本文選題：心理動力學(xué)治療 + 認知治療��； 參考：《中南大學(xué)》2014年碩士論文

【摘要】：目的： 力求呈現(xiàn)心理動力學(xué)治療與認知心理治療全過程,確定其具體療效及相關(guān)因素,對比兩種心理療法的異同。 方法： 本實驗從課題“十種心理咨詢與心理治療的規(guī)范與示范研究”中選取心理動力學(xué)治療與認知治療兩種療法進行縱向平行對比。每種療法均包含心理治療+藥物治療組和單純藥物治療組兩組。評估治療全過程中四個時點患者的多個觀察指標,以及心理治療師按照要求對所采用的每次心理治療概括記錄,通過對兩組具體量化數(shù)據(jù)和心理治療情況記錄的分別分析,對比呈現(xiàn)兩種心理治療過程,并對治療結(jié)果進行量化分析。采用軟件SPSS18.0,進行獨立樣本t檢驗、卡方檢驗、重復(fù)測量的方差分析,logistic回歸分析。 結(jié)果： 1.心理動力學(xué)療法量化數(shù)據(jù)分析顯示SCL-90量表總分及因子分在兩種處理間的差別有統(tǒng)計學(xué)意義(總分F=27.888,軀體化F=24.101,強迫F=9.826,人際關(guān)系F=8.502,抑郁F=11.412,焦慮F=18.727,敵對F=9.278,恐怖F=16.453,偏執(zhí)F=4.487,精神病性F=4.904；P0.05)；GQOLI-74量表總分、軀體功能維度、心理功能維度在兩種處理之間的差異具有統(tǒng)計學(xué)意義(總分F=11.381,P=0.001；軀體維度F=13.667,心理維度F=11.783；P0.05)。SCL-90減分率分析顯示在治療結(jié)束時、結(jié)束后三個月、結(jié)束后六個月時心理治療組與藥物治療組的痊愈+顯著好轉(zhuǎn)人數(shù)均多于單純藥物治療組(χ2=6.372,8.336,11.577；P0.05)。影響治療效果改善因素的logistic回歸分析顯示最終進入方程的變量為試驗分組,基線期GQOLI-74量表心理維度評分,基線期SSRS主觀支持評分。 2.通過對心理動力學(xué)治療過程的文本分析,了解治療基本過程及治療方案,發(fā)現(xiàn)在治療過程中來訪者主觀評價情況除了在遇到“防御和阻抗”時有波動,基本維持穩(wěn)定在“3”(稍進步)及以上水平,并可能對治療效果的維持有預(yù)測作用。 3.認知療法量化數(shù)據(jù)分析顯示SCL-90量表總分(F=5.294,P=0.024)、人際敏感(F=4.396, P=0.039)、抑郁(F=5.715,P=0.019)、焦慮(F=4.659,P=0.034)、恐怖(F=7.404,P=0.008)、精神病性(F=8.651,P=0.004)在兩種處理間的差別有統(tǒng)計學(xué)意義,且在不同時間點兩組SCL-90總分及各因子分有差異。GQOLI-74量表總分(F=19.479,P=0.000)、軀體功能維度(P=11.988,T=0.001)、社會功能維度(F=26.326,P=0.000)在兩種處理間差異有統(tǒng)計意義,且兩組包括心理功能維度在內(nèi),以上各評分在不同時間點有差異。SSRS總分在不同時間點、不同處理方式的變化有差異(F=11.337,P=0.000)。SCL-90減分率分析顯示治療結(jié)束后六個月的痊愈+顯著好轉(zhuǎn)人數(shù)心理治療組多于藥物治療組(χ2=6.873,P0.05)。影響治療效果改善因素的logistic回歸分析顯示進入方程的變量為：試驗分組,基線期GQOLI-74量表心理維度、基線SCSQ積極應(yīng)付方式評分。 4.通過對認知治療過程的文本分析,了解治療基本過程及治療技術(shù),發(fā)現(xiàn)在進行“負性自動思維”的處理時來訪者的主觀評價有波動,其余時間基本穩(wěn)定在“3”(稍進步)及以上水平,并可能對治療效果的維持有預(yù)測作用。結(jié)論： 1.量化數(shù)據(jù)分析表明兩種心理治療結(jié)合藥物治療與單純藥物治療相比療效都更為顯著,且療效6個月內(nèi)可維持。 2.除了接受心理治療外,心理動力學(xué)治療組中影響效果改善的因素還包括基線GQOLI-74心理維度及SSRS評分,認知療法組中影響效果改善的因素還有基線GQOLI-74心理維度及SCSQ積極應(yīng)付方式評分。 3.在心理動力學(xué)治療過程中,來訪者充分挖掘利用自身能力及資源滿足自身的情感需求時,其軀體和心理癥狀會有所改善；而認知療法癥狀的改善則出現(xiàn)在來訪者學(xué)會識別并矯正中間信念和核心信念,并強化培養(yǎng)新的認知模式時。 4.兩種心理治療在治療時長、治療結(jié)構(gòu),以及治療師的作用方面有所不同；但兩種治療方法同樣以來訪者為中心,且積極的主觀評價和良好的治療關(guān)系對治療效果都能夠起到促進作用。
[Abstract]:Objective:
Strive to present the whole process of psychodynamic therapy and cognitive psychotherapy, determine its specific efficacy and related factors, and compare the similarities and differences between the two psychotherapies.
