Charlesworth Georgina, Sadek Susan, Schepers Astrid, Spector Aimee
University College London, UK North East London NHS Foundation Trust, UK
South Essex Partnership Foundation Trust, UK.
Behav Modif. 2015 May;39(3):390-412. doi: 10.1177/0145445514561317. Epub 2014 Dec 16.
This article describes a 10-session cognitive-behavioral therapy (CBT) used in a randomized controlled trial with people with anxiety and mild-to-moderate dementia. The aim of the therapy is to reduce symptoms of anxiety by increasing a sense of safety and self-efficacy. The therapy is characterized by a person-centered approach to CBT, using individual tailoring to accommodate for cognitive deficits and other challenges. Three phases of therapy are described: (a) socialization to model (including overcoming barriers to participation), goal setting, and formulation; (b) application of cognitive and behavioral change techniques to address unhelpful autonomic reactions, "strategic" reactions, "rules for living," and interpersonal aspects; and (c) consolidation and ending in the context of chronic, deteriorating illness. The approach prioritizes direct work with the person with dementia, with the involvement of a "supportive other" where available and when necessary. The protocol is designed for use by therapists with prior experience in CBT.
本文介绍了一种用于焦虑症和轻至中度痴呆症患者的随机对照试验中的10节认知行为疗法（CBT）。该疗法的目的是通过增强安全感和自我效能感来减轻焦虑症状。该疗法的特点是以患者为中心的CBT方法，采用个性化定制以适应认知缺陷和其他挑战。文中描述了三个治疗阶段：（a）向模式社会化（包括克服参与障碍）、目标设定和制定；（b）应用认知和行为改变技术来处理无益的自主反应、“策略性”反应、“生活规则”和人际关系方面；（c）在慢性、病情恶化的背景下进行巩固和结束。该方法优先与痴呆症患者直接合作，必要时在有“支持他人”的情况下让其参与。该方案专为有CBT经验的治疗师设计。
