcance y objetivos de la guía para ser socializados. Estos se presentaron en el grupo de la línea de investigación Psicología Clínica y Bienestar Psicológico del Grupo de Investigación en Estilos de Vida y Desarrollo Humano de la Universidad Nacional de Colombia, donde se recibieron recomendaciones de expertos sobre cómo buscar información y se llegó al acuerdo de que el foco de la guía fuera el manejo de las rupturas en la alianza terapéutica. Para la segunda fase se realizó una búsqueda de guías sobre manejo de rupturas en la alianza para determinar si era posible llevar a cabo la adaptación de una de ellas. Para esto se llevó se usaron los buscadores: Pubmed, TripDatabase, Google Academyc, Guiasalud, National Guideline Clearinghouse (NGC) y CPG-infobase Guidelines International Netword (GIN), con la siguientes palabras clave: Alliance OR Alliance rupture AND Guideline, . Del resultado de esta búsqueda solo se obtuvo un manual de observación de rupturas y de estrategias de resolución llamado RUPTURE RESOLUTION RATING SYSTEM (3RS): MANUAL, escrito por Catherine F. Eubanks, J. Christopher Muran, y Jeremy D. Safran (2015). Se analizó este manual y se determinó que, aunque tenía información práctica, útil y necesaria para el desarrollo de la presente guía, la información presentada era incompleta, estaba desarrollada para ser usada como un manual de observación y carecía de una perspectiva más integradora de la literatura sobre el manejo de las rupturas. Por lo cual, se tomó la decisión de que el manual fuera un recurso bibliográfico para el desarrollo final de la guía. Se procede entonces a realizar una búsqueda sistemática en la literatura, de información teórica, evidencia empírica y recomendaciones clínicas presentadas desde los distintos enfoques de intervención en psicoterapia (relacional, cognitivo-conductual, sistémico y gestalt) que permitiera el desarrollo de una guía integrada que contemplara diferentes visiones. La búsqueda de información para el enfoque relacional se realizó en las siguientes bases de datos: APA PsycNet, PubMed, Scielo y Scopus, utilizando los siguientes tesauros: Title: Alliance rupture, AND, Relational Therapy, con un resultado inicial de 59 artículos. Después de una selección inicial, se excluyeron aquellos artículos que no estaban disponibles, que no tuvieran información sobre rupturas en la alianza, o que estuvieran enfocados en trastornos de alimentación, episodios psicóticos o en terapias grupales, familiares o de niños. Finalmente se quedaron 13 artículos. La búsqueda de información para el enfoque cognitivo conductual se realizó en las siguientes bases de datos: APA PsycNet, PubMed, Scielo y Scopus, utilizando los siguientes tesauros: Title: Alliance rupture, AND, (Cognitive behavioural therapy OR Behaviour therapy OR Behavioral Therapy) con un resultado inicial de 7.349 artículos. Después de una selección inicial, se excluyeron aquellos artículos que no estaban disponibles, que no tuvieran información sobre rupturas en la alianza, o que estuvieran enfocados en trastornos de alimentación, episodios psicóticos o en terapias grupales, familiares o de niños. Finalmente quedaron 97 artículos. La búsqueda de información para el enfoque sistémico se realizó en las siguientes bases datos: APA PsycNet, PubMed, Scielo y Scopus, utilizando los siguientes tesauros: Title, Keyword, Abstract: Alliance OR Title, Keyword, Abstract: therapeutic alliance AND Title, Keyword, Abstract: systemic AND Title, Keyword, Abstract: psychotherapy, con un resultado inicial de 157 artículos. Después de una selección inicial, se excluyeron aquellos artículos que no estaban disponibles, que no tuvieran información sobre rupturas en la alianza, o que estuvieran enfocados en trastornos de alimentación, episodios psicóticos o en terapias grupales, familiares o de niños. Finalmente se quedaron 10 artículos. La búsqueda de información para el enfoque gestáltico se realizó en las siguientes bases de datos: APA PsycNet, PubMed, Scielo y Scopus, utilizando los siguientes tesauros: Title, Keyword, Abstract: alliance AND Title, Keyword, Abstract: gestalt , con un resultado inicial de 104 artículos. Después de una selección inicial, se excluyeron aquellos