Method:
In this experiment, we selected two kinds of psychodynamic therapy and cognitive therapy from ten kinds of psychological counseling and psychotherapy in a vertical parallel comparison. Each therapy includes two groups of psychotherapy + drug therapy group and simple drug treatment group. The multiple views of four time points in the whole process of treatment are evaluated. Inspection indicators, as well as the psychotherapists in accordance with the requirements of each psychotherapy summary records, through the two groups of specific quantitative data and psychotherapy records of the analysis, compared with the presentation of two psychotherapy processes, and quantitative analysis of the results of the treatment. Software SPSS18.0, independent sample t test, chi square test, Repeated measurement of variance analysis, logistic regression analysis.
Result:
1. the quantitative data analysis of psychodynamic therapy showed that the difference between the total score and the factor score of the SCL-90 scale was statistically significant (total score F=27.888, somatization F=24.101, forced F=9.826, interpersonal F=8.502, depression F=11.412, anxiety F=18.727, hostile F=9.278, terror F=16.453, paranoid F=4.487, F=4.904; P0.05); -74 total score, body function dimension and psychological function dimension were statistically significant between the two treatments (total score F=11.381, P=0.001; body dimension F=13.667, psychological dimension F=11.783; P0.05).SCL-90 subtraction rate analysis showed at the end of treatment, three months after the end of the end, and six months after the end of the psychotherapy group and drug treatment. The number of recovery + significant improvement in the group was more than that of the simple drug treatment group (x 2=6.372,8.336,11.577; P0.05). The logistic regression analysis of the factors affecting the effect of treatment showed that the variables of the final entry equation were the experimental group, the baseline GQOLI-74 scale psychological dimension score, and the baseline SSRS subjective support score.
2. through the text analysis of the psychodynamic therapy process, we know the basic process of treatment and the treatment plan. It is found that the subjective evaluation of the visitors in the course of treatment has fluctuated in addition to the "defense and impedance", which is basically maintained at "3" (slightly progressed) and above the level of water, and may have a predictive effect on the maintenance of the therapeutic effect.
3. the quantitative data analysis of cognitive therapy showed that the total score of SCL-90 (F=5.294, P=0.024), interpersonal sensitivity (F=4.396, P=0.039), depression (F=5.715, P=0.019), anxiety (F=4.659, P=0.034), terror (F=7.404, P=0.008), and psychotic (F=8.651, and P=0.008) were statistically significant in the two treatments, and two groups in different time points and each The factors have different.GQOLI-74 total score (F=19.479, P=0.000), body function dimension (P=11.988, T=0.001), and the social function dimension (F=26.326, P=0.000) have statistical significance in the difference between the two treatments, and the two groups include the psychological function dimension, and the above scores are different at different time points at different time points and different processing parties at different time points. The difference (F=11.337, P=0.000).SCL-90 reduction rate analysis showed that the recovery + significant improvement after the end of the treatment was more than that of the drug treatment group (x 2=6.873, P0.05). The logistic regression analysis of the factors affecting the improvement of the therapeutic effect showed that the variables of the entry path were the experimental group, the baseline GQOLI-74 scale heart. Physical dimension, baseline SCSQ positive coping style score.
4. through the text analysis of the cognitive treatment process, we know the basic process of treatment and the treatment technology. It is found that the subjective evaluation of the visitors is fluctuating in the process of "negative automatic thinking". The rest of the time is basically stable in "3" (slightly progressed) and above, and may have a predictive effect on the maintenance of the therapeutic effect.
1. quantitative data analysis showed that two psychotherapy combined with drug therapy had more significant efficacy compared with simple drug therapy, and the efficacy could be maintained within 6 months.
2. in addition to receiving psychotherapy, the factors affecting the effect of psychodynamic therapy included the baseline GQOLI-74 psychological dimension and the SSRS score. The factors affecting the effect in the cognitive therapy group were the baseline GQOLI-74 psychological dimension and the SCSQ positive coping style score.
3. in the process of psychodynamic therapy, when the visitors fully exploit their own ability and resources to meet their emotional needs, their physical and psychological symptoms will be improved, while the improvement of cognitive therapy symptoms occurs when the visitors learn to recognize and correct the middle beliefs and core beliefs, and strengthen the training of new cognitive patterns.
4. the two kinds of psychotherapy are different in the length of the treatment, the structure of the treatment, and the role of the therapist, but the two treatments are the same as the visitor, and the positive subjective evaluation and the good treatment relationship can contribute to the effect of the treatment.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R749

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