Un curso de destrezas practica para apoyar el bienestar de terapeutas con formación en TF-CBT en Puerto Rico: Un estudio exploratorio
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Publicado
2025-12-30
Yahaira Márquez
Julie P. Harrison
Elisabeth Pollio
Francesca L. Martelli
Beth Cooper
Christine M. Schroeder
Nicole Schuler
Esther Deblinger
https://orcid.org/0000-0001-9205-8012
Resumen
Las personas terapeutas que trabajan con clientela expuesta a traumas tienen más riesgo de desarrollar síntomas de estrés traumático secundario (ETS) y quemazón, y quienes experimentan traumas compartidos tienen más riesgo de experimentar angustia psicológica. Para ayudar a mitigar esto, ofrecimos un curso a terapeutas de la Terapia Cognitiva Conductual Enfocada en el Trauma (TF-CBT, por sus siglas en inglés) con capacitación previa en Puerto Rico. Este implicó apoyarles para usar personalmente las destrezas de afrontamiento que enseñan a su clientela de TF-CBT. Este estudio exploratorio de método mixto evaluó el impacto del curso, que incluyó ajustes culturales para abordar algunas experiencias de las personas terapeutas. La mayoría de las personas participantes reportaron beneficios personales (95.8%) y profesionales (87.5%). Informaron aumentos significativos en uso de las destrezas de afrontamiento PRACTICA (N = 26; p < .001) y disminuciones significativas en los síntomas de ETS (p = .041). Quienes participaron (n = 19) describieron cualitativamente los beneficios relacionados con su bienestar y su trabajo clínico. Las respuestas cualitativas aludieron a elementos culturales. Los hallazgos informarán los ajustes futuros del curso para ayudar a mejorar su impacto y aplicabilidad cultural para profesionales del trauma en Puerto Rico.
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Keywords
estrés traumático secundario, quemazón, destrezas PRACTICA, autocuidado, competencias TF-CBT
References
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Aminihajibashi, S., Skar, A-M. S., & Jensen, T. K. (2022). Professional wellbeing and turnover intention among child therapists: A comparison between therapists trained and untrained in Trauma-Focused Cognitive Behavioral Therapy. BMC Health Services Research, 22, Article 1328.
https://doi.org/10.1186/s12913-022-08670-3
Bad Bunny. (2018). Estamos bien [Song]. On X 100pre. Rimas Entertainment.
Bauwens, J., & Tosone, C. (2010). Professional posttraumatic growth after a shared traumatic experience: Manhattan clinicians’ perspectives on post-9/11 practice. Journal of Loss & Trauma, 15(6), 498-517.
https://doi.org/10.1080/15325024.2010.519267
Berger, R. (2015). Now I see it, now I don’t: Researcher’s position and reflexivity in qualitative research. Qualitative Research, 15(2), 219-234.
https://doi.org/10.1177/1468794112468475
Bernal, G., Cumba-Avilés, E., & Rodriguez-Quintana, N. (2014). Methodological challenges in research with ethnic, racial, and ethnocultural groups. In F. T. L. Leong, L. Comas-Díaz, G. C. Nagayama Hall, V. C. McLoyd, & J. E. Trimble (Eds.), APA handbook of multicultural psychology, Vol. 1. Theory and research (pp. 105–123). American Psychological Association.
https://doi.org/10.1037/14189-006
Birks, M., Chapman, Y., & Francis, K. (2008). Memoing in qualitative research: Probing data and processes. Journal of Research in Nursing, 13(1), 68-75.
https://doi.org/10.1177/1744987107081254
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa
Bride, B. E. (2007). Prevalence of secondary traumatic stress among social workers. Social Work, 52(1), 63–70.
https://doi.org/10.1093/sw/52.1.63
Bride, B. E., Robinson, M. M., Yegidis, B., & Figley, C. R. (2004). Development and validation of the Secondary Traumatic Stress Scale. Research on Social Work Practice, 14(1), 27-35.
