Kutheni i-CBT iCetyiswa ngokuqhelekileyo njengenxalenye yonyango
I-CBT yonyango yokuziphatha (Cognitive behavioral treatment) yindlela yokwenza ngengqondo equka iindlela ezahlukeneyo zobugcisa. Ezi ndlela zinceda umntu ukuba aqonde ukusebenzisana phakathi kwengcamango yakhe, iimvakalelo zakhe, kunye nokuziphatha kwakhe kwaye aphuhlise izicwangciso zokutshintsha iingcamango ezingathandekiyo nokuziphatha ukuze kuphuculwe imizwa kunye nokusebenza.
I-CBT ngokwayo ayilona lucalulo olulodwa lonyango kwaye kukho iindlela ezahlukeneyo ze-CBT ezabelana ngeengcamango eziqhelekileyo malunga neengxaki zokugcina uxinzelelo lweengqondo.
Ukwamkelwa kunye nokuzibophezela kwonyango (UMTHETHO) kunye neNyango yokuLungiswa koBomi (DBT) yimizekelo yeentlobo ezithile zonyango lwe-CBT.
I-CBT ngokuqhelekileyo iphelelwe ixesha kwaye ijoliswe kwiinjongo kwaye ibandakanya umsebenzi wesikolo ngaphandle kweeseshoni. I-CBT igxininisa ukubambisana phakathi kweengcali kunye nabaxumi kunye nokuthatha inxaxheba ngokusebenzayo ngumxhasi. I-CBT iyasebenza kakhulu kwiingxaki zeengqondo eziquka iingcinezelo, ingxaki yokukhathazeka jikelele , i-phobias kunye ne-OCD.
Imbali
I-CBT yaveliswa ngu-psychiatrist u-Aaron Beck kunye nengcali yeengqondo uAlbert Ellis ngasekupheleni kweminyaka yama-1950 neye-1960, eyagxininisa indima yeengcamango ekuthinteleleni iimvakalelo nokuziphatha.
I-CBT yokukhathazeka kokutya yenziwa ngasekupheleni kweminyaka yee-1970 nguG. Terence Wilson, uChristopher Fairburn kunye noStuart Agras. Aba baphandi bachonga ukukhutshwa kokutya kunye nokuma kunye nokuxhalabisa ngokwezinto eziphambili ekugcinweni kwe-bulimia nervosa, kwakha i-protocol-treatment protocol ye-20, kwaye yaqala ukuqhuba izilingo zonyango.
Ngama-1990, i-CBT yayisetyenziselwa ukutywala ukutya. Ngonyaka ka-2008, i-Fairburn yashicilela incwadi yonyango ehlaziyiweyo yeNyango yokuCheculwa kweNtsebenzo (CBT-E) ephucukisiwe yokucwangcisa zonke izifo zokutya. I-CBT-E iqukethe amafomathi amabini: iprojekthi ejoliswe kwi-manual ye-original, kunye nolwaphulo olubanzi oluqulethe iimodyuli ezingaphezulu ukujongana nokunyamezela, ukuphelela , ukuzithemba, kunye nobunzima bebonke abachaphazela ukugcinwa kweengxaki zokutya.
I-CBT isetyenziswe ngempumelelo kwi- self-help and formats self-help formats ukuze unyango lwe-bulimia nervosa kunye nokutya okuxilisayo. Ikwabonelelwa kwakhona kwiifom zeqela kunye namazinga aphezulu okunyamekela, njengendawo yokuhlala okanye izilwanyana zesifo.
Ukulungelelaniswa kwamva nje kubandakanya ukusetyenziswa kwethekhnoloji ekwandiseni uluhlu lwabantu abanokufikelela kwizibonelelo eziphambili ezifana ne-CBT. Uphando luqalise ekuhanjisweni kwe-CBT unyango ngobuchwepheshe obuhlukeneyo, kuquka i-imeyile, ingxoxo, i-app yeselula, kunye ne-intanethi.
Impumelelo
I-CBT iyabonwa ngokubanzi njengonyango olusebenzayo kakhulu kunyango lwe-bulimia nervosa kwaye ngoko ke, kufuneka kube yonyango oluthile lokunyangwa kwengqondo. Izikhokelo zeSizwe sase-UK zeZempilo kunye noKhathalelo (Career Excellence) (NICE) zikhuthaza i-CBT njengonyango wokuqala kumntu abadala kunye ne-bulimia nervosa kunye nokutya okuxhamlayo kunye neyesithathu zonyango ezinokuthi ziqwalaselwe ngabantu abadala abane-anorexia nervosa.
Olunye uphando lucatsanisa neenyanga ezintlanu ze-CBT (iiseshoni ezingama-20) kubasetyhini abane-bulimia nervosa kunye neminyaka emibini ye-psychoanalytic ye-psychotherapy. Izigulane ezingamashumi asixhenxe zanikezelwa ngenye indlela kula maqela amabini. Emva kweenyanga ezintlanu zonyango (ekupheleni kwonyango lwe-CBT), iipesenti ezingama-42 zezigulane kwiqela le-CBT kunye neepesenti ezingama-6 zezigulane kwiqela lonyango le-psychoanalytic liyekile ukutya nokucoca.
