Estudos do NI-ICI

Exploring the Effectiveness of Individual Family Constellations for Adult Psychoemotional Distress: A Quasi-Experimental Study

Authors: Jorge A. Ramos & Sandra Ramos
Published in Practice Innovations

Abstract

Aims: The rising prevalence of psychological distress requires the exploration of novel therapeutic approaches. This study aimed to evaluate the effectiveness of individual Family Constellations (FC), an integrative transgenerational psychotherapy, in a naturalistic outpatient setting—a modality and context where empirical evidence is scarce.

Methods: A quasi-experimental, single-group pretest-posttest design was used with seventy-five adults in Portugal who received an average of 7.5 individual FC sessions. Psychological distress was assessed at baseline and post-intervention using the Depression, Anxiety, and Stress Scales (DASS-21).

Results: The intervention resulted in large and statistically significant reductions in symptoms of depression (d = 1.04), stress (d = 0.93), and anxiety (d = 0.67).  Beyond these group-level effects, individual clinical change was also substantial: 88% of participants achieved clinically significant improvement based on the Reliable Change Index. The intervention was well-tolerated, with low dropout (6%) and reliable deterioration (8%) rates.

Conclusions: This study provides important preliminary evidence that individual FC is an effective, efficient, and well-tolerated intervention. While its efficacy awaits confirmation through rigorous randomized controlled trials, its demonstrated effectiveness and brevity in a real-world setting highlight its potential as a valuable treatment option for adults experiencing psychological distress.

PsycInfo Database Record © 2025 APA, all rights reserved.

Process of change and effectiveness of family constellations: “On the verge of divorce, I glimpse my finitude.” A mixed methods single case study on suicidal ideation

Authors: Jorge A. Ramos & Sandra Ramos
Published in The Humanistic Psychologist, Aug 5, 2021.

Abstract

Aims: This article analyzed the process of change and the effectiveness of 10 sessions of Family Constellations (FC), explored elements that may aid reconciliation effectiveness, and decrypted factors underlying four variables of interest: suicidal ideation, verge of divorce, depression, and anxiety.

Methods: Using a mixed methods design, this single case study used a triangulation of data: quantitative (DASS-21) and qualitative (the notes from the consultations and the patient’s responses to the Psychotherapeutic Process Data Mining Questionnaire, or PPDMQ). The Reliable Change Index (RCI) was used to gauge clinical change in the DASS-21 scores.

Results: RCI analysis showed a clinically and statistically significant change at process termination, and at the 6-month follow-up, on the patient’s symptoms of anxiety and depression. As a member of a couple on the verge of divorce, by undoing that drive to divorce, the suicidal ideation of the patient seemed to stop.

Conclusions: Two focuses of interventions are proposed to mitigate divorce rates, suicide rates linked to divorce, as well as depression and anxiety levels associated with divorce and suicidal ideations. FC, as a psychotherapy, seems to possess a substantial financial and societal positive change potential (e.g., at the judicial sphere) and perhaps needs to be addressed from an unbiased perspective.

PsycInfo Database Record © 2021 APA, all rights reserved.

Process of change and effectiveness of Family Constellations: A mixed methods single case study on depression

Authors: Jorge A. Ramos & Sandra Ramos
Published in The Family Journal, Aug 13, 2019.

Abstract

Aims: To analyze the process of change and the effectiveness of five sessions of family constellations (FC) using mixed methods in mixed settings (videoconference and in person). To obtain variables associated with processes and results.

Methods: Using an exploratory design with mixed methods, this single case study used a triangulation of data: quantitative (DASS-21) and qualitative (the notes from the consultations and the patient’s responses to the Psychotherapeutic Process Data Mining Questionnaire (PPDMQ)).

Results: The patient’s symptoms of depression went from a level of severe to normal, and the posttest results persisted after a 3-month follow-up. The severe depression seems to have been mitigated through interventions that promoted contact with reality, self-determination, the psychoemotional establishment of systemic places, and through finding meaning in autobiographical events.

Conclusions: This article may encourage further studies that use the PPDMQ to create a metasynthesis and to gauge whether the effectiveness of FC, as a systemic, intergenerational, and integrative psychotherapy, could plausibly contribute to enrich the body of scientific evidence–based psychotherapies and mitigate the global escalation of depression.

Copyright © 2019, Sage Publications, all rights reserved.

In Utero II. Intrauterine Psychodynamics – Idealized Sex Projection, Existentialism, Psychosomatics, and Spirituality

Authors: Jorge A. Ramos & Sandra Ramos
Independently published on October 10, 2025.

Abstract

Aims: Based on 50 cases worked on with Family Constellations, to analyze the transgenerational implications of the Idealized Sex Projection (ISP) in the existential, psychosomatic, and spiritual domains.

Method: Hermeneutic-phenomenological.

Results: The second volume of this study reveals the connections between ISP and the apparent lifelong existential, psychosomatic, and spiritual consequences experienced by individuals who thwart the ISP.

Conclusions: Discrepancies between one's actual biological sex and their parents' idealized biological sex appear to have various consequences throughout life.

In Utero II. Psicodinâmicas Intrauterinas – Projeção Idealizada de Sexo, Existencialismo, Psicossomática e Espiritualidade

Autores: Sandra Ramos & Jorge A. Ramos
Publicação Independente no dia 31 de outubro de 2024.

Resumo

Objetivos: Com base em 50 casos trabalhados com Constelações Familiares, analisar o potencial impacto ao longo da vida de não se satisfazer o desejo parental de ter um filho de um sexo biológico específico.

Método: Fenomenológico-hermenêutico.

Resultados: Neste segundo volume desta investigação, são apresentadas associações entre a frustração da PIS (Projeção Idealizada de Sexo) e as suas aparentes consequências nos domínios do existencialismo, psicossomática e espiritualidade.

Conclusões: A discordância entre o sexo biológico real e o sexo biológico idealizado parece resultar em várias consequências ao longo da vida, que vão desde dificuldades identitárias e distorções da realidade, até problemas graves de saúde.

In Utero I. Intrauterine Psychodynamics: The ISP - Idealized Sex Projection

Authors: Jorge A. Ramos & Sandra Ramos
Independently published on November 22, 2022.

Abstract

Aims: Based on 50 cases worked on with Family Constellations, to analyze the potential lifelong impact of not fulfilling the parental desire to have a child of a specific biological sex.

Method: Hermeneutic-phenomenological.

Results: The first volume of this research presents associations between ISP (Idealized Sex Projection) frustration and maladaptive psychodynamics between parents and children, between siblings, and in couples, as well as in the sphere of non-heterosexuality.

Conclusions: It is estimated that between 50 and 70% of the world's population does not correspond to the sex idealized by their parents, especially women. The mismatch between the real biological sex and the idealized biological sex appears to have various consequences throughout life, particularly in affectively significant interpersonal relationships.

In Utero I. Psicodinâmicas intrauterinas: a PIS – Projeção Idealizada de Sexo

Autores: Jorge A. Ramos e Sandra Ramos
Publicação Independente no dia 22 de fevereiro de 2022.

Resumo

Objetivos: Com base em 50 casos trabalhados com Constelações Familiares, analisar o potencial impacto ao longo da vida de não se satisfazer o desejo parental de ter um filho de um sexo biológico específico.

Método: Fenomenológico-hermenêutico.

Resultados: Neste primeiro volume desta investigação, são apresentadas associações entre a frustração da PIS (Projeção Idealizada de Sexo) e psicodinâmicas mal-adaptativas entre pais e filhos, entre irmãos e nos casais, bem como na esfera da não-heterossexualidade.

Conclusões: Estima-se que entre 50 a 70% da população mundial não corresponda ao sexo idealizado pelos seus pais, sobretudo as mulheres. A não correspondência entre o sexo biológico real e o sexo biológico idealizado, aparenta ter várias consequências ao longo da vida, mormente no domínio das relações interpessoais afetivamente significativas.