School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia.
J Clin Psychol. 2022 Mar;78(3):386-395. doi: 10.1002/jclp.23314. Epub 2022 Jan 19.
An important component of case formulation is to understand the patient's difficulties in the context of their relationships. The Core Conflictual Relationship Theme (CCRT) method provides a clinical guide for understanding the narratives of relationship conflicts told during therapy. We follow the case of Barbara, a 60 year old with a long history of chronic shyness. Her narratives follow a common CCRT: she wishes to feel safe, but fears that others are out to get her, which makes her withdraw. These patterns have pervasively repeated themselves in the past, present, and across different relationships (self, family, partners, colleagues). The therapist responds carefully by creating safety, tolerating her fears, and working to overcome these CCRT patterns, thus reducing her impulse to withdraw from treatment. Psychotherapists from many theoretical orientations can learn how patients mastering these repetitive negative CCRTs can lead to more adaptive relationship patterns that improve their mental health.
个案概念化的一个重要组成部分是要了解患者在人际关系背景下的困难。核心冲突关系主题（CCRT）方法为理解治疗期间讲述的关系冲突叙述提供了临床指导。我们以芭芭拉的案例为例，她是一位 60 岁的慢性害羞患者，有着长期病史。她的叙述遵循常见的 CCRT：她希望感到安全，但担心别人会对她不利，这使她退缩。这些模式在过去、现在和不同的人际关系（自我、家庭、伴侣、同事）中反复出现。治疗师通过创造安全感、容忍她的恐惧并努力克服这些 CCRT 模式来做出谨慎的回应，从而减少她从治疗中退出的冲动。来自许多理论取向的心理治疗师都可以学习到，掌握这些重复性消极 CCRT 的患者如何能够导致更适应的关系模式，从而改善他们的心理健康。
