人格障碍的图式治疗:患者和治疗师观点的定性研究。
Schema Therapy for Personality Disorders: a Qualitative Study of Patients' and Therapists' Perspectives.
机构信息
NPI Specialist in Personality Pathology,the Netherlands.
VU Medical Center,the Netherlands.
出版信息
Behav Cogn Psychother. 2017 Jan;45(1):31-45. doi: 10.1017/S1352465816000357. Epub 2016 Aug 30.
BACKGROUND
Several studies have evaluated the (cost) effectiveness of schema therapy for personality disorders, but little research has been done on the perspectives of patients and therapists.
AIM
The present study aims to explore patients' and therapists' perspectives on schema therapy.
METHOD
Qualitative data were collected through in-depth semi-structured interviews with 15 patients and a focus group of 8 therapists. A thematic analysis was performed.
RESULTS
Most patients and therapists agreed that helpful aspects in schema therapy were the highly committed therapeutic relationship, the transparent and clear theoretical model, and the specific schema therapy techniques. About unhelpful aspects, several patients and some therapists shared the opinion that 50 sessions was not enough. Furthermore, patients lacked clear advance information about the possibility that they might temporarily experience stronger emotions during therapy and the possibility of having telephone contact outside session hours. They missed practical goals in the later stage of therapy. With regard to imagery, patients experienced time pressure and they missed a proper link between the past and the present. For therapists, it was hard to manage the therapeutic relation, to get used to a new kind of therapy and to keep the treatment focused on personality problems.
CONCLUSIONS
Patients and therapists found some aspects of the schema therapy protocol helpful. Their views about which aspects are unhelpful and their recommendations need to be taken into consideration when adjusting the protocol and implementing schema therapy.
背景
已有多项研究评估了图式治疗对人格障碍的(成本)有效性,但针对患者和治疗师的观点,研究甚少。
目的
本研究旨在探讨患者和治疗师对图式治疗的看法。
方法
通过对 15 名患者和 8 名治疗师进行深入的半结构化访谈,收集定性数据。采用主题分析方法。
结果
大多数患者和治疗师都认为图式治疗中有益的方面是高度投入的治疗关系、透明清晰的理论模型和具体的图式治疗技术。关于无益的方面,一些患者和一些治疗师认为 50 次治疗疗程不够。此外,患者缺乏关于在治疗过程中他们可能暂时经历更强烈情绪的可能性以及在治疗时间之外进行电话联系的可能性的明确预先信息。他们在治疗后期缺少实际目标。关于意象,患者感到时间紧迫,并且缺少过去和现在之间的适当联系。对于治疗师而言,管理治疗关系、适应新的治疗方式以及保持治疗专注于人格问题都具有挑战性。
结论
患者和治疗师发现图式治疗方案的某些方面有帮助。在调整方案和实施图式治疗时,需要考虑他们对哪些方面无益的看法和建议。