https://doi.org/10.1177/1049731503254106
Brugman, D. A. F., van Dam, A., van Loon, L. M. A., & van den Broek, A. H. S. (2022). Secondary traumatisation and emotional exhaustion in mental healthcare providers: The mediating role of social support. Psychology, 13(13), 1865-1883. https://doi.org/10.4236/psych.2022.1313116
Caringi, J. C., Hardiman, E. R., Weldon, P., Fletcher, S., Devlin, M., & Stanick, C. (2017). Secondary traumatic stress and licensed clinical social workers. Traumatology, 23(2), 186-195.
https://doi.org/10.1037/trm0000061
Child Abuse Research Education and Service (CARES) Institute, School of Osteopathic Medicine. (2014). TF-CBT Competency Self-Report Survey [Unpublished instrument].
Chu, J., & Leino, A. (2017). Advancement in the maturing science of cultural adaptations of evidence-based interventions. Journal of Consulting and Clinical Psychology, 85(1), 45-57. https://doi.org/10.1037/ccp0000145
Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155-159. https://doi.org/10.1037//0033-2909.112.1.155
Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2017). Treating trauma and traumatic grief in children and adolescents (2nd ed.). The Guilford Press.
Craig, C. D., & Sprang, G. (2010). Compassion satisfaction, compassion fatigue, and burnout in a national sample of trauma treatment therapists. Anxiety, Stress, & Coping, 23(3), 319-339. https://doi.org/10.1080/10615800903085818
Cruz-González, I., Morales-Cruz, J., & Zambrana-Ortiz, N. (2024). Desafíos laborales dentro de la comunidad escolar: Docentes y profesionales de la psicología [Workplace challenges within the school community: Teachers and psychology professionals]. Psicologías, 7, 27-55.
Deblinger, E., Mannarino, A. P., Cohen, J. A., Runyon, M. K., & Heflin, A. H. (2015). Child sexual abuse: A primer for treating children, adolescents, and their nonoffending parents (2nd ed.). Oxford University Press.
Deblinger, E., Pollio, E., Cooper, B., Harrison, J. P., & Steer, R. A. (2024). PRACTICE Makes Progress, a self-care course for mental health professionals in the child trauma field: A preliminary investigation. Psychological Trauma: Theory, Research, Practice, and Policy, 16(Suppl 3), S751–S759.
https://doi.org/10.1037/tra0001582
Deblinger, E., Pollio, E., Cooper, B., & Steer, R. A. (2020). PRACTICE Activity Scale-Revised [Unpublished instrument].
Deblinger, E., Pollio, E., Harrison, J. P., Cooper, B., Martelli, F. L., Schuler, N., & Steer, R. A. (2025). Refining the PRACTICE course for trauma professionals across organizational roles to enhance well-being and TF-CBT competency. Journal of Child & Adolescent Trauma, Advance online publication. https://doi.org/10.1007/s40653-025-00787-x
Eliacin, J., Flanagan, M., Monroe-DeVita, M., Wasmuth, S., Salyers, M. P., & Rollins, A. L. (2018). Social capital and burnout among mental healthcare providers. Journal of Mental Health, 27(5), 388-394. https://doi.org/10.1080/09638237.2017.1417570
Elo, S., & Kyngäs, H. (2008). The qualitative content analysis process. Journal of Advanced Nursing, 62(1), 107-115. https://doi.org/10.1111/j.1365-2648.2007.04569.x
Faul, F., Erdfelder, E., Lang, A-G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191.
https://doi.org/10.3758/BF03193146.
