{"id":3001,"date":"2023-10-17T08:59:27","date_gmt":"2023-10-17T08:59:27","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?p=3001"},"modified":"2025-11-04T09:16:11","modified_gmt":"2025-11-04T09:16:11","slug":"acceptance-and-commitment-therapy-a-promising-approach-for-those-living-with-long-covid","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/es\/2023\/10\/acceptance-and-commitment-therapy-a-promising-approach-for-those-living-with-long-covid\/","title":{"rendered":"Terapia de aceptaci\u00f3n y compromiso: Un enfoque prometedor para quienes viven con la COVID-19 prolongada"},"content":{"rendered":"<p><strong>Por Amy Barradell, Hospital Universitario de Leicester NHS Trust<\/strong><\/p>\n<p>Un subconjunto de personas que contrajeron la enfermedad por coronavirus 2019 (COVID-19) han seguido experimentando s\u00edntomas debilitantes durante m\u00e1s de 4 semanas despu\u00e9s de su infecci\u00f3n aguda. Suelen notificar <a href=\"https:\/\/www.thelancet.com\/journals\/lanres\/article\/PIIS2213-2600(21)00383-0\/fulltext\">s\u00edntomas tanto f\u00edsicos (p. ej., disnea, fatiga) como psicol\u00f3gicos (p. ej., ansiedad, deterioro cognitivo).<\/a> Aquellos que experimentan estos s\u00edntomas lo llaman \u201cCOVID larga\u201d.<\/p>\n<p><!--more--><\/p>\n<h2>En mi experiencia&#8230;<\/h2>\n<p>Trabajar en una cl\u00ednica de COVID-19 persistente, me ha demostrado que las personas tienen dificultades para aceptar sus nuevos s\u00edntomas (y las consecuencias de sus s\u00edntomas), lo que pone un obst\u00e1culo en el camino de sus estrategias de autogesti\u00f3n. Se centran en lo que pod\u00edan hacer antes de desarrollar covid persistente y en c\u00f3mo ha cambiado su vida a peor desde su diagn\u00f3stico.\u00a0 Esto indica la evitaci\u00f3n de experiencias (es decir, un intento o deseo de suprimir experiencias internas no deseadas, como emociones, pensamientos, recuerdos y sensaciones corporales) y una tendencia de las personas a centrarse en la forma de los s\u00edntomas en lugar de en la funci\u00f3n de los s\u00edntomas (es decir, el indicador del cuerpo para cambiar el comportamiento). Muestra que las personas no est\u00e1n abiertas a estas experiencias y t\u00edmidas de vivir en el momento presente.<\/p>\n<p>Adem\u00e1s, <a href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2021.03.22.21254057v2\">m\u00e1s del 25 % de las personas<\/a> que fueron hospitalizadas por COVID-19 tienen s\u00edntomas continuos de depresi\u00f3n 6 meses despu\u00e9s de haber sido dadas de alta. Dado que la depresi\u00f3n est\u00e1 vinculada a la<a href=\"https:\/\/www.mindwell-leeds.org.uk\/myself\/exploring-your-mental-health\/depression\/what-keeps-depression-going\/\"> evitaci\u00f3n de <\/a>actividades (es decir, elegir no entrar en una situaci\u00f3n), muestra que las personas pueden no estar participando en acciones valiosas.<\/p>\n<h2>El papel de la flexibilidad psicol\u00f3gica en la COVID-19 prolongada<\/h2>\n<p>La flexibilidad psicol\u00f3gica es el mecanismo de acci\u00f3n para la terapia<a href=\"https:\/\/www.ijpsy.com\/volumen10\/num1\/256.html\"> de aceptaci\u00f3n y compromiso (ACT).