Psicoterapia analítico funcional y adicciones: una revisión sistemática selectiva
Functional analytical psychotherapy and addictions: a selective systematic reviewBarra lateral del artículo
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La presente revisión sistemática selectiva explora el potencial de la Psicoterapia Analítico Funcional (FAP) en el tratamiento de los trastornos por uso de sustancias (SUD). Partiendo de un enfoque conductual, se analiza cómo la FAP, al centrarse en la transformación del repertorio interpersonal y la reducción de la aversividad social, puede ofrecer ventajas respecto a intervenciones tradicionales que se enfocan solo en la abstinencia. Se describe la conceptualización de las Conductas Clínicamente Relevantes (CRB) y el papel activo del terapeuta en la identificación, modelado y reforzamiento de nuevas formas de interacción social dentro del espacio terapéutico. A través de una estrategia de búsqueda rigurosa en bases de datos especializadas y criterios de selección explícitos, se identificaron estudios fundamentales, pero se constató la escasez de investigación empírica que aísle los efectos específicos de la FAP en adicciones. Los estudios revisados, aunque prometedores, suelen combinar FAP con otros enfoques, lo que limita la interpretación de sus resultados. Se concluye que la FAP representa una aportación valiosa y novedosa en el abordaje de las adicciones, pero se requieren investigaciones futuras con diseños experimentales robustos y medición detallada de los procesos terapéuticos para establecer su eficacia y mecanismos de cambio.
This selective systematic review explores the potential of Functional Analytic Psychotherapy (FAP) in the treatment of substance use disorders (SUD). Based on a behavioral approach, it analyzes how FAP, by focusing on transforming interpersonal repertoire and reducing social aversiveness, can offer advantages over traditional interventions that focus solely on abstinence. It describes the conceptualization of Clinically Relevant Behaviors (CRB) and the active role of the therapist in identifying, modeling, and reinforcing new forms of social interaction within the therapeutic space. Through a rigorous search strategy in specialized databases and explicit selection criteria, fundamental studies were identified, but a lack of empirical research isolating the specific effects of FAP on addiction was found. The studies reviewed, although promising, often combine FAP with other approaches, which limits the interpretation of their results. It is concluded that FAP represents a valuable and novel contribution to the treatment of addiction, but future research with robust experimental designs and detailed measurement of therapeutic processes is needed to establish its effectiveness and mechanisms of change.
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American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Banaco, R. A., y Montan, R. N. M. (2018). Terapia analítico-comportamental. En N. A. Zanelatto y R. Laranjeira (Orgs.), O tratamento da dependência química e as terapias cognitivo-comportamentais: Um guia para terapeutas (115– 132). Artmed.
Callaghan, G. M., y Follette, W. C. (2021). Functional Analytic Psychotherapy: A review of process, outcome, and implementation research. Journal of Contextual Behavioral Science, 20, 1-12.
Callaghan, G. M., Gregg, J. A., Marx, B. P., Kohlenberg, R. J., y Gifford, E. V. (2020). The Functional Analytic Psychotherapy Rating Scale: Recent developments and future directions. Journal of Contextual Behavioral Science, 15, 45-56.
