Lysaker Paul H, Buck Kelly D
Roudebush VA Medical Center and Indiana University School of Medicine, Department of Psychiatry, Indianapolis, Indiana 46202, USA.
Issues Ment Health Nurs. 2006 Apr;27(3):233-47. doi: 10.1080/01612840500502676.
Recovery from schizophrenia may involve persons developing a renewed sense of their illness, identity, agency, and worth within their life stories. To explore the requirements and challenges of psychotherapy that could facilitate this, we present a case study of a person with schizophrenia enrolled in treatment for over 19 months. Observed challenges to this process include the therapist's inclinations to "fix" the client, the client's own deficits and symptoms, and discomfort within the therapeutic relationship. Techniques to address these difficulties are presented, along with an objective means of assessing the treatment outcomes in terms of changes in narrative processes.
精神分裂症的康复可能涉及患者在其人生故事中重新培养对自身疾病、身份、能动性和价值的认识。为了探讨有助于实现这一点的心理治疗的要求和挑战,我们展示了一个参与治疗超过19个月的精神分裂症患者的案例研究。在这个过程中观察到的挑战包括治疗师“修复”患者的倾向、患者自身的缺陷和症状,以及治疗关系中的不适感。文中介绍了应对这些困难的技巧,以及一种根据叙事过程的变化客观评估治疗效果的方法。