<\/a> Implica tres pilares de la terapia: (1) fomentar la apertura a la experiencia, (2) tener conciencia del momento presente y (3) participar en acciones valiosas. Como se ha descrito anteriormente, estos pilares parecen estar desequilibrados en las personas que viven con COVID-19 persistente, por lo que es importante abordarlos. Por lo tanto, el ACT puede utilizarse para ayudar a las personas a cambiar la relaci\u00f3n que tienen con su angustia (es decir, reducir su evitaci\u00f3n de experiencias), construir su aceptaci\u00f3n de una nueva \u201cnormalidad\u201d (es decir, aumentar su conciencia del momento presente) y motivarlas y capacitarlas para realizar cambios de comportamiento que sean importantes para ellas (es decir, participar en acciones valiosas). La QTC en la COVID-19 persistente <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/34931160\/\">ya est\u00e1 progresando<\/a>, los participantes notificaron mejora del bienestar, a\u00fan experimentan angustia relacionada con la COVID, pero se sintieron m\u00e1s capaces de afrontar el angustia psicol\u00f3gica general (como la ansiedad).<\/p>\n<h2>Uso de ACT en la cl\u00ednica de COVID-19 prolongada: Presentamos a Jo<\/h2>\n<p>Cuando me reun\u00ed por primera vez con Jo, estaban experimentando recidivas regulares de los s\u00edntomas. Para mantener el anonimato, Jo es una representaci\u00f3n de una serie de personas con las que he trabajado en la cl\u00ednica de la COVID-19 persistente. Sus s\u00edntomas m\u00e1s debilitantes fueron disnea y fatiga, lo que dificult\u00f3 mucho las actividades diarias. Jo ten\u00eda miedo a las reca\u00eddas y se esforz\u00f3 conscientemente por evitar cualquier cosa que las agravara (es decir, evitar experiencias, evitar el momento presente). Dedicaron poco tiempo a actividades que les dieron alegr\u00eda y significado (es decir, evitar participar en acciones valiosas).<\/p>\n<p>En nuestras sesiones juntas, abordamos cada uno de los componentes del ACT:<\/p>\n<ul>\n<li><strong>Defusi\u00f3n cognitiva<\/strong>(es decir, notar pensamientos en lugar de quedar atrapado en el pensamiento y dejar que los pensamientos vengan y vayan en lugar de aferrarse al pensamiento) &#8211; para diferenciar entre pensamientos\/sentimientos y experiencias reales (\u00a1no son necesariamente los mismos!)<\/li>\n<li><strong>Contacto con el momento<\/strong> presente: adoptar estrategias de mindfulness para basarlas en sus experiencias sensoriales (es decir, conciencia del momento presente).<\/li>\n<li><strong>Explorar valores<\/strong>: identificar las \u00e1reas de su vida que fueron m\u00e1s importantes para ellos.<\/li>\n<li><strong>Tomar medidas<\/strong> comprometidas: establecer objetivos conductuales que se ajusten a sus valores.<\/li>\n<li><strong>Ser uno mismo como contexto<\/strong>: hacer contacto con su \u201cobservarse\u201d y ver sus pensamientos a distancia (es decir, una perspectiva m\u00e1s precisa) sin enredarse con ellos.<\/li>\n<li><strong>Aceptaci\u00f3n<\/strong>: dejar de luchar con lo que est\u00e1 fuera de su control y volver a centrarse en lo que est\u00e1 bajo su control (es decir, sus comportamientos).<\/li>\n<\/ul>\n<p>En la segunda sesi\u00f3n, Jo se estableci\u00f3 dos objetivos de comportamiento alineados con sus valores fundamentales. Utilic\u00e9 t\u00e9cnicas<a href=\"https:\/\/motivationalinterviewing.org\/understanding-motivational-interviewing\"> de entrevistas <\/a>motivacionales para apoyarlos en el desarrollo de <a href=\"https:\/\/www.mindtools.com\/a4wo118\/smart-goals\">un objetivo SMART<\/a> y, planeamos prever cualquier preocupaci\u00f3n que puedan tener.