Ekupheleni kweminyaka emibini (ukugqitywa kwe-psychoanalytic therapy), i-44 ekhulwini yeqela le-CBT kunye neepesenti ezili-15 zeqela le-psychoanalytic zazingenasifo.
Olunye uhlolisiso lufanisa i-CBT-E kunye neyeza elithandanayo (IPT), enye indlela ekhokelayo kubantu abadala abanesifo sokutya. Esi sifundo, izigulane ezili-130 ezidliwayo ezinezifo zokutya ziye zabelwa ukuba zifumane i-CBT-E okanye i-IPT. Zomibini iinkonzo zenza iiseshoni ezingama-20 ngaphezulu kweeveki ezingama-20, zilandelwa lixesha elilandelelwano lweeveki ezingama-60. Kwizithuba zonyango, ama-66 ekhulwini yabathathi-nxaxheba be-CBT-E badibana neendlela zokuxolelwa, xa kuthelekiswa nama-33 ekhulwini kuphela abathathi-nxaxheba be-IPT.
Ngethuba lolandelelwano, isantya sokubuyiselwa kwe-CBT-E sahlala siphezulu (iipesenti ezingama-69 ukuya kuma-49 ekhulwini).
Iingcamango eziCognitive of Disorders Disorders
Inkqubo yokuqonda yokukhathazeka kokutya ibonisa ukuba ingxaki ebalulekileyo kuyo yonke ingxaki yokutya ixhomekeke kwiimo kunye nokulinganiswa. Indlela ekhethekileyo yokubonakalisa ngokugqithiseleyo iyahluka. Inokuqhuba nayiphi na le ndelayo:
- Ukutya ngokukhawuleza
- Isisindo esiphantsi
- Ukutya ukutya
- Ukuziphatha okuhlawulelayo njengokuzihlanza okuzenzekelayo, i-laxatives kunye nokuzivocavoca ngokweqile
Ukongezelela, ezi ngxenye zinokusebenzisana ukudala iimpawu zesifo sokutya. Ukutya ngokukhawuleza-kuquka ukusila ukudla, ukutya ukutya okuncinci, nokuphepha ukutya okungavumelekanga-kunokukhokelela kwisisindo esiphantsi kunye / okanye ukutya ukutya. Isisindo esincinci singakhokelela ekungondlekeni kwaye kunokukhokelela ekudleni. Ukuxinwa kunokukhokelela ekubeni netyala elikhulu kunye neentloni kunye nokuzama ukuhlaziya ukutya. Inokubangela ukuba kwenziwe imigudu yokulungisa ukuhlanjululwa ngokuziphatha okuhlawulelwayo. Izigulane ziyabanjwa ngokujikeleza kumjikelezo.
Izixhobo ze-CBT
I-CBT yonyango olulungisiweyo. Kwindlela yayo eqhelekileyo, iqukethe iiseshoni ezingama-20. Iinjongo zibekwe. Iiseshoni zisetyenziselwa ukulinganisa isigulane, ukuphonononga umsebenzi wesikolo, ukuhlaziywa kwenkqubo yokwenza iimeko, izakhono zokufundisa kunye nokuxazulula iingxaki.
I-CBT iquka ngokubanzi oku:
- Ingqondo ukuqonda oko kukugcina ingxaki yokutya kunye nemiphumo yengqondo kunye neyonyango.
- Ukutshatyalaliswa kokutya kunye nokutya okuqhelekileyo- ngokuphindaphindiweyo kokutya ezintathu kunye neentsuku ezi-2 ukuya kwintlanu ngosuku lokutya. Isigulane sinokugqiba isigqibo sokutya okokude sifana nesidlo okanye ukutya.
- Ukucwangciswa kokutya . Isigulane sifanele sicwangcise ukutya ngaphambi kwexesha kwaye sihlale siyazi ukuba "yintoni na nini" sakhe isidlo esizayo.
- Ukugqitywa kweirekhodi zokutya emva kokutya kunye nokucinga iingcamango neemvakalelo kunye nokuziphatha.
- Ukuxinwa rhoqo (ngokuqhelekileyo kanye ngeveki) ukwenzela ukulandelela inkqubela phambili nokuqhuba iimvavanyo.
- Ukuphuhliswa kwezicwangciso zokukhusela ibinge kunye nokuziphatha okuhlawulelwayo , njengokusetyenziswa kokulibaziseka kunye nezinye iindlela kunye nezicwangciso zokusombulula iingxaki.
- Umngeni wemithetho yokutya. Oku kubandakanya ukuchonga imithetho kunye nocelomngeni ekuziphatheni (njengokutya emva kwe-8 ntambama okanye ukutya isandwich ngesidlo sasemini).
- Ukuphuhliswa kokuqhubeka kokucinga ukutshintsha yonke into-okanye akukho nto yokucinga .