Flett, G. L., Hewitt, P. L., Nepon, T., Sherry, S. B., & Smith, M. (2022). The destructiveness and public health significance of socially prescribed perfectionism: A review, analysis, and conceptual extension. Clinical Psychology Review, 93, Article 102130. https://doi.org/10.1016/j.cpr.2022.102130
García Borrero, L. M., Aguirre Acevedo, D. C., Zapata Rueda, C. M., & García García, H. I. (2022). Validity and reliability of the SBI (Spanish Burnout Inventory) in medical surgical specialists. Colombian Journal of Anesthesiology, 50(2), Article e1017. https://doi.org/10.5554/22562087.e1017
Gil-Monte, P. (2011). Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo (CESQT). The Spanish Burnout Inventory. TEA Ediciones.
Gil-Monte, P. R., Espejo, B., Checa, I., Gil-LaOrden, P., Angeline, J. K., Carlotto, M. S., Converso, D., Deroncele-Acosta, A., Figueiredo-Ferraz, H., Galarza, L., Gómez-Ortiz, V., Grau-Alberola, E., Labarthe, J., Llorca-Pellicer, M., Mekala, C., Misiolek-Marín, A., Román-Cao, E., Salas-Blas, E., Schoenenberger, S., … Viotti, S. (2023). Factor structure and measurement invariance of the Spanish Burnout Inventory among professionals across 17 countries and regions. Applied Research in Quality of Life, 18(2), 869-892.
https://doi.org/10.1007/s11482-022-10108-1
Gopalkrishnan, N. (2018). Cultural diversity and mental health: Considerations for policy and practice. Frontiers in Public Health, 6, Article 179.
https://doi.org/10.3389/fpubh.2018.00179
Huang, C. Y., & Zane, N. (2016). Cultural influences in mental health treatment. Current Opinion in Psychology, 8, 131-136. https://doi.org/10.1016/j.copsyc.2015.10.009
Hubbell, S. L., Young, S. E., Duea, S. R., & Prentice, C. R. (2024). Identifying protective factors related to burnout, moral injury, and resilience of registered nurses: An exploratory analysis. Mental Health Science, 2(3), Article e71. https://doi.org/10.1002/mhs2.71
Kunst, J. R., & Bierwiaczonek, K. (2023) Utilizing AI questionnaire translations in cross-cultural and intercultural research: Insights and recommendations. International Journal of Intercultural Relations, 97, Article 101888. https://doi.org/10.1016/j.ijintrel.2023.101888
Lakens, D. (2013). Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs. Frontiers in Psychology, 4, Article 863.
https://doi.org/10.3389/fpsyg.2013.00863
Lichtveld, M. (2018). Disasters through the lens of disparities: Elevate community resilience as an essential public health service. American Journal of Public Health, 108(1), 28-30. https://doi.org/10.2105/AJPH.2017.304193
McSorley, A-M. M., Rivera-González, A. C., Lopez Mercado, D., Pagán, J. A., Purtle, J., & Ortega, A. N. (2024). United States federal policies contributing to health and health care inequities in Puerto Rico. American Journal of Public Health, 114(S6), S478-S484.
https://doi.org/10.2105/AJPH.2024.307585
Nagayama Hall, G. C., Ibaraki, A. Y., Huang, E. R., Marti, C. N., & Stice, E. (2016). A meta-analysis of cultural adaptations of psychological interventions. Behavior Therapy, 47(6), 993-1014.
https://doi.org/10.1016/j.beth.2016.09.005
O’Connor, K., Muller Neff, D., & Pitman, S. (2018). Burnout in mental health professionals: A systematic review and meta-analysis of prevalence and determinants. European Psychiatry, 53, 74-99. https://doi.org/10.1016/j.eurpsy.2018.06.003
Pollio, E., Deblinger, E., Cooper, B., Garbade, M., Harrison, J. P., & Pfeiffer, E. (2025). Engaging Ukrainian TF-CBT therapists in a PRACTICE skills course to support their well-being. European Journal of Psychotraumatology, 16(1), Article 2476898. https://doi.org/10.1080/20008066.2025.2476898
Powell, T., Scott, J., Yuma, P., & Hsiao, Y. (2022). Surviving the storm: A pragmatic non-randomised examination of a brief intervention for disaster-affected health and social care providers. Health & Social Care in the Community, 30(6), e6217–e6227. https://doi.org/10.1111/hsc.14059
Powell, T. M., Yuma, P. J., Scott, J., Suarez, A., Morales, I., Vinton, M., Marrero, M., Li, S-J. (2020). In the aftermath: The effects of hurricanes Harvey and Maria on the well-being of health-care and social service providers. Traumatology, 26(3), 298-307.
