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基于夫妻关系的干预措施在成人神经性厌食症治疗中的应用:UCAN的一个简短案例示例

Couple-based interventions in the treatment of adult anorexia nervosa: A brief case example of UCAN.

作者信息

Kirby Jennifer S, Fischer Melanie S, Raney Thomas J, Baucom Donald H, Bulik Cynthia M

机构信息

Department of Psychiatry, University of North Carolina at Chapel Hill.

Department of Psychology, University of North Carolina at Chapel Hill.

出版信息

Psychotherapy (Chic). 2016 Jun;53(2):241-50. doi: 10.1037/pst0000053.

Abstract

Adult anorexia nervosa (AN) is a serious and often fatal illness that significantly erodes quality of life for both the patient and loved ones. Treatment of adults with AN has focused largely on individual therapy, with recent findings suggesting that improvement is limited and dropout rates are high. In an effort to improve treatment response, we developed a couple-based intervention, Uniting Couples in the treatment of Anorexia Nervosa (UCAN) as an adjunct treatment to standard multidisciplinary care. UCAN leverages the support of a partner and the relationship in treatment by decreasing avoidance around AN, teaching the couple how to effectively address the eating disorder, and helping to foster a more satisfying relationship. This paper presents a case study of a couple who completed UCAN, "Laura and Steve," including their experiences in treatment and outcome measures at pretest, posttest, and 3-month follow-up. Laura showed clinically significant change on the Restraint subscale of the Eating Disorders Examination at follow-up, and both partners showed clinically significant improvements in relationship satisfaction, as well as on self-reported and observed communication. Both partners reported very high satisfaction with the treatment. A discussion of therapists' experiences in delivering UCAN is provided, including common challenges for therapists with primarily a couple therapy or an individual CBT for eating disorders background, as well as important factors for therapists to consider in order to optimally leverage the benefits of including partners in treatment for AN. (PsycINFO Database Record

摘要

成人神经性厌食症(AN)是一种严重且往往致命的疾病,会显著损害患者及其亲人的生活质量。成人AN的治疗主要集中在个体治疗上,最近的研究结果表明,改善效果有限且脱落率很高。为了提高治疗反应,我们开发了一种基于伴侣的干预措施,即“夫妻联合治疗神经性厌食症”(UCAN),作为标准多学科护理的辅助治疗方法。UCAN通过减少围绕AN的回避行为、教导夫妻如何有效应对饮食失调以及帮助培养更令人满意的关系,来利用伴侣的支持和治疗中的关系。本文介绍了一对完成UCAN治疗的夫妻“劳拉和史蒂夫”的案例研究,包括他们在治疗中的经历以及在预测试、后测试和3个月随访时的结果测量。随访时,劳拉在《饮食失调检查》的克制子量表上显示出临床上的显著变化,并且双方伴侣在关系满意度以及自我报告和观察到的沟通方面都显示出临床上的显著改善。双方伴侣都对治疗表示非常满意。本文还讨论了治疗师在提供UCAN治疗方面的经验,包括主要具有伴侣治疗或个体认知行为疗法治疗饮食失调背景的治疗师所面临的常见挑战,以及治疗师为了最佳利用将伴侣纳入AN治疗的益处而需要考虑的重要因素。(PsycINFO数据库记录)

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本文引用的文献

1
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