http://www.dbsalliance.org/info/Psychotherapy.html
Psychotherapy: How it Works and How it Can Help
PartIII
How will I know if I’m making progress?
After some time has passed, check the list and see if you’re closer to reaching your goals. It may be helpful to track how you feel each day and how you cope with difficult situations. Review your progress with your therapist. Improvement won’t happen overnight, but you should see some change, even if it’s just a better understanding of your own thoughts and feelings. It is also helpful to learn everything you can about mood disorders and their treatments. Visit the information pages on this website and check your local library for other books and reference materials.
What if I’m not making progress?
If after several weeks you don’t begin to feel some relief, you have a right to seek a second opinion (as you would with any illness) from another therapist. You have a right to have the best treatment possible.
What type of therapy is best for me?
There are many types of therapy and most therapists use a combination of approaches. Behavioral therapy concentrates on your actions; cognitive therapy focuses on your thoughts; and interpersonal therapy looks at your relationships with others. Your loved ones may join you in sessions of family or couples therapy. Group therapy involves several, usually unrelated people working with the same therapist and each other. One approach is not necessarily better than another – the best choice is the one that works best for you.
What are some therapies commonly used for depression or bipolar disorder?
Interpersonal therapy (IPT) was originally developed to treat depression. It has since been adapted for bipolar and other disorders. It is time-limited and goal-oriented, and addresses a person’s symptoms, social relationships and roles. IPT focuses on what is happening “here and now” and attempts to help a person change, rather than just understand his or her actions and reactions. The patient and therapist examine current and past relationships. IPT does not focus on unconscious or subconscious motivations, wishes or dreams. It looks at conscious, outward action and social adaptation. It does not try to change the personality, but rather to teach new skills that can lessen some personality disorder symptoms.
An IPT therapist is an active supporter of the patient in the wellness journey. The therapist does not assign homework, but may encourage a patient to engage in social activities. The therapist helps the patient review his or her symptoms and relate these symptoms to one of four things: unresolved grief over a loss, interpersonal role disputes (conflicts with others), role transitions (changes in life status such as moving or changing jobs) or interpersonal deficits (isolation or lack of social skills). The therapist and patient then work through specific situations, one by one, to relieve symptoms and stress.
Cognitive-behavioral therapy (CBT) combines cognitive therapy, which involves examining how thoughts affect emotions, and behavioral therapy, which involves changing a person’s reactions to challenging situations. CBT is goal-oriented and works best when the patient takes an active role. The cognitive aspect of CBT helps a person recognize the automatic thoughts or core beliefs that contribute to negative emotions. The therapist helps the person see that some of these thoughts and beliefs are false or don’t make sense and helps the person change them. Types of automatic thoughts may include focusing on one negative detail (an unkind person) and applying the negative quality to everything (the human race in general); perceiving things as “all good” or “all bad”; or applying labels such as “loser,” “no good,” or “worthless.” Types of core beliefs may include, “I have to succeed at everything,” “Everyone has to love me,” “It’s a disaster if things don’t go the way I plan or expect,” or “I can’t change the miserable way I am.”
The behavioral aspect of CBT takes place after a person has a more calm state of mind. The person can then take actions that help him or her move closer to planned goals. For example, if depression has caused someone to withdraw from life, that person may be encouraged to participate in hobbies or spend time with friends. Or a person may be gently coached, under supervision, to confront situations, things or people that cause fear or panic. Through practice, a person learns new, healthier behaviors.
With CBT, the therapist assigns homework. It may include journaling, reviewing notes or tapes of the therapy session, or trying a new approach to an old problem. There may also be exercises to make a person more aware of his or her own thoughts and actions without judging them.
The most important parts of any type of therapy are partnership, communication, goals, collaboration, trust, understanding and action. Successful therapy can help a person change thoughts, beliefs, perceptions, actions and moods for the better.
如何得知有没有进步。
一段时间后,检查列表看看是否靠近了你的目标。每天感觉怎么样以及你如何面对艰难处境可能对你跟踪治疗有帮助。与你的治疗师讨论你的进展。改变不会在瞬间发生,但是你会看得到有所不同,即便只是更好的了解自己的想法和情绪。 了解情绪混乱以及如何治疗也同样很有帮助。访问本网站的内容并且在当地图书馆查阅书籍和相关资料。
没有进展怎么办
几周后,如果觉得没有什么帮助,那么你有权力从其它治疗师那里获取不同的建议(你在生病的话)。你有权获得可能最好的治疗方式。
哪种疗法最适合我
治疗方法有很多中,大部分的治疗师采取混合疗法。行为疗法关注与你的行为;认知疗法重点在于你的思想;而人际疗法注重你的人际关系。你和你的亲人可能共同参与家庭治疗,或者夫妻治疗。团体治疗包括几种,最常用的是不相关的人员与治疗师协同并且这些人员相互协同。这个方法不一定比其它的更好 – 最合适的才是最好的。
抑郁症、间歇性狂躁-抑郁型精神失常常用的治疗方式有哪些。
人际治疗(IPT)最初用以治疗抑郁。现在更多的用于治疗间歇性狂躁-抑郁型精神失常以及其它精神失常。它是有时效性并且具目标导向的,针对患者的症状,以及社会关系和角色。IPT关注于”这里现在”发生了什么,来试图帮助患者,而不仅仅是理解他或者他行为和反应。患者以及治疗师研究现在以及过去的关系。 IPT不关心无意识或者下意识的反应。更多的关注于有意识的,外在行为以及社会适应性。也不试图改变个性,而是尝试教一些减少人格失常的技巧。
对于患者,IPT治疗师是在健康旅途的积极支持者。治疗师不布置家庭作业,但是会鼓励患者参多参加社会活动。治疗师也帮助患者注意他的征兆以及相关的四个症状:未解决事件遗忘,角色冲突(与其它冲突),角色转型(改变生活状态,如搬家或者换工作) 或者人际孤立(孤立无援或者缺乏社会技能)。患者与治疗师一起,根据具体情况,逐步治疗,以减轻症状以及压力。
认知行为疗法(CBT)结合认知疗法,其中包括研究思考如何影响情绪以及行为治疗-用以改变一个人面对挑战的反应。CBT是目标导向的,当患者积极配合时效果会很好。CBT的认知方面会帮助患者认识到基本信念或者无意识思维会导致幅面情绪。治疗师帮助患者认识到不正确的思想和信念并且帮助他们改变。无意识思维包括总是关注负面细节(无情的人)以及负面思维面对一切(一般人都是这样);看事情总是:”很好”或者”很坏”;或者把所有的东西标上标签,比如”失败”、”成功”、”毫无价值”。基本信念包括 ”所有事情我都要成功”、”每个人都得爱我”、”如果不是按照我计划的进行就是灾难”、”我没办法改变我的苦痛”
CBT中的行为疗法运用在患者情绪较为平稳的状态下。患者可以采取一些行动来帮助他靠近计划目标。比如,如果有谁因为抑郁导致生活封闭,那么可以鼓励他参加业余爱好,或和朋友在一起。或者在监护状态下面对可能引起惊恐的情况、人或事,那么通过实践,使患者学习新的健康行为模式。
通过CBT, 治疗师安排作业。其中可能包括写日记、查看治疗纪录或磁带,或者用新方法对待旧问题。还有通过练习不加判定的明白自己的思想行为。
任何一种治疗很重要的部分是 患者与治疗师的伙伴关系,沟通、目标、协作、信任、理解以及行动。成功的治疗可以帮助患者重建思想、信念、行为,并且情绪良好。
[ 本帖最后由 无界 于 06-9-8 15:58 编辑 ] |