https://doi.org/10.1037/trm0000228
Rivera, F. I., Belligoni, S., Arroyo Rodriguez, V., Chapdelaine, S., Nannuri, V., & Steen Burgos, A. (2024). Compound crises: The impact of emergencies and disasters on mental health services in Puerto Rico. International Journal of Environmental Research and Public Health, 21(10), Article 1273.
https://doi.org/10.3390/ijerph21101273
Rivera Pichardo, E. J., Jost, J. T., & Benet-Martínez, V. (2022). Internalization of inferiority and colonial system justification: The case of Puerto Rico. Journal of Social Issues, 78(1), 79-106. https://doi.org/10.1111/josi.12437
Sprang, G., Lei, F., & Bush, H. (2021). Can organizational efforts lead to less secondary traumatic stress? A longitudinal investigation of change. American Journal of Orthopsychiatry, 91(4), 443-453.
https://doi.org/10.1037/ort0000546
Stahnke, B., & Firestone, K. (2024). Beyond secondary trauma: A systematic review of shared trauma research in the U.S. Social Work in Mental Health, 22(1), 149-169. https://doi.org/10.1080/15332985.2023.2251632
Steigerwald, E., Ramírez-Castañeda, V., Brandt, D. Y. C., Báldi, A., Shapiro, J. T., Bowker, L., & Tarvin, R. D. (2022). Overcoming language barriers in academia: Machine translation tools and a vision for a multilingual future. BioScience, 72(10), 988-998. https://doi.org/10.1093/biosci/biac062
Tabachnick, B. G., & Fidell, L. S. (2019). Using multivariate statistics (7th ed.). Pearson.
United States Geological Survey. (2022). Puerto Rico natural hazards. United States Department of the Interior. https://www.usgs.gov/mission-areas/natural-hazards/science/puerto-rico-natural-hazards-coastal-peligros-naturales-de
Yang, Y., & Hayes, J. A. (2020). Causes and consequences of burnout among mental health professionals: A practice-oriented review of recent empirical literature. Psychotherapy, 57(3), 426-436. https://doi.org/10.1037/pst0000317
Aminihajibashi, S., Skar, A-M. S., & Jensen, T. K. (2022). Professional wellbeing and turnover intention among child therapists: A comparison between therapists trained and untrained in Trauma-Focused Cognitive Behavioral Therapy. BMC Health Services Research, 22, Article 1328.
https://doi.org/10.1186/s12913-022-08670-3
Bad Bunny. (2018). Estamos bien [Song]. On X 100pre. Rimas Entertainment.
Bauwens, J., & Tosone, C. (2010). Professional posttraumatic growth after a shared traumatic experience: Manhattan clinicians’ perspectives on post-9/11 practice. Journal of Loss & Trauma, 15(6), 498-517.
https://doi.org/10.1080/15325024.2010.519267
Berger, R. (2015). Now I see it, now I don’t: Researcher’s position and reflexivity in qualitative research. Qualitative Research, 15(2), 219-234.
https://doi.org/10.1177/1468794112468475
Bernal, G., Cumba-Avilés, E., & Rodriguez-Quintana, N. (2014). Methodological challenges in research with ethnic, racial, and ethnocultural groups. In F. T. L. Leong, L. Comas-Díaz, G. C. Nagayama Hall, V. C. McLoyd, & J. E. Trimble (Eds.), APA handbook of multicultural psychology, Vol. 1. Theory and research (pp. 105–123). American Psychological Association.
