Grant Paul M, Reisweber Jarrod, Luther Lauren, Brinen Aaron P, Beck Aaron T
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania.
Psychol Serv. 2014 May;11(2):125-133. doi: 10.1037/a0033912. Epub 2013 Sep 30.
Individuals with severe and persistent schizophrenia can present challenges (e.g., difficulties sustaining motivation and conducting information processing tasks) to the implementation of recovery-oriented care. We present a successful application of recovery-oriented cognitive therapy (CT-R), a fusion of the spirit and principles of the recovery movement with the evidence base and know-how of cognitive therapy, that helped an individual with schizophrenia move along her recovery path by overcoming specific obstacles, including a 20-year cycle of hospitalizations (five per year), daily phone calls to local authorities, threatening and berating "voices," the belief that she would be killed at any moment, and social isolation. Building on strengths, treatment included collaboratively identifying meaningful personal goals that were broken down into successfully accomplishable tasks (e.g., making coffee) that disconfirmed negative beliefs and replaced the phone calling. At the end of treatment and at a 6-month follow-up, the phone calls had ceased, psychosocial functioning and neurocognitive performance had increased, and avolition and positive symptoms had decreased. She was not hospitalized once in 24 months. Results suggest that individuals with schizophrenia have untapped potential for recovery that can be mobilized through individualized, goal-focused psychosocial interventions.
患有严重且持续性精神分裂症的个体可能会给以康复为导向的护理实施带来挑战（例如，难以维持动机以及执行信息处理任务）。我们展示了以康复为导向的认知疗法（CT-R）的成功应用，这是康复运动的精神和原则与认知疗法的证据基础及专业知识的融合，它帮助一名精神分裂症患者克服了特定障碍，沿着康复之路前行，这些障碍包括长达20年的住院周期（每年5次）、每天给地方当局打电话、威胁和斥责的“幻听”、认为自己随时会被杀的信念以及社会隔离。基于优势，治疗包括共同确定有意义的个人目标，这些目标被分解为可成功完成的任务（例如煮咖啡），这些任务否定了消极信念并取代了打电话的行为。在治疗结束时和6个月的随访中，打电话的行为停止了，心理社会功能和神经认知表现有所提高，意志缺失和阳性症状有所减少。她在24个月内未住院一次。结果表明，精神分裂症患者具有尚未开发的康复潜力，可通过个性化、以目标为导向的心理社会干预来调动。
