Authors
- Victor Jesús Chávez Galindo
- Clinical psychologist
- Area Specialist – Los Pisingos Foundation
- psicologiafamilia@lospisingos.com
- Edmanuel Higuera Torres
- Clinical psychologist
- Area Specialist – Los Pisingos Foundation
- profesionalarea01@lospisingos.com
Among the major challenges faced by our society in relation to interventions carried out from an institutional framework lies the importance of constructing therapeutic devices that allow for intervention in the social fabric in a humanized, respectful, and contextualized manner. These interventions must also recognize structural, social, economic, and cultural differences in order to dignify, safeguard, and ensure the guarantee and access to fundamental rights.
For this reason, in recent years, as a Foundation, we have sought to build an intervention device that also serves as a provocation, encouraging professionals linked to this modality to mobilize and re-signify their disciplinary expectations regarding intervention with children and adolescents (C&A). This involves understanding the pluriparadigmatic frameworks that are part of psychological practice in accompanying survivors of various forms of violence, among which sexual violence stands out as a problem that must be understood as a collective social phenomenon. This phenomenon is organized around cultural and social values linked to social constructions rooted in hierarchy, power, gender, and social class, and is also influenced by the interpretations constructed around it. Therefore, the process of re-signifying the model not only allows for deeper understanding of consulting systems but also enables professionals to question diverse beliefs stemming from their personal, disciplinary, and professional experience.
Thus, this provocation makes it possible to integrate a rights-based perspective that recognizes the primacy of the rights of children and adolescents, as well as the identification of vulnerability factors present in broader systems (family, community, and institutions). This allows for an ecological and complex understanding of human dilemmas related to interventions with multiproblematic and multi-assisted families, which are part of the referral context of the administrative process for the restoration of rights in Colombia.
Under this premise, another need arises: to accompany professionals in continuously deconstructing and re-signifying the interpretations they make of social and clinical phenomena, in this case, child sexual violence. This is achieved through supervision spaces, case analysis groups, and collective constructions through group interventions or co-therapies, which in turn promote a micropolitical positioning that advocates for the transformation of violent practices.
It is important to highlight that this micropolitical approach allows for reflection on the meanings and constructions held by therapists regarding childhood and adolescence, as well as family systems, typologies, and structures in which they are situated. This is done through a reflective exercise that identifies power as an intersubjective practice that impacts the relationship between therapist and client.
For this reason, the present device seeks to deconstruct biopolitical constructions present in consulting systems, particularly adult-centered perspectives that prevent many caregivers, mothers, or fathers from recognizing the needs inherent to childhood life cycles. This allows for recognition of the ontological dimension of the therapeutic experience, considering both the possibilities and limitations rooted in the cultural variables specific to each context.
Considering these variables, the evaluation model enables the intervening therapist to carry out a comprehensive reading that recognizes the institutional demand for help, that of the family system, and that of the child or adolescent, as well as a structural understanding divided into four phases that acknowledge the ecology of the process. The first phase seeks to understand what is established by the macrosystem regarding the integral development of children and adolescents; the second focuses on the mesosystem, exploring family dynamics and the beliefs and myths constructed around child-rearing, parenting, and shared responsibility; the third is situated in the microsystem and the developmental stage of children and adolescents; and finally, the fourth challenges the therapist to develop an understanding that integrates both clinical and social aspects in diagnosing patterns of violence within the relational context.
Below, we briefly summarize the information referred to in the previous paragraph through a table:
Variables considered
Identify demands for help, explore previous mental health, psychosocial, or legal interventions, socioeconomic and housing variables, explore differential conditions, access to fundamental rights, as well as gender constructions; explore risks and activate referral pathways when necessary. Frame the therapeutic process and highlight the ethical and moral responsibilities of the professional.
Expected mobilizations
That therapists identify scenarios of oppression and resources for care, recognizing the various macrosystem variables.
Variables considered
Explore family dynamics, the configuration of relational patterns linked to communication practices, discipline, processes of autonomy and individuation in relation to childhood, as well as identifying vulnerability and generativity factors within the family system.
Expected mobilizations
Broaden understanding of family dynamics and the relational context of the mesosystem.
Variables considered
Explore connections and interconnections through the assessment of adjustment areas in which children and adolescents are situated in relation to their socio-affective, physical, academic, social, and sexual development, as well as the application of a risk-factor questionnaire to identify adverse or predisposing events affecting mental health in biopsychosocial development.
Expected mobilizations
Recognize the voice of children and adolescents in processes of understanding and impact related to the referral reason, developmental crises, and their own constructions, in order to identify the pattern that connects.
Variables considered
Integrate elements that enable the construction of a comprehensive ecosytemic reading that facilitates the redefinition of the demand for help through an exploration of family life cycles and the definition of the problem by children and adolescents, families, and/or caregivers.
Expected mobilizations
Invite the therapist to observe what is being observed through a metacommunicative exercise that allows reflection on a comprehensive diagnosis.
This process allows for the redefinition of the demand in order to construct the treatment and accompaniment plan, linking public policies on childhood and adolescence, such as Laws 1098 of 2006, 1878 of 2018, and 1804 of 2016, as well as other perspectives addressing gender, violence, and family practices. These were integrated into five main modules for addressing trauma or adverse events that have marked the lives of children and adolescents.
Priority is therefore given to emotional recognition, identity constructions within the framework of diversity, and the deconstruction of practices of power and hierarchy, as well as gender and social class. This is followed by work with families to mobilize violent practices affecting children and adolescents, allowing for debate around deficit-based and pathologizing perspectives imposed by the phenomenon of violence, while also expanding networks and socio-affective skills. These processes then enable a comprehensive approach to trauma through a module that seeks to promote agency and confrontation of violent practices through testimony.
This provocation has enabled therapists to construct new intervention devices that respect the comprehensive nature of this type of care, incorporating complementary modules related to psychoactive substance use, grief, and sexual and reproductive rights, which are implemented according to identified needs.
Additionally, a pluriparadigmatic approach emerges, allowing for an understanding of clinical psychology perspectives within comprehensive care. It is the professional who mobilizes these disciplinary and epistemological perspectives in function of change within consulting systems, renegotiating legal, psychosocial, cognitive-behavioral, psychodynamic, and systemic positions in favor of intervention.
Finally, the aim is to promote a harmonious discharge process that allows for the consolidation of a life project aligned with the possibilities of the consulting system, articulated with the broader network to foster new opportunities that not only impact mental health but also promote quality of life and well-being.
It is important to note that these modules are designed to be applied in a circular-helicoidal manner, according to the needs identified in the diagnosis provided by the comprehensive evaluation carried out by professionals. They may be implemented based on the clinical reading performed by the professional. Each module has been designed to include four sessions, considering the administrative timeframes established by the Colombian Institute of Family Welfare, which are approximately six months.
As highlighted previously, this methodology has allowed us to make visible the importance of addressing with professionals the interpretations they construct about the social fabric, inviting them to re-signify, debate, and build devices tailored to each consulting system, identifying matrices of privilege and oppression that may foster institutional violence and harmful actions that exacerbate the problem.
This gives rise to a questioning of intervention practices among the various entities involved in addressing the social fabric, advocating for devices that are not only designed for external or consulting subjects, but also for the intervening subjects themselves. This allows for an understanding that institutional violence can be prevented through new positions that humanize professional bias as part of a constant renegotiation with intervention contexts, facilitating the deconstruction of hegemonic discourses present in our society.
