中文题名: | 认知行为疗法对青少年抑郁的干预:一例个案研究 |
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保密级别: | 公开 |
论文语种: | 中文 |
学科代码: | 045400 |
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学生类型: | 硕士 |
学位: | 应用心理硕士 |
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学位年度: | 2019 |
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研究方向: | 应用心理 |
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提交日期: | 2019-06-09 |
答辩日期: | 2019-06-09 |
外文题名: | COGNITIVE BEHAVIOR THERAPY FOR ADOLESCENT DEPRESSION: A CASE STUDY |
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中文摘要: |
抑郁通常被用来指称从轻微的消极情绪等抑郁症状到严重的情绪障碍这一范围较广的情绪问题。 当达到抑郁症的诊断标准后, 个体通常存在持续性的情绪低落,并可能伴有兴趣丧失、精力不足等其他症状。美国的调查发现, 青少年期是抑郁症的高发时期,且同一群体中, 随着个体从儿童期发展到青少年期, 抑郁症状的检出率会提高到原先的 4 倍左右。认知行为疗法是目前公认的对于青少年抑郁最为有效的心理干预方法之一。本研究使用认知行为疗法干预一例有抑郁症状的青少年个案,旨在探讨该疗法对于中国青少年的适用性,以期为青少年心理健康的相关专业人员提供实践参考。
本研究主要包括招募被试、筛选被试、实施干预、回访四个步骤。通过网络平台招募被试之后,咨询师使用贝克儿童青少年量表(第二版)和简明国际神经精神访谈第 5.0.0 版进行半结构化访谈筛选出符合条件的来访者。干预阶段以认知行为疗法为理论基础, 从2018 年 11 月初开始,到 2019 年 1 月底结束, 共包括 12 次咨询。 收集资料后, 结合认知行为理论进行个案概念化,制定咨询计划并拟定干预策略。 在咨询过程中,根据个案的实际情况对干预方案进行微调。咨询过程总体上可分为四个阶段。初始阶段(1-3 次)为与 F建立良好的咨访关系,建立咨询目标,进行认知行为疗法的心理教育,与来访者制订咨询计划。认知干预阶段(4-8 次)主要是针对引发 F 负面情绪的不合理认知,使用三栏表、 五栏表、行为实验等技术进行识别和挑战,重建新的适应性认知。压力应对阶段(9-10 次)的主要任务是启动问题解决策略帮助 F 平稳度过情绪容易波动的期末考试时期,同时也进一步挑战 F 的不合理认知并对其进步进行巩固。结束阶段(11-12 次)的重点在于巩固前几个阶段取得的效果,并进一步发掘她生活中的其他资源来应对今后可能存在的挫折。
经过 12 次的咨询,咨询初期设立的咨询目标基本达成,来访者在贝克儿童青少年量表(第二版)抑郁分量表上的分数显著下降至 15 分以下的正常范畴。一个月后的回访结果显示咨询效果维持良好,来访者在贝克儿童青少年量表(第二版)抑郁分量表得分为 1 分,且主观表示情绪调节能力和自信心均有明显提高,能够应对生活中出现的挫折。在该个案上,认知行为疗法对抑郁症状的干预显示出较好的干预效果; 但单一的个案报告并不具备普遍意义,寻找到本土化的青少年抑郁症状干预方案还需要进一步更大规模的研究和探索。
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外文摘要: |
Depression normally refers to an emotional problem widely ranging from depressive symptoms such as slight negative emotions to severe mood disorders. The individual diagnosed with depression usually has a feeling of persistent depression, and may be accompanied by loss of interest, lack of energy and other symptoms. An American survey finds that adolescence is the peak period of depression; and in the same group, the detection rate of depressive symptoms for the individual in adolescence is four times higher than in childhood. Cognitive behavior therapy is currently acknowledged as one of the most effective psychological interventions for adolescent depression. In this paper, cognitive behavior therapy is adopted to intervene in an adolescent with depressive symptoms, aiming to explore the applicability of this therapy to Chinese adolescents and provide a practical reference for professionals committed to adolescent mental health.
This study consists of four steps of recruiting the participants, screening the participants, implementing interventions, and return visit. After recruiting the participants through the online platforms, the consultant conducted a semi-structured interview according to the Mini International Neuropsychiatric Interview Version 5.0.0, and screened out the qualified participant according to Beck Youth Inventories?– Second Edition for Children and Adolescents. The intervention phase began in early November 2018 and ended at the end of January 2019 with totally 12 consultations. After the materials were collected, the consultant carried out the case conceptualization with the cognitive behavior therapy as the theoretical basis, developed the consultation plan and the intervention strategy, and slightly adjusted the intervention strategy according to the actual situation of the case. The consultation process contains four phases in general. At the initial phase (1-3 times), the consultant established a good counseling relationship with F, set up the consultation target, conducted the psychological education of the cognitive behavior therapy, formulated the consultation plan through consultation with the participant. At the intervention phase (4-8 times), aiming at F’s unreasonable cognition triggering the negative emotions, the consultant identified and challenged them by means of tables in three columns, tables in five columns, and behavioral experiment, etc. to rebuild the adaptive cognition. At the stress response phase (9-10 times), the main task of the consultant was to initiate the problem-solving strategy to help F spend smoothly the final examination period when F’s mood swings easily; meanwhile, the consultant further challenged F’s unreasonable cognition and consolidated her progress. At the final phase (11-12 times), the consultant mainly focused on consolidating the effect achieved in the previous phases, and further explored other resources in her life to help her cope with the possible setbacks in the future.
After 12 consultations, the consultation target set at the initial stage was basically achieved. There is an apparent decrease in the participant’s score shown on the depression subscale of Beck Youth Inventories?– Second Edition for Children and Adolescents, with the score in the normal range. Furthermore, a return visit after one month showed that consultation effect was well maintained, and the participant indicated that her emotional regulation ability and self-confidence had improved obviously, and she had been able to cope with the setbacks in life. In this case, cognitive behavior therapy shows a good effect for the intervention of depression symptoms. However, as the specificity of the participant makes the single case report not universally meaningful, it is necessary to conduct more large-scale research and exploration to seek out localized intervention programs for adolescent depressive symptoms.
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参考文献总数: | 70 |
馆藏号: | 硕045400/19062 |
开放日期: | 2020-07-09 |