¿Qué Es lo que Cambia en la Psicoterapia? La Perspectiva de Pacientes Adolescentes con Síntomas Depresivos, sus Terapeutas y Observadores Externos

Depression in adolescents constitutes a public health problem that can be effectively treated with psychotherapy. However, it is still necessary to improve the understanding of the process of change. A qualitative approach was used to characterize the content of therapeutic change in psychotherapies with adolescents with depressive symptoms from several perspectives (adolescents, therapists, and external observers). Post-therapy follow-up interviews with 6 purposively selected adolescents and their therapists were conducted. The Youth Outcome Questionnaire, the Beck Depression Inventory, and a sociodemographic and clinical survey were administered to the patients. Eight external observers followed an observation and coding manual to identify change moments in video recordings of the therapy sessions. A content analysis revealed convergences and divergences in the participants' evaluation of psychotherapy and change facilitators. The adolescents and external observers both ascribed importance to intrapsychic changes, whereas the therapists emphasized behavioral changes. The importance of integrating multiple perspectives in order to understand psychotherapeutic change is discussed.