<\/p>\n<p>Cuatro semanas despu\u00e9s, se enorgullecieron de decirme que hab\u00edan cumplido sus objetivos. Tambi\u00e9n hab\u00edan incorporado varias actividades de mindfulness en su vida diaria (es decir, el ejercicio de las hojas en un arroyo, un diario de gratitud y 5 minutos de yoga). Hab\u00edan experimentado una mayor flexibilidad psicol\u00f3gica (es decir, cuando una persona es psicol\u00f3gicamente flexible, tomar\u00e1 decisiones basadas en sus valores y creencias duraderas en lugar de las emociones inmediatas a corto plazo que est\u00e1 experimentando), reducci\u00f3n de los s\u00edntomas de depresi\u00f3n y aumento de la confianza en el autocontrol fuera de las sesiones.<\/p>\n<h2>Recomendaciones para los profesionales sanitarios que apoyan a las personas con COVID-19 prolongada:<\/h2>\n<ol>\n<li><strong>No olvide la importancia de una evaluaci\u00f3n biopsicosocial <\/strong>: comprender realmente la complejidad de los s\u00edntomas de la COVID-19 prolongada de una persona y las consecuencias de estos s\u00edntomas es clave para identificar estrategias de tratamiento centradas en el paciente. No tenga miedo de hacer preguntas como: \u201c\u00bfCu\u00e1l es el s\u00edntoma con el que m\u00e1s problemas tiene?\u201d; \u201c\u00bfCu\u00e1l es el impacto de su disnea\/fatiga\/niebla cerebral&#8230; en su vida?\u201d; \u201c\u00bfQu\u00e9 pensamientos acuden a su mente cuando experimenta disnea\/fatiga\/niebla cerebral?\u201d<\/li>\n<li><strong>Considere medir la flexibilidad<\/strong> psicol\u00f3gica: la evaluaci\u00f3n integral de los procesos de Aceptaci\u00f3n y Compromiso terap\u00e9utico (<a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S2212144716300229\">CompACT<\/a>) es una medida r\u00e1pida y validada de la flexibilidad psicol\u00f3gica autodeclarada. Puede identificar r\u00e1pidamente cu\u00e1les de los pilares de la flexibilidad psicol\u00f3gica necesitan aumentar y planificar su estrategia de gesti\u00f3n en consecuencia (es decir, si evitan participar en acciones valiosas, explore cu\u00e1les son sus valores fundamentales y ay\u00fadelos a establecer un objetivo SMART).<\/li>\n<li><strong>Proporcione\/se\u00f1ale ejercicios de mindfulness <\/strong>: los ejercicios de mindfulness pueden ser extremadamente potentes en ACT para ayudar a las personas a construir sus pilares de flexibilidad psicol\u00f3gica. Dependiendo de lo que alguien presente con usted, puede ofrecer un ejercicio adecuado, estas son algunas ideas:\n<ol>\n<li>Defusi\u00f3n cognitiva: <a href=\"https:\/\/www.youtube.com\/watch?v=r1C8hwj5LXw\">deje fluir sus pensamientos<\/a><\/li>\n<li>Contacto con el momento presente: <a href=\"https:\/\/www.youtube.com\/watch?v=CBYhuhSiO8Q\">observe 5 cosas<\/a><\/li>\n<li>El yo como contexto: <a href=\"https:\/\/www.youtube.com\/watch?v=nBPPr1hsbMM\">la met\u00e1fora de los espect\u00e1culos<\/a><\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<p>Nota del traductor: se mantienen los materiales en ingl\u00e9s de la entrada original.<\/p>\n<ol start=\"4\">\n<li><strong>Mant\u00e9ngase al d\u00eda con la gu\u00eda de mejores pr\u00e1cticas <\/strong>: al igual que con muchas afecciones m\u00e9dicas, la base de pruebas de la COVID-19 prolongada est\u00e1 en constante evoluci\u00f3n, as\u00ed que aseg\u00farese de estar al tanto de la literatura y las directrices de pr\u00e1ctica cl\u00ednica. \u00a1Las pruebas del ACT est\u00e1n creciendo!