- Ukusetyenziswa kwezilingo zokuziphatha. Umzekelo, ukuba umthengi ukholelwa ukuba ukutya ikhefu kuya kubangela ukuba uzuze ubunzima beepounds ezintlanu, uya kukhuthazwa ukuba adle ikhefu kwaye abone ukuba wenza ntoni. Ezi zilingo zokuziphatha ziqheleke ngakumbi kunokwenziwa kohlengahlengiso kwedwa.
- Ukubonakalisa ukwesaba ukutya . Emva kokutya ngokuqhelekileyo kusungulwe kakuhle kwaye ukuziphatha okuhlawulekayo kuphantsi kolawulo, izigulane zincinci ngokutsha kwakhona ukutya okuyiyo.
- Ukuthintela ukukhusela ukufumanisa zombini izicwangciso eziye zanceda kunye nendlela yokujongana nezikhubekiso ezizayo. Ngenxa yokuba unyango lukhawulelwe ixesha, injongo yeso sigulane ukuba abe ngumlobi wakhe.
Ezinye izinto ziquka ngokubanzi:
- Ukuyeka ukuhlola umzimba
- Ukunciphisa ukuphepha komzimba
- Ukuphuhliswa kwemithombo emitsha yokuzithemba
- Umngeni wesifo sokugula ngengqondo
Ukuphuculwa kwezakhono zobuntu
Abaviwa abafanelekileyo be-CBT
Abantu abadala abane- bulimia nervosa , ukuxhamla ingxaki yokutya , kunye nokunye ukuphazamiseka kokutya (OSFED) banokuba ngabaviwa abalungileyo kwi-CBT. Abantu abadala asebekhulile kunye ne-bulimia kunye nokutya okuxhamla ingxaki banokuzuza kwi-CBT.
Ukuphendula Ngonyango
Iingcali eziqhuba i-CBT zijolise ekuveliseni utshintsho lokuziphatha ngokukhawuleza. Uphando lubonisile ukuba izigulane ezikwazi ukwenza utshintsho lwexesha lokuqala ezifana nokusekwa kokutya rhoqo kunye nokunciphisa imvama yokuziphatha okuhlanjululwayo kunokwenzeka ukuba uphathwe ngempumelelo ekupheleni kokonyango.
Xa i-CBT ayisebenzi
I-CBT idla ngokucetyiswa njengonyango lokuqala. Ukuba isilingo se-CBT asiphumelelanga, abantu ngabanye bangathunyelwa kwi- DBT (uhlobo oluthile lwe-CBT ngamandla amakhulu) okanye kwinqanaba eliphezulu lokunyamekela njengendawo yokulaliswa esibhedlele okanye inkqubo yokhathalela indawo yokuhlala.
> Imithombo:
> Agras, W. Stewart, uEllen E. Fitzsimmons-Craft, kunye noDenise E. Wilfley. 2017. "Ukuguqulwa kweengxaki zengqondo yokuziphatha ekudleni ukuphazamiseka kokutya." Uphando loPhando kunye noPilisa , ukwandisa impembelelo yonyango yokuziphatha kwengqondo: Uhlobo olukhethekileyo lokuhlonipha uG. Terence Wilson, 88 (ngoJanuwari): 26-36. i-doi: 10.1016 / j.brat.2016.09.004.
> "Ukuphazamiseka kokutya: Ukuqwalaselwa kunye nokunyango | Isikhokelo kunye nezikhokelo | NICE. "2017. Isiko leSizwe lezeMpilo kunye noKhathalelo lokuKhathalela: UK. https://www.nice.org.uk/guidance/ng69.
> Fairburn, CG (2008). Iingxaki zengqondo kunye neengxaki zokutya . ENew York, NY: Guilford Press.
> Fairburn, uChristopher G., uSuzanne Bailey-Straebler, uShawnee Basden, uHelen A. Doll, uRebcca Jones, uRebcca Murphy, uMarianne E. O'Connor kunye noZafra Cooper. 2015. "Ukuqhathaniswa kwe-Transdiagnostic ye-Treatment of Conduct behavior (CBT-E) kunye ne-Psychotherapy kwi-Treatment of Disorders." Uphando loPhando kunye noPilisa 70 (ngoJulayi): 64-71. i-doi: 10.1016 / j.brat.2015.04.010.
> UPoulsen, uStig, uSusanne Lunn, uSara UKUBA uDaniel, uSoffie Folke, uBirgit Bork Mathiesen, uHana Katznelson noChristopher G. Fairburn. 2014. "Uvavanyo olulinganisiweyo lwe-Psychoanalytic Psychotherapy okanye I-Cognitive-Behavioral Treatment yeBulimia Nervosa." I-American Journal ye-Psychiatry 171 (1): 109-16. I-doi: 10.1176 / appi.ajp.2013.12121511.
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> I-Waller, Glenn, uHelen Cordery, uEmn Corstorphine, uHendrik Hinrichsen, uRail Lawson, uVictoria Mountford kunye noKathy Russell. Ngo-2013. Unyango lweChabnitive Practice of Disorders . I-Cambridge: I-Cambridge University Press.
> Wilson, GT, Grilo, C., & Vitousek, KM (2007). Ukunyangwa kwengqondo kweengxaki zokutya. I-American Psychologist, 62 (3). 199- 216.