认知行为疗法对慢性疲劳综合征 .ppt

* Cognitive Behavioural Therapy in Chronic Fatigue Syndrome/ME Alice E. Green Highly Specialist Counselling Psychologist Oldchurch Hospital CFS Team * ppt课件 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 * ppt课件 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 * ppt课件 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 * ppt课件 CBT Models of CFS/ME Illness beliefs and coping strategies are key factors in the onset perpetuation of CFS/ME Cognitions, Behaviours, Emotional reactions and Physiological factors interact to maintain CFS/ME symptoms * ppt课件 Cognitive Behavioural Therapy * ppt课件 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 * ppt课件 Wessely, Butler, Chalder David (1991) Organic Insult e.g. virus Physical Symptoms Rest to relieve symptoms Physical Deconditioning Increased Pain / Fatigue * ppt课件 Cycle of Avoidance Pain symptoms are misinterpreted by patient as due to a physical disease / illness. Rest is used to cope and perpetuates the CFS/ME Cycle of Symptoms, Avoidance and Deconditioning Demoralisation; Depression; Anxiety etc Exacerbates CFS/ME symptoms * ppt课件 Additional Factors Precipitant