综合的降低危害心理治疗的治疗任务课件.pptxVIP

综合的降低危害心理治 疗的治疗任务 聪明出于勤奋， 天才在于积累 1 2 3 4 5 Initial Engagement ( 1 ) 初次接触 Make contact with patient, connection will keep patient coming; but what kind? 和病人建立联系，联 系能保持病人不流失，但该是什么样的联系呢？ Get patient’s definition of problem and reason for coming 了解病人对问题的界定和前来就诊的原因 What does patient want? 病人想要什么？ l Initial goals: assessment, better understanding, safer use, reduced use, abstinence 初步目标：评估、更好地了解、安全使 用、减低使用量、戒除 Long term 长期性 Regarding substance use and other issues (we can talk about anything) 物质滥用和其它问题(我们 可以谈论任何问题) 6 Initial Engagement (2 ) 初次接触 Reflect understanding and empathy as question open to clarification (Did I hear you right?)- “formulation” 表现理解和共情， 通过问题来公开确认对问题的理解(我这样理解对 么？) -“构想” Agree on initial goals and treatment plan 在初步目标和治疗计划上达成一致 7 Maintaining the Therapeutic Alliance 保持治疗联盟( 1 ) • How do we make contact in ways that build, maintain and repair alliance throughout therapy? 我们如何建立联系，使得联系在治疗过 程中能够建立、保持和修复联盟？ • How can we be used differently by different patients in ways that are helpful to their growth? 我们如何让自己适应不同的病人，并提供 有利他们发展的帮助? • We have to change as they change 病人变，我 们也要跟着变 8 Maintaining the Therapeutic Alliance 保持治疗联盟(2 ) • When do we lead and when do we follow? 我 们什么时候需要引导，什么时候需要跟进？ • What are the clinical challenges? 临床挑战有哪 些？ • Disruptions are inevitable and repairing them can be therapeutic opportunities 中断是 不可避免的，修复中断也可能就是治疗的机会。 9 Engagement Skills 让病人参与的技巧 Activelistening 积极的倾听 o “start where the patient is” 从病人的立场出发 oTry to put aside your presumptions 尽量避免事先推 断 o Listen with no agenda except to be helpful 不拘泥 于定式，尽量倾听，并提供帮助 o Face not knowing 不必认脸 oManage countertransference 处理好反移情 Collaborative inquiry 合作式询问 okeeps client and clinician on the same side 病人和 医生的立场一致 ofocus on clarification 重点在澄清问题 o open-ended questions 开放式提问 10 Engagement Skills Cont. 让病人参与的技巧 Empathy for client´s experience