Carroll, K. M., y Onken, L. S. (2005). Behavioral therapies for drug abuse. The American Journal of Psychiatry, 162(8), 1452–1460. DOI: 10.1176/appi.ajp.162.8.1452
García, M. T., y Valero-Aguayo, L. (2022). Psicoterapia Analítico Funcional: Aplicaciones clínicas y evidencia empírica en el contexto hispano. Revista Latinoamericana de Psicología, 54(3), 210-225. https://revistas.urosario.edu.co/index.php/apl/article/view/1321
Gifford, E. V., Kohlenberg, B. S., Hayes, S. C., Pierson, H. M., Piasecki, M. P., Antonuccio, D. O., y Palm, K. M. (2011). Does acceptance and relationship focused behavior therapy contribute to bupropion outcomes? A randomized controlled trial of functional analytic psychotherapy and acceptance and commitment therapy for smoking cessation. Behavior Therapy, 42, 700–715. https://www.sciencedirect.com/science/article/pii/S0005789411000657
Higgins, S. T., Heil, S. H., y Sigmon, S. C. (2007). A behavioral approach to the treatment of substance use disorders. En P. Sturmey (Ed.), Functional analysis in clinical treatment (261–282). https://doi.org/10.1016/B978-012372544-8/50015-X
Holman, G. I., Kanter, J. W., Tsai, M., Kohlenberg, R. J., y Waltz, T. (2012). Functional analytic psychotherapy is a framework for implementing evidence-based practices: The example of integrated smoking cessation and depression treatment. International Journal of Behavioral Consultation and Therapy, 7, 58–62. DOI:10.1037/h0100938
Kanter, J. W., Manbeck, K., Kuczynski, A. M., Maitland, D. W. M., Villas Bôas, A., y Reyes, M. (2017). A comprehensive review of research on Functional Analytic Psychotherapy. Clinical Psychology Review, 58, 141–156. DOI: 10.1016/j.cpr.2017.09.010
Kanter, J. W., Manbeck, K. E., Kuczynski, A. M., Maitland, D. W., Villas-Bôas, A., y Tsai, M. (2020). A randomized controlled trial of Functional Analytic Psychotherapy
with acceptance and commitment therapy for depression. Journal of Contextual Behavioral Science, 15, 1-10. https://doi.org/10.1016/j.jcbs.2019.12.003
Kanter, J. W., Tsai, M., y Kohlenberg, R. J. (2022). Functional Analytic Psychotherapy: Distinctive features (2nd ed.). Routledge.
Kazdin, A. E. (2003). Research design in clinical psychology (4.a ed.). Allyn y Bacon.
Kohlenberg, R. J., y Tsai, M. (1991). Functional analytic psychotherapy: A guide for creating intense and curative therapeutic relationships. Plenum.
Maitland, D. W., y Gaynor, S. T. (2020). Functional Analytic Psychotherapy: contemporary behavioral approach to the therapeutic relationship. Current Opinion in Psychology, 36, 34-39. https://doi.org/10.1016/j.copsyc.2020.01.007
Maitland, D. W., y Kanter, J. W. (2023). Functional Analytic Psychotherapy: Mechanisms of change and clinical applications. Clinical Psychology Review, 101, 102-115. https://doi.org/10.1016/j.cpr.2023.102115
Maitland, D. W., Kanter, J. W., y Manbeck, K. E. (2021). Functional Analytic Psychotherapy for diverse populations: A review and future directions. Behavior Analysis: Research and Practice, 21(2), 123-135. https://doi.org/10.1016/j.cpr.2023.102115
Maitland, D. W., Kanter, J. W., y Tsai, M. (2024). Functional Analytic Psychotherapy: Recent advances and future directions. Behavior Therapy, 55(2), 145-160.
Paul, R. H., Marx, B. P., y Orsillo, S. M. (1999). Acceptance-based psychotherapy in the treatment of an adjudicated exhibitionist: A case example. Behavior Therapy, 30, 149–162. https://doi.org/10.1016/S0005-7894(99)80051-3
Sidman, M. (1960). Tactics of scientific research: Evaluating experimental data in psychology. Basic Books. https://archive.org/details/tacticsofscienti00sidm?utm_source=chatgpt.com
Tourinho, E. Z., y Luna, S. V. (Orgs.). (2010). Análise do comportamento: Investigações históricas, conceituais e aplicadas. Roca.
Valero-Aguayo, L., y Ferro-García, R. (2021). Intervenciones basadas en la Psicoterapia Analítico Funcional: Un análisis de casos clínicos. Análisis y Modificación de Conducta, 47(167), 89-110.