https://doi.org/10.1037/14189-006
Birks, M., Chapman, Y., & Francis, K. (2008). Memoing in qualitative research: Probing data and processes. Journal of Research in Nursing, 13(1), 68-75.
https://doi.org/10.1177/1744987107081254
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa
Bride, B. E. (2007). Prevalence of secondary traumatic stress among social workers. Social Work, 52(1), 63–70.
https://doi.org/10.1093/sw/52.1.63
Bride, B. E., Robinson, M. M., Yegidis, B., & Figley, C. R. (2004). Development and validation of the Secondary Traumatic Stress Scale. Research on Social Work Practice, 14(1), 27-35.
https://doi.org/10.1177/1049731503254106
Brugman, D. A. F., van Dam, A., van Loon, L. M. A., & van den Broek, A. H. S. (2022). Secondary traumatisation and emotional exhaustion in mental healthcare providers: The mediating role of social support. Psychology, 13(13), 1865-1883. https://doi.org/10.4236/psych.2022.1313116
Caringi, J. C., Hardiman, E. R., Weldon, P., Fletcher, S., Devlin, M., & Stanick, C. (2017). Secondary traumatic stress and licensed clinical social workers. Traumatology, 23(2), 186-195.
https://doi.org/10.1037/trm0000061
Child Abuse Research Education and Service (CARES) Institute, School of Osteopathic Medicine. (2014). TF-CBT Competency Self-Report Survey [Unpublished instrument].
Chu, J., & Leino, A. (2017). Advancement in the maturing science of cultural adaptations of evidence-based interventions. Journal of Consulting and Clinical Psychology, 85(1), 45-57. https://doi.org/10.1037/ccp0000145
Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155-159. https://doi.org/10.1037//0033-2909.112.1.155
Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2017). Treating trauma and traumatic grief in children and adolescents (2nd ed.). The Guilford Press.
Craig, C. D., & Sprang, G. (2010). Compassion satisfaction, compassion fatigue, and burnout in a national sample of trauma treatment therapists. Anxiety, Stress, & Coping, 23(3), 319-339. https://doi.org/10.1080/10615800903085818
Cruz-González, I., Morales-Cruz, J., & Zambrana-Ortiz, N. (2024). Desafíos laborales dentro de la comunidad escolar: Docentes y profesionales de la psicología [Workplace challenges within the school community: Teachers and psychology professionals]. Psicologías, 7, 27-55.
Deblinger, E., Mannarino, A. P., Cohen, J. A., Runyon, M. K., & Heflin, A. H. (2015). Child sexual abuse: A primer for treating children, adolescents, and their nonoffending parents (2nd ed.). Oxford University Press.
Deblinger, E., Pollio, E., Cooper, B., Harrison, J. P., & Steer, R. A. (2024). PRACTICE Makes Progress, a self-care course for mental health professionals in the child trauma field: A preliminary investigation. Psychological Trauma: Theory, Research, Practice, and Policy, 16(Suppl 3), S751–S759.
https://doi.org/10.1037/tra0001582
Deblinger, E., Pollio, E., Cooper, B., & Steer, R. A. (2020). PRACTICE Activity Scale-Revised [Unpublished instrument].
Deblinger, E., Pollio, E., Harrison, J. P., Cooper, B., Martelli, F. L., Schuler, N., & Steer, R. A. (2025). Refining the PRACTICE course for trauma professionals across organizational roles to enhance well-being and TF-CBT competency. Journal of Child & Adolescent Trauma, Advance online publication. https://doi.org/10.1007/s40653-025-00787-x
Eliacin, J., Flanagan, M., Monroe-DeVita, M., Wasmuth, S., Salyers, M. P., & Rollins, A. L. (2018). Social capital and burnout among mental healthcare providers. Journal of Mental Health, 27(5), 388-394. https://doi.org/10.1080/09638237.2017.1417570
Elo, S., & Kyngäs, H. (2008). The qualitative content analysis process. Journal of Advanced Nursing, 62(1), 107-115. https://doi.org/10.1111/j.1365-2648.2007.04569.x
Faul, F., Erdfelder, E., Lang, A-G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191.
https://doi.org/10.3758/BF03193146.
