Protocolo alemão de terapia do esquema para transtorno obsessivo-compulsivo infanto-juvenil: conceitos e técnicas

Abstract

The standard treatment of the obsessive-compulsive disorder (OCD) in children and teenagers matchs cognitive behavioral therapy (CBT) with selective serotonin reuptake inhibitors (SSRI). Although some patients respond well to the treatment, the prognosis its unfavorable and tends to cronify. In this sense this work shows from a translation and semantic adaptation, concepts and techniques of a protocol developed to the treatment of children and teenagers by the germany school of Schema Therapy (ST). The translation and adaptation procedure followed this steps: (I) protocol translation to brazilian portuguese; (II) synthesis of translations; and (III) sintesis evaluation by a ST children and teenagers expert. The results of these procedure showed that the germany protocol understand the OCD from the schematic model, involving Desadaptatives Initials Schemes (DIS) and Schematics Modes (SM), and supports itself in: evaluation and psychoeducation; therapeutic intervention with the patiente; and caregivers/parents orientation. It was identified that the main DIS actives in OCD’s children and teenagers are: damage and disease vulnerability; shame and inadequacy; entanglement; self sacrifice; unflexibles standards; and emotional inhibition. The main SM dysfunctions are: vulnerable child mode; father/mother punitive-critical; the father/mother demanding mode; and the compulsive controller mode. It is perceived that the protocol acts significativally in the quality of the relation between the patient and the caregivers/parents and in the improvement of the care practices, what in the attachment theory perspective can became the children/teenager’s attachment stile healthier, interfering positively in the symptomatic dynamics of the disorder.