Interview with Teresa Garcia Rivera, research director - LACT scientific committee.
Founding director of CIRCE (official representative of the MRI of Palo-Alto for French-speaking Europe).
This interview concerns the improvement of the input module of the database tool used within the framework of the LACT research program.
Teresa Garcia
The work that you have just presented to me regarding the organization of the database is very interesting.
My opinion is that the data would be easier to analyze by pathologies but that it would make no sense for us, no interest for us, Palo Alto practitioners, to limit ourselves for research to one or more pathologies. We are problem solving people and with our method and experience, the number of patients we see, the numbers will speak for themselves. There's not too much to worry about and we have time ahead of us.
It really all depends on what you want. If we wanted to acquire legitimacy with psychiatric hospitals to say "yes it works with the Palo Alto method", we could obviously limit ourselves to 3 or 4 pathologies and focus on them: melancholic depression, paranoia , schizophrenia...for example. But that's not what we're looking for, is it?
My suggestion is therefore to take the lowest common denominator as the starting point, ie the symptom or the syndrome.
Gregoire Vitry
I also told myself that we weren't going to confine ourselves right away to categories that were too strict.
I made a "relational" list of problems. For the pathologies, we have chosen for the moment the following classification: problems of relationship to oneself, problem of relationship to others, to the organization or to the world....
Teresa Garcia
Why don't you put symptom/syndrome?; if a person suffers from bulimia because she has a job problem for example, or she has anxiety disorders because she doesn't get along with her husband........it's more it isn't?
Gregoire Vitry
What do you think of an alphabetical classification but without grouping by categories, as in the DSM? This table would be validated by 3 or 4 therapists.
Teresa Garcia
Yes it's good. I would indeed leave the whole list but without the categories. Because everyone may want to link symptomatic manifestations in their own way, according to their own focus, and we need something more permanent than the DSM anyway.
We will also be able to make as many crosses as we want and say for example “such a person has such a symptom + such another + such and such another and the therapy has worked particularly well”. “We can also realize the frequency of two or three combinations of symptoms and/or find a common complementary feature. The analysis is therefore much richer. Someone might say to themselves "well, let's look at someone who has vaginismus, what other problem she has".
Gregoire Vitry
It's a very good idea and it's simple to do; I will therefore modify in this direction and have it validated.
Teresa Garcia
You can make a first draft; and we will see in six months how things evolve. If a pathology appears in 4 months and becomes "super fashionable", it will have to be integrated. For example, people come to consult me a lot at the moment about binge drinking.
Gregoire Vitry
Regarding the Scientific Committee, my idea is for there to be a very small number of people, in a logic of research. The people who encode will give us interesting feedback and the discussions around this, to be constructive, must be done with a few people at a time, by video conference.
Teresa Garcia
I found for the moment 6/7 people to encode.
Gregoire Vitry
It's already good. One of the strengths of the study will be the number of cases. I also have the idea that there will be other partners who will not encode because they do not practice the Palo Alto model, but who will also give us feedback.
Teresa Garcia
In all the universities in the world, we talk about 6 emotions by adding surprise (traumas) and disgust to the 4 that everyone knows.
Gregoire Vitry
Then with respect to logic. For me the objective is to know for research: when we made the RV, how we evaluate, what are the symptoms and what is the strategy. The rest is optional. But suddenly, I tell myself who will inform the attempts at a solution.
Teresa Garcia
If people want to do it, they will write it. I can hear the logic of the solution but if everyone writes the attempted solution, it will be complicated. We have to agree on how we write it.
Gregoire Vitry
Yes, but it is above all to facilitate the daily work of the therapist. I don't do verbatim statistics, I can't.
Teresa Garcia
You also took into account the prescriptions/tasks; I find it an important part because many therapists are very creative in this area, like Claude and me for example, and it will be extremely rich.
Gregoire Vitry
So, how are we going to encode them. Because if we have 200 tasks, that's not going to mean much. I suggest you send you all the tasks I have listed and you will tell me what you think.
The same goes for reframes/aphorisms/metaphors; sometimes it can become tasks. We will therefore also encode them and create a kind of knowledge base. We could for example note which aphorism/reframing works for such or such symptom. Here again, we can see by cross-referencing that a metaphor works very well on very different symptoms.
Teresa Garcia
You could ask a few therapists to list the prescriptions/tasks they give most often and we'll see what comes up most often and how they are worded. Which will help you with encoding.
Gregoire Vitry
I now come to the analysis of psychosocial risks: this concerns companies. Is the risk serious or very serious, can it happen again, etc........ I left that. We use it. It's good, because it's the customer's language. If one day we have a laboratory that is in the workplace, it would be interesting for him.
Teresa Garcia
The interest of the tool is indeed to make it something very broad that can be used by very different populations: academics, master's students, medical students, even doctors...
For drugs that obviously do not have the same name in all countries, there are not too many difficulties because you should be able to find equivalences on the internet.
Teresa Garcia
I will now, after our interview, send the links to my research partners who encode and to my colleagues in Mons and Liège who are research partners.
Gregoire Vitry
Thanks for all of this.