Flett, G. L., Hewitt, P. L., Nepon, T., Sherry, S. B., & Smith, M. (2022). The destructiveness and public health significance of socially prescribed perfectionism: A review, analysis, and conceptual extension. Clinical Psychology Review, 93, Article 102130. https://doi.org/10.1016/j.cpr.2022.102130
García Borrero, L. M., Aguirre Acevedo, D. C., Zapata Rueda, C. M., & García García, H. I. (2022). Validity and reliability of the SBI (Spanish Burnout Inventory) in medical surgical specialists. Colombian Journal of Anesthesiology, 50(2), Article e1017. https://doi.org/10.5554/22562087.e1017
Gil-Monte, P. (2011). Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo (CESQT). The Spanish Burnout Inventory. TEA Ediciones.
Gil-Monte, P. R., Espejo, B., Checa, I., Gil-LaOrden, P., Angeline, J. K., Carlotto, M. S., Converso, D., Deroncele-Acosta, A., Figueiredo-Ferraz, H., Galarza, L., Gómez-Ortiz, V., Grau-Alberola, E., Labarthe, J., Llorca-Pellicer, M., Mekala, C., Misiolek-Marín, A., Román-Cao, E., Salas-Blas, E., Schoenenberger, S., … Viotti, S. (2023). Factor structure and measurement invariance of the Spanish Burnout Inventory among professionals across 17 countries and regions. Applied Research in Quality of Life, 18(2), 869-892.
https://doi.org/10.1007/s11482-022-10108-1
Gopalkrishnan, N. (2018). Cultural diversity and mental health: Considerations for policy and practice. Frontiers in Public Health, 6, Article 179.
https://doi.org/10.3389/fpubh.2018.00179
Huang, C. Y., & Zane, N. (2016). Cultural influences in mental health treatment. Current Opinion in Psychology, 8, 131-136. https://doi.org/10.1016/j.copsyc.2015.10.009
Hubbell, S. L., Young, S. E., Duea, S. R., & Prentice, C. R. (2024). Identifying protective factors related to burnout, moral injury, and resilience of registered nurses: An exploratory analysis. Mental Health Science, 2(3), Article e71. https://doi.org/10.1002/mhs2.71
Kunst, J. R., & Bierwiaczonek, K. (2023) Utilizing AI questionnaire translations in cross-cultural and intercultural research: Insights and recommendations. International Journal of Intercultural Relations, 97, Article 101888. https://doi.org/10.1016/j.ijintrel.2023.101888
Lakens, D. (2013). Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs. Frontiers in Psychology, 4, Article 863.
https://doi.org/10.3389/fpsyg.2013.00863
Lichtveld, M. (2018). Disasters through the lens of disparities: Elevate community resilience as an essential public health service. American Journal of Public Health, 108(1), 28-30. https://doi.org/10.2105/AJPH.2017.304193
McSorley, A-M. M., Rivera-González, A. C., Lopez Mercado, D., Pagán, J. A., Purtle, J., & Ortega, A. N. (2024). United States federal policies contributing to health and health care inequities in Puerto Rico. American Journal of Public Health, 114(S6), S478-S484.
https://doi.org/10.2105/AJPH.2024.307585
Nagayama Hall, G. C., Ibaraki, A. Y., Huang, E. R., Marti, C. N., & Stice, E. (2016). A meta-analysis of cultural adaptations of psychological interventions. Behavior Therapy, 47(6), 993-1014.
