适应障碍（Adjustment Disorder,AD）是创伤及应激相关障碍的一个类别，其基本特征为针对可确定的应激源而出现的一系列情绪或行为不良反应。适应障碍是最常见的心理障碍之一，在国内高校中适应不良或适应障碍也是最为常见的心理困扰。目前，认知行为疗法（cognitive behavior therapy, CBT）是针对适应障碍最多实证研究支持的有效干预方法。本研究的目标是探索和检验认知行为疗法对国内患有适应障碍的高校学生干预的有效性。 本研究内容为对1名存在适应不良症状的来访者进行12次面对面的认知行为个体心理咨询干预。第1—3次咨询主要聚焦于收集与来访者主诉相关的背景信息，进行初步评估，建立良好的咨访关系，与来访者共同讨论问题清单和咨询目标，并对认知行为疗法相关概念进行心理教育。第4—11次咨询对自动思维进行识别、评估和挑战，修正来访者的中间信念，转变来访者的不合理信念，发展并练习新的应对策略，增强积极解释能力，主动寻求社会支持，以达到提高现实应对能力的目的。第12次咨询进行回顾总结，讨论咨询目标的完成情况，帮助来访者梳理和总结咨询成果，预防问题复发，最后结束整个心理咨询。 经过12次咨询，使用贝克抑郁量表、应对量表、来访者及咨询师评价从情绪、认知和行为三个角度对咨询效果进行评估总结。具体结果为来访者抑郁情绪得到缓解，贝克抑郁量表分数由中度抑郁水平（22分）降至临界值以下（5分）；应对量表分数显示来访者消极应对策略分数显著降低，积极应对策略显著提升；通过来访者评价和咨询师评价可知，来访者对“我是无能的”核心信念相信程度下降，当面对生活事件时可以及时觉察并有效躲避惯有的歪曲认知中。 本研究结果表明，认知行为疗法对高校学生适应障碍的干预是切实有效的，且干预效果明显。本研究对适应障碍干预研究进行补充，着重关注于诱发事件紧密相关的心理问题，在干预技术上采取整合多种取向的认知行为技术且依据具体咨询方案进行灵活干预。并且与传统心理咨询不同的是，本研究更加强调问题解决策略。本干预方案应用于中国被试，是认知行为本土化应用的一个新的尝试，可供临床工作者在实践中借鉴。并且，本研究在临床实践上对一个具体案例分析形成个案概念化，可作为后续咨询师的实践参考。

Adjustment disorder (AD) is a category of trauma and stress related disorder, and the basic characteristic is a series of emotional and behavioral adverse reactions to the identifiable stressors. AD is one of the most common psychological disorders, and maladjustment or adjustment disorder is also the most common psychological distress in domestic colleges and universities. Currently, cognitive behavior therapy (CBT) is the most effective intervention supported by empirical studies on adaptation disorders. The objective of this study is to explore and test the effectiveness of CBT in Chinese college students Maladjustment. The content of this study is to conduct 12 face-to-face individual psychological counseling on cognitive behavior for a client with maladaptive symptoms.The Session 1~3 mainly focused on collecting background information related to the client's complaint, conducting preliminary assessment, establishing a good relationship with the client, discussing the list of questions and consultation objectives with the client, and conducting psychological education on the concepts related to cognitive behavioral therapy. The session 4-11 were to identify, evaluate and challenge of automatic thinking, to correct the middle faith, to change the visitor’s irrational beliefs, to develop and practice new coping strategies, and to increase the ability of explanation, to actively seek supports, and all of these were going to improve the real response capacity. The 12th consultation was reviewed and summarized to discuss the completion of the consultation objectives, help the client sort out and summarize the consultation results, prevent the recurrence of problems, and finally finish the completely psychological consultation. After 12 times of counseling, beck depression scale, coping scale, client and consultant evaluation were used to evaluate and summarize the counseling effect from the perspectives of emotion, cognition and behavior. The specific results were that the client's depression was relieved, and the score of beck depression scale decreased from moderate depression (21) to below the critical value (5). The score of coping scale showed that the client's score of negative coping strategy was significantly decreased and that of positive coping strategy was significantly increased. According to the client's evaluation and the consultant's evaluation, the client's belief in the core belief of "I am incompetent" decreases, and when facing life events, the client can timely detect and effectively avoid the conventional distorted cognition. The results of this study show that cognitive behavioral therapy is effective and the effectiveness in the intervention is obvious among the college students’ AD. Due to the scarcity of studies on adaptive disorders in China, this study can fill the gap of studies on the intervention of adaptive disorders and focus on the psychological problems closely related to the evoked events. In terms of intervention techniques, specific counseling programs integrating multiple orientations of cognitive behavior are adopted, which are different from traditional psychological counseling and emphasize on problem-solving strategies. This intervention program applied to Chinese subjects is an attempt to localize the application of cognitive behavior, which can be used for reference by clinical workers in practice. In clinical practice, case conceptualization is formed from a specific case analysis, which can be used as a practical reference for subsequent consultants.