Udliwano-ndlebe malunga ne-CBT noDkt. J. Russell Ramsay
J. Russell Ramsay, Ph.D. , nguMlawuli weNxulumano kunye nomseli-mququzeleli we-ADDD Treatment and Programme yoPhando kwi-Yunivesithi yase-Pennsylvania School of Medicine, kunye neengcali zengqondo eziphezulu kwiziko lePenn leChnitive Treatment. Nguye umbhali weChnitive Behavioral Treatment kwi-ADHD yabantu abadala (uRoutledge, 2008) kunye noNyango lweZonyango ezingabandakanyiