Aim: This systematic review identified systematic reviews of quantitative and qualitative empirical studies on the promotion and development of critical thinking in higher education students that allowed us to answer the following research questions: (1) What are the main definitions of critical thinking found in systematic reviews of critical thinking in higher education, and what are their similarities and differences? and (2) What are the most commonly used teaching strategies in higher education for teaching or promoting critical thinking, and how effective have they proven to be?Methods: Systematic reviews were selected according to the guidelines for systematic reviews and meta-analyzes (PRISMA, 2020) and the eligibility criteria proposed by the PICOS strategy (population, interventions, comparators, outcomes and study design), based on 23 records of scientifically identified registers in the Journal Citation Report databases of the Web of Science.Results: The bibliometric and systematic search of reviews of empirical studies on the topic allowed the selection of five systematic reviews. The results highlighted that conceptually critical thinking is related to both dispositions and skills, and that although there is no consensus on its definition, it is established that it is a higher-order cognitive process that can be trained. However, the results show that more studies have been conducted considering critical thinking as a skill than as a disposition, that the immersion approach has been widely used, and that some instructional strategies have shown greater effectiveness than others when the disciplines are evaluated independently.Discussion: Despite the relative consensus on the importance of critical thinking for professional development in higher education, this review highlights some difficulties in conceptualizing critical thinking, in the relationship between dispositions and skills, and in its assessment in academic disciplines.

Introduction: This systematic review identified qualitative and mixed-methods empirical studies on psychotherapy from dialogical and narrative approaches, aiming to address the following questions: (1) How are subjectivity and intersubjectivity qualitatively understood in dialogical and/or narrative psychotherapies studied using dialogical and narrative approaches? (2) How do therapeutic changes occur, including their facilitators and barriers? (3) What psychotherapeutic resources are available for psychotherapists in these types of studies?Method: The articles were selected according to the Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the eligibility criteria proposed by the PICOS strategy (participants, interventions, comparators, outcomes, and study design) from 163 records identified in the Web of Science Core Collection databases.Results: The systematic review process allowed the selection of 16 articles. The results provided insights into the understanding of subjectivity, intersubjectivity, change in psychotherapy, its facilitators, and barriers from these perspectives. It also offered some therapeutic interventions that can be implemented in psychotherapies, integrating dialogical and/or narrative aspects.Discussion: The centrality of dialogical exploration of patient/client resources, therapists as interlocutors fostering client agency, polyphony serving as scaffolding for change, and interconnection with the sociocultural environment are discussed. The integration of this latter topic has been a challenge for these types of studies, considering the active construction of shared meanings. The dialogical and narrative approaches focus psychotherapy on transforming meanings through dialogue and re-authoring stories, evolving within cultural and historical contexts. Thus, this study highlights the relevance of these perspectives in contemporary psychotherapy, emphasizing dialogue in co-creation within an intersubjective framework.

This case study identified the subjective change in a patient diagnosed with Borderline Personality Disorder (BPD) by analyzing the dynamic patterns that emerged during discursive interaction with her therapist during a successful long-term psychotherapy. A qualitative analysis was conducted by applying the Model of Analysis of Discursive Positioning in Psychotherapy (MAPP), tracking voices and the personal positions of the patient and therapist in all sessions. Subsequently, dynamic patterns were identified and the hypothetical attractors were defined (i.e., the most stable patterns in the interaction of voices) using the Space State Grid (SSG) technique. Five sessions (representing the initial, middle and final stages) were selected to describe the trajectory of the patient’s subjective change. These sessions highlight the presence of different attractors and depict the intersubjective interaction that developed during the process. The results suggest a process of subjective transformation from a monological to a dialogical dimension, a change supported by therapeutic interaction based on propositional and reflective discursive aspects; a transition from a state of dissociation of the patient to a reorganization of her subjectivity. The most relevant characteristics of this process as an emergent quality of psychotherapy and its relation to the patient’s positive outcomes are discussed.

Considerando la perspectiva de las polaridades de la personalidad (Blatt, 2004, 2007, 2008), el objetivo de este estudio fue describir la relación entre los niveles de autocriticismo y dependencia (DEQ) en pacientes con depresión (BDI-I) y su abandono de la psicoterapia, explorando el rol mediador de la alianza terapéutica (WAI-P) y el rol moderador de la edad de los pacientes. Mediante un diseño longitudinal y un muestreo por conveniencia, se reclutaron 81 pacientes adultos con depresión que estaban en psicoterapia breve en un centro de salud privado de Santiago, Chile, de los cuales 22 abandonaron el tratamiento. Por medio de un modelo de regresión con interacción, los resultados indican que, controlando sexo, escolaridad y edad de los pacientes y años de experiencia de los terapeutas, a mayor autocriticismo mayor probabilidad de abandonar la psicoterapia, relación que no es explicada por la alianza terapéutica. La asociación entre autocriticismo y abandono no se observa en los pacientes más jóvenes (30 años), pero sí en aquellos de mayor edad (> 40 años). Además, a mayor dependencia menor probabilidad de abandonar la psicoterapia.

Personal positions and voices of a patient diagnosed with borderline personality disorder (BPD) and the therapist during long-term psychotherapy were studied aiming to find differences in the patterns formed in these aspects of subjectivity according to the level of elaboration of the change episodes achieved by the patient. This case study considered a stage of qualitative analysis where change episodes of the patient were traced through the Change Episodes Model. Later, through the Model of Analysis of Discursive Positioning in Psychotherapy (MAPP), the voices and personal positions of the patient and her therapist were identified in each of the change episodes. In the stage of quantitative analysis, dynamic patterns in the voices and personal positions were established, accounting for hypothetical attractors using the Space State Grid (SSG) technique in each of the three different levels of subjective elaboration that constitute the change episodes. The results established differentiated dynamic patterns in the change episodes, coherent with the patient’s change process, and formation of propositive/reflective specific patterns as the patient evolved in the three different levels of subjective elaboration. The above suggests that a subjective transformation process is displayed, and this is manifested in the different voices and personal positions that emerged as the change episodes evolve. The identified dynamic patterns can be considered nonlinear and emergent subjective exchanges between the patient and the therapist throughout the psychotherapy.