抑郁障碍是 21 世纪最常见的身心疾病之一，主要症状有持久的心境低落、意志减退、 思维迟缓等。阈下抑郁是指个体不符合抑郁障碍的诊断标准，但存在抑郁症状的一种状 态。对于阈下抑郁的个体而言，如不加以干预，有可能进一步发展为抑郁障碍，对个体的 身心健康、社会功能造成严重危害，甚至出现自伤、自杀行为。在抑郁障碍患病群体中， 女性的数量显著高于男性，而就业状况是个体抑郁的影响因素之一，故研究者将全职主妇 选定为本次个案研究的干预对象。 本文首先回顾了阈下抑郁的概念、成因和干预方法，全职主妇群体的界定、心理健康 状况以及研究现状，提出了运用接纳承诺疗法干预全职主妇阈下抑郁的可能性，然后基于 接纳承诺疗法的治疗模型设计了干预全职主妇阈下抑郁的咨询计划，尝试对其可行性和 效果进行研究。 本研究招募了一名受到阈下抑郁困扰的全职主妇参与研究，干预从 2020 年 11 月底 开始，至 2021 年 3 月中结束，进行了 1 次初筛访谈，9 次咨询，由研究者做咨询师。咨 询分为三个阶段：①开始阶段（第 1 次咨询）：咨询师向来访者讲述研究目的，说明风 险，双方自愿签署知情同意书。咨询师收集来访者信息，初步形成个案概念化，初步制定 咨询计划；②实施阶段（第 2 至 8 次咨询）：咨询师实施咨询计划，在每次咨询后完善个 案概念化，调整咨询计划；③结束阶段（第 9 次咨询）：咨询师与来访者回顾、反馈咨询 历程，巩固咨询效果，邀请来访者参加之后的回访，结束咨询。在咨询结束的三个月后进 行了一次回访，了解咨询的维持效果。本研究使用了抑郁自评量表、接纳与行动问卷第二 版中文版、生活满意度量表、自尊量表等量表进行施测，随时监测咨询进度，辅助评估咨 询效果，施测时间为第 1 至 8 次咨询的每次干预前、第 9 次咨询后和回访前。 干预结束后，来访者的抑郁水平减轻，心理灵活性提高，生活满意度提高，自尊水平 提高，来访者表示自己看待事情和看待自己的方式明显转变，无效行为减少，符合价值的 行为增多，更少地感受到抑郁情绪，家人对来访者的态度与行为也出现改变。来访者的变 化涵盖了行为、认知和情绪三个层面，接纳承诺疗法显示出良好的干预效果。本研究还总 结了接纳承诺疗法对全职主妇阈下抑郁干预的适用性，对干预过程和本研究的局限性进 行反思，对未来相关干预和研究进行展望。 

Depressive disorder is one of the most common physical and mental diseases in the 21st
century. The main symptoms are persistent low mood, decreased will, slow thinking and so on.
Subthreshold depression is a condition in which an individual does not meet the diagnostic
criteria for a depressive disorder, but has depressive symptoms. For individuals with subthreshold
depression, if no intervention is given, they may develop into depression disorder, causing serious
harm to their physical and mental health and social functions, and even self-injury and suicide.
The number of female patients with depressive disorder is significantly higher than that of male
patients, and employment status is one of the influencing factors of individual depression.
Therefore, the researcher selected the full-time housewives as the intervention object of this case
study.
This article first reviewed the concept, origin and intervention method of subthreshold
depression, full-time housewife group definition, mental health status and the research status,
proposes using accepted promises the possibility of a full-time housewife subthreshold
depression therapy intervention, and then based on the received commitment therapy in the
treatment of model design intervention housewife subthreshold depression consulting plan. Try
to study its feasibility and effectiveness.
A stay-at-home housewife suffering from subthreshold depression was recruited to
participate in the study. The intervention began at the end of November 2020 and ended in midMarch 2021. A preliminary screening interview and 9 consultations were conducted, with the
investigator as the counselor. The consultation is divided into three stages: (1) The initial stage
(the first session): The counselor tells the client the purpose of the study, explains the possible
risks, and both parties sign the informed consent voluntarily. Counselor collect clients'
information, preliminarily form case conceptualization, and preliminarily make consultation plan;
(2) Implementation stage (the 2nd to 8th session): The counselor implement the consultation plan,
improve the case conceptualization and adjust the consultation plan after each consultation; (3)
The end stage (the ninth session) : The counselor reviewed the counseling history with the client,
asked the client to give feedback on the counseling and consolidated the effect of the counseling.
Finally, the client was invited to participate in the subsequent return visit and the counseling ended. Three months after the consultation, the counselor conducted a follow-up visit with the
client to assess the maintenance effect of the consultation. In this study, Self-rating Depression
Scale, Acceptance and Action Questionnaire-2nd Edition, Satisfaction with Life Scale, Selfesteem Scale and other scales were used to monitor the counseling progress at any time and assist
in evaluating the counseling effect. The time of measurement was before each intervention from
the 1st to 8th session, after the 9th counseling and before the return visit.
After the end of the intervention, the client’s depression level was reduced and her
psychological flexibility, life satisfaction, and self-esteem level were increased. This client said a
significant shift in the way she saw things and herself, less ineffective behaviors, more behaviors
consistent with values, less feelings of depression, and a change in her family's attitudes and
behaviors toward her. The changes in the client covered behavioral, cognitive, and emotional
dimensions. Aacceptance and commitment therapy showed a good intervention effect. This study
also summarized the applicability of acceptance and commitment therapy for subthreshold
depression of full-time housewives, reflected on the intervention process and the limitations of this
study, and looked forward to related interventions and research in the future.