<\/li>\n<li><strong>Aseg\u00farese de que tambi\u00e9n se le cuida <\/strong>: trabajar con personas que tienen COVID-19 persistente puede ser un desaf\u00edo, as\u00ed que aseg\u00farese de tener una supervisi\u00f3n regular o \u201creuniones\u201d con alguien en quien conf\u00ede. Esto no solo es \u00fatil para hablar de pacientes espec\u00edficos, sino que tambi\u00e9n le ayuda a mantenerse psicol\u00f3gicamente bien en su consulta.<\/li>\n<\/ol>\n<p>[<em>traducido por Manuel Armayones Ruiz,PhD.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Amy Barradell, University Hospitals of Leicester NHS Trust If I were to say to you, Long-Covid, what would that mean to you? A sub-set of people that contracted Coronavirus Disease 2019 (COVID-19), have continued to experience debilitating symptoms for [&hellip;]<\/p>\n","protected":false},"author":9,"featured_media":3034,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[38,58,13,36,56],"tags":[],"class_list":["post-3001","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-acceptance-and-commitment-therapy","category-covid","category-interventions","category-mental-health","category-public-health"],"translation":{"provider":"WPGlobus","version":"3.0.2","language":"es","enabled_languages":["en","id","my","bg","zh","hr","cz","da","de","es","fr","gr","he","it","ja","kr","lv","lt","hu","nl","no","pl","pt","ro","ru","sk","sr","fi","et","sv","tr","uk","hi","sw","ta"],"languages":{"en":{"title":true,"content":true,"excerpt":false},"id":{"title":true,"content":true,"excerpt":false},"my":{"title":true,"content":true,"excerpt":false},"bg":{"title":true,"content":true,"excerpt":false},"zh":{"title":true,"content":true,"excerpt":false},"hr":{"title":false,"content":false,"excerpt":false},"cz":{"title":true,"content":true,"excerpt":false},"da":{"title":false,"content":false,"excerpt":false},"de":{"title":true,"content":true,"excerpt":false},"es":{"title":true,"content":true,"excerpt":false},"fr":{"title":true,"content":true,"excerpt":false},"gr":{"title":false,"content":false,"excerpt":false},"he":{"title":true,"content":true,"excerpt":false},"it":{"title":true,"content":true,"excerpt":false},"ja":{"title":true,"content":true,"excerpt":false},"kr":{"title":false,"content":false,"excerpt":false},"lv":{"title":true,"content":true,"excerpt":false},"lt":{"title":false,"content":false,"excerpt":false},"hu":{"title":false,"content":false,"excerpt":false},"nl":{"title":true,"content":true,"excerpt":false},"no":{"title":false,"content":false,"excerpt":false},"pl":{"title":true,"content":true,"excerpt":false},"pt":{"title":false,"content":false,"excerpt":false},"ro":{"title":false,"content":false,"excerpt":false},"ru":{"title":true,"content":true,"excerpt":false},"sk":{"title":true,"content":true,"excerpt":false},"sr":{"title":false,"content":false,"excerpt":false},"fi":{"title":true,"content":true,"excerpt":false},"et":{"title":false,"content":false,"excerpt":false},"sv":{"title":false,"content":false,"excerpt":false},"tr":{"title":true,"content":true,"excerpt":false},"uk":{"title":true,"content":true,"excerpt":false},"hi":{"title":false,"content":false,"excerpt":false},"sw":{"title":false,"content":false,"excerpt":false},"ta":{"title":false,"content":false,"excerpt":false}}},"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 4.9.10 - aioseo.com -->\n\t<meta name=\"description\" content=\"{:en}By Amy Barradell, University Hospitals of Leicester NHS Trust If I were to say to you, Long-Covid, what would that mean to you? 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