CognitiveBehaviouralTherapyinChronicFatigueSyndrome：认知行为疗法对慢性疲劳综合征.pptVIP

Alice Green, Oldchurch Hosiptal, Essex Centre for Neurosciences Cognitive Behavioural Therapy in Chronic Fatigue Syndrome/ME Alice E. Green Highly Specialist Counselling Psychologist Oldchurch Hospital CFS Team Overview What is CFS/ME? CBT Overview Psychological Models of CFS/ME Psychological Factors in CFS/ME Evidence-based Practice Using CBT in Treatment of CFS/ME Conclusions Diagnosis of CFS/ME Ongoing disabling fatigue 6m Defined onset of symptoms Impairment of short-term memory concentration Sore throat/Tender cervical or axillary lymph nodes Muscle pain/ Multijoint pain/Headaches Unrefreshing sleep Post-exertion malaise lasting more than 24 hours Exclusion Criteria Any active medical condition that could explain the chronic fatigue Past / current major depressive disorder with psychotic or melancholic features; bipolar affective disorders, schizophrenia; delusional disorders, dementias, anorexia nervosa, bulimia nervosa Alcohol or other substance abuse within 2 years prior to the onset CBT Models of CFS/ME Cognitive Behavioural Therapy Process of CBT Therapy Therapeutic Alliance Trust Awareness of Domains of experience Underlying Core Beliefs (Schemas) Understanding Links between Domains Instilling the Possibility of Change Challenging Beliefs Experimentation Reviewing Changes made in therapy Wessely, Butler, Chalder David (1991) Additional Factors Precipitants: Virus / Excessive stress Predisposition: Personality traits / Biology Perpetuators: “Boom Bust”, personality traits, beliefs Interpretation of Symptoms:Attributional Styles Somatic attributions e.g. virus Psychological attribution e.g. stress Normalising attribution e.g. Symptoms due to change in lifestyle, behaviour, environment etc. Somatic Attributions and CFS/ME How are Symptoms Experienced? Possible Underlying Reasons…. Illness Beliefs in CFS/ME Illness Beliefs cont…. Cognition leads to Coping styles Coping styles… Cognitive Behavioural Therapy Strategies CBT inte