artículos que no estaban disponibles, que no tuvieran información sobre rupturas en la alianza, o que estuvieran enfocados en trastornos de alimentación, episodios psicóticos o en terapias grupales, familiares o de niños. Finalmente se quedaron 9 artículos. Posteriormente se realizó un análisis de contenido de la información a través de la herramienta NVIVO 14. En primera instancia se codificaron los documentos a partir de ocho categorías preestablecidas las cuales eran: concepto de alianza, concepto de ruptura, justificación y alianza, factores de personalidad y alianza, habilidades clínicas, identificación de rupturas, estrategias de resolución de rupturas y factores que afectan la alianza. A partir del análisis de los códigos emergieron nuevas subcategorías que permitieron reorganizar la información y las categorías al considerar que justificación, concepto de ruptura y concepto de alianza, conformaban una sola categoría definida como aspectos teóricos; adicionalmente, se identificó que factores de la personalidad se podía considerar como una subcategoría de la categoría factores que afectan la alianzas. Es así como se obtuvieron las cinco categorías definitivas: aspectos teóricos, identificación de rupturas, estrategias de resolución, habilidades clínicas y factores que afectan la alianza. Posteriormente se hizo una segunda codificación de la información con la nueva reorganización de las categorías y subcategorías. Por último, la tercera fase de elaboración consistió en la redacción de la guía, desarrollada a partir de la información analizada y se decidió organizar la guía con los siguientes apartados: aspectos teóricos, indicadores de rupturas en la alianza, proceso de resolución de rupturas, estrategias de resolución, habilidades generales y transversales, y manejo de factores que influyen la alianza terapéutica.
dc.description.researchareaPsicología clínica y bienestar psicológico
dc.format.extent159 páginas
dc.format.mimetypeapplication/pdf
dc.identifier.instnameUniversidad Nacional de Colombiaspa
dc.identifier.reponameRepositorio Institucional Universidad Nacional de Colombiaspa
dc.identifier.repourlhttps://repositorio.unal.edu.co/spa
dc.identifier.urihttps://repositorio.unal.edu.co/handle/unal/89781
dc.language.isospa
dc.publisherUniversidad Nacional de Colombia
dc.publisher.branchUniversidad Nacional de Colombia - Sede Bogotá
dc.publisher.facultyFacultad de Ciencias Humanasspa
dc.publisher.placeBogotá, Colombia
dc.publisher.programBogotá - Ciencias Humanas - Maestría en Psicologíaspa
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dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.licenseAtribución-NoComercial-CompartirIgual 4.0 Internacional
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/
dc.subject.ddc150 - Psicología
dc.subject.lembSEPARACION (PSICOLOGIA)spa
dc.subject.lembSeparation (Psychology)eng
dc.subject.lembRELACIONES HUMANASspa
dc.subject.lembInterpersonal relationseng
dc.subject.lembDEPENDENCIA (PSICOLOGIA)spa
dc.subject.lembDependency (Psychology)eng
dc.subject.lembCONDUCTA DEPENDIENTEspa
dc.subject.lembAttachment behavioreng
dc.subject.proposalAlianza terapéuticaspa
dc.subject.proposalProceso psicoterapeuticospa
dc.subject.proposalPsicoterapiaspa
dc.subject.proposalTherapeutic alliancespa
dc.subject.proposalGuía clínicaspa
dc.subject.proposalTherapeutic relationshipeng
dc.subject.proposalAlliance resolutioneng
dc.subject.proposalReparacióneng
dc.subject.proposalRepaireng
dc.subject.proposalRelación terapéuticaeng
dc.subject.proposalPsychotherapy processeng
dc.titleGuía para el manejo de las rupturas en la alianza terapéuticaspa
dc.title.translatedGuide to managing ruptures in the therapeutic allianceeng
dc.typeTrabajo de grado - Maestría
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.redcolhttp://purl.org/redcol/resource_type/TM
dc.type.versioninfo:eu-repo/semantics/acceptedVersion
dcterms.audience.professionaldevelopmentEstudiantes
dcterms.audience.professionaldevelopmentInvestigadores
dcterms.audience.professionaldevelopmentMaestros
dcterms.audience.professionaldevelopmentPúblico general
oaire.accessrightshttp://purl.org/coar/access_right/c_abf2

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