多重创伤、精神分离、自杀和药物滥用案例中的运用教程方案.ppt

Capacities for Change 2改变的能力 To support greater self-reflective awareness I suggested that she monitor her use between sessions by counting and charting her drinks and pot smoking and noting the circumstances and feelings surrounding her use and how she felt during and the next day. She liked the charting saying it gave her a sense of control.为了帮助她的自我审视意识，我建议她每天通过计量和记录酗酒情况和吸食情况来进行监控，注意使用时的环境和感受以及她当时和第二天的感觉，她喜欢情况记录，说这样使她感觉自己在控制情况。 Capacities for Change 3改变的能力 I also suggested she particularly see if she could notice the desire to use, slowly breathe as she described the related sensations, thoughts and feelings (Urge surfing for affect tolerance and management). 我同时建议她具体看是否她能够体会到自己想要吸食和酗酒时的感觉，在她描述相关的感觉、思想和体会时慢慢呼吸（效果忍受和管理的冲动体会） * * * * * * * * * * * * * * * * * * * * * * 综合的减低危害心理治疗 在一个多重创伤、精神分离、自杀和药物滥用案例中的运用 安德鲁·塔塔斯基博士 Andrew Tatarsky, PhD 凯瑟琳案例 The Case of Katherine A 33 year old single, professional woman referred by her neurologist, himself in AA, for daily drinking and marijuana smoking.她是一名33岁的单身职业女性，由她的神经科医师转介。她自己因为每天酗酒和吸食大麻而正处于成瘾者匿名小组（AA）的治疗之中。 Heavy substance use was potentially life threatening because a hangover could and occasionally did precipitate grand mal seizures that could kill or cause serious harm.严重的滥用潜在的威胁着生命，宿醉能够----某种情况下也确实会导致癫痢发作、丧命或严重伤害。 Harm reduction psychotherapy was recommended because her neurologist had been suggesting A.A. and abstinence for seven years but she was only interested in pursuing moderation and safer use. 推荐使用减低危害心理疗法，因为她的神经科医生7年来一直建议使用成瘾者匿名治疗和完全戒除，但她本人只希望适度和安全使用。 Initial presentation 最初接触 Katherine was a successful, intelligent, thoughtful, good looking, slightly overweight woman who dressed in a somewhat masculine style. 凯瑟琳是一位成功的、聪明的、思维周全的、漂亮的、有点丰满的女性，她的穿着略带男性风格。 She appeared to be open and engaged, smiling frequently and apparently motivated for help.她显得比较外向也比较投入，经常微笑，并表现出明显对于帮助的期望。 However, her smile seemed forced and there was a wooden “as if” quality to her well adjusted presentation that made it hard to em