Browsing by Author "Herrera Salinas, Pablo"

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    A collaborative, computer-assisted, psycho-educational intervention for depressed patients with chronic disease at primary care: protocol for a cluster randomized controlled trial
    (2021) Rojas Castillo, María Graciela; Martínez, Pablo; Guajardo, Viviana; Campos Romero, Solange; Herrera Salinas, Pablo; Vöhringer, Paul; Gómez, Víctor; Szabo, Wilsa; Araya, Ricardo
    Abstract Background Depression and chronic diseases are frequently comorbid public health problems. However, clinical guidelines often fail to consider comorbidities. This study protocol describes a cluster randomized trial (CRT) aimed to compare the effectiveness of a collaborative, computer-assisted, psycho-educational intervention versus enhanced usual care (EUC) in the treatment of depressed patients with hypertension and/or diabetes in primary care clinics (PCC) in Santiago, Chile. Methods Two-arm, single-blind, CRT carried out at two municipalities in Santiago, Chile. Eight PCC will be randomly assigned (1:1 ratio within each municipality, 4 PCC in each municipality) to the INTERVENTION or EUC. A total of 360 depressed patients, aged at least 18 years, with Patient Health Questionnaire-9 Item [PHQ-9] scores ≥15, and enrolled in the Cardiovascular Health Program at the participating PCC. Patients with alcohol/substance abuse; current treatment for depression, bipolar disorder, or psychosis; illiteracy; severe impairment; and resident in long-term care facilities, will be excluded. Patients in both arms will be invited to use the Web page of the project, which includes basic health education information. Patients in the INTERVENTION will receive eight sessions of a computer-assisted, psycho-educational intervention delivered by trained therapists, a structured telephone calls to monitor progress, and usual medical care for chronic diseases. Therapists will receive biweekly and monthly supervision by psychologist and psychiatrist, respectively. A monthly meeting will be held between the PCC team and a member of the research team to ensure continuity of care. Patients in EUC will receive depression treatment according to clinical guidelines and usual medical care for chronic diseases. Outcome assessments will be conducted at 3, 6, and 12 months after enrollment. The primary outcome will be depression improvement at 6 months, defined as ≥50% reduction in baseline PHQ-9 scores. Intention-to-treat analyses will be performed. Discussion This study will be one of the first to provide evidence for the effectiveness of a collaborative, computer-assisted, psycho-educational intervention for depressed patients with chronic disease at primary care in a Latin American country. Trial registration retrospectively registered in ClinicalTrials.gov , first posted: November 3, 2020, under identifier: NCT04613076 .
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    Revisión teórica y metodológica de las dificultades en Psicoterapia: Propuesta de un Modelo Ordenador
    (2009) Herrera Salinas, Pablo; Fernández González, Olga; Krause Jacob, Mariane; Vilches Álvarez, Oriana; Valdés Sánchez, Nelson; Dagnino Robles, Paula Andrea
    El presente artículo tiene como objetivo presentar el resultado de una revisión teórica de los conceptos asociados a dificultades en psicoterapia desde distintas perspectivas y niveles de análisis, para luego proponer una estructura que permita sintetizar, diferenciar y comparar los distintos conceptos y hallazgos relevantes que tienen que ver con el amplio espectro de las dificultades en psicoterapia. Los conceptos relativos a las dificultades en psicoterapia fueron organizados como variables de input, proceso y output, dentro del proceso terapéutico, para finalmente realizar una discusión acerca de las implicancias teóricas, clínicas y especialmente metodológicas en el estudio de las dificultades en psicoterapia.