https://doi.org/10.1016/j.beth.2016.09.005
O’Connor, K., Muller Neff, D., & Pitman, S. (2018). Burnout in mental health professionals: A systematic review and meta-analysis of prevalence and determinants. European Psychiatry, 53, 74-99. https://doi.org/10.1016/j.eurpsy.2018.06.003
Pollio, E., Deblinger, E., Cooper, B., Garbade, M., Harrison, J. P., & Pfeiffer, E. (2025). Engaging Ukrainian TF-CBT therapists in a PRACTICE skills course to support their well-being. European Journal of Psychotraumatology, 16(1), Article 2476898. https://doi.org/10.1080/20008066.2025.2476898
Powell, T., Scott, J., Yuma, P., & Hsiao, Y. (2022). Surviving the storm: A pragmatic non-randomised examination of a brief intervention for disaster-affected health and social care providers. Health & Social Care in the Community, 30(6), e6217–e6227. https://doi.org/10.1111/hsc.14059
Powell, T. M., Yuma, P. J., Scott, J., Suarez, A., Morales, I., Vinton, M., Marrero, M., Li, S-J. (2020). In the aftermath: The effects of hurricanes Harvey and Maria on the well-being of health-care and social service providers. Traumatology, 26(3), 298-307.
https://doi.org/10.1037/trm0000228
Rivera, F. I., Belligoni, S., Arroyo Rodriguez, V., Chapdelaine, S., Nannuri, V., & Steen Burgos, A. (2024). Compound crises: The impact of emergencies and disasters on mental health services in Puerto Rico. International Journal of Environmental Research and Public Health, 21(10), Article 1273.
https://doi.org/10.3390/ijerph21101273
Rivera Pichardo, E. J., Jost, J. T., & Benet-Martínez, V. (2022). Internalization of inferiority and colonial system justification: The case of Puerto Rico. Journal of Social Issues, 78(1), 79-106. https://doi.org/10.1111/josi.12437
Sprang, G., Lei, F., & Bush, H. (2021). Can organizational efforts lead to less secondary traumatic stress? A longitudinal investigation of change. American Journal of Orthopsychiatry, 91(4), 443-453.
https://doi.org/10.1037/ort0000546
Stahnke, B., & Firestone, K. (2024). Beyond secondary trauma: A systematic review of shared trauma research in the U.S. Social Work in Mental Health, 22(1), 149-169. https://doi.org/10.1080/15332985.2023.2251632
Steigerwald, E., Ramírez-Castañeda, V., Brandt, D. Y. C., Báldi, A., Shapiro, J. T., Bowker, L., & Tarvin, R. D. (2022). Overcoming language barriers in academia: Machine translation tools and a vision for a multilingual future. BioScience, 72(10), 988-998. https://doi.org/10.1093/biosci/biac062
Tabachnick, B. G., & Fidell, L. S. (2019). Using multivariate statistics (7th ed.). Pearson.
United States Geological Survey. (2022). Puerto Rico natural hazards. United States Department of the Interior. https://www.usgs.gov/mission-areas/natural-hazards/science/puerto-rico-natural-hazards-coastal-peligros-naturales-de
Yang, Y., & Hayes, J. A. (2020). Causes and consequences of burnout among mental health professionals: A practice-oriented review of recent empirical literature. Psychotherapy, 57(3), 426-436. https://doi.org/10.1037/pst0000317
Cómo citar
Un curso de destrezas practica para apoyar el bienestar de terapeutas con formación en TF-CBT en Puerto Rico: Un estudio exploratorio. (2025). Revista Puertorriqueña De Psicologia, 36(2), 250-269. https://doi.org/10.55611/reps.3602.09
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Cómo citar
Un curso de destrezas practica para apoyar el bienestar de terapeutas con formación en TF-CBT en Puerto Rico: Un estudio exploratorio. (2025). Revista Puertorriqueña De Psicologia, 36(2), 250-269. https://doi.org/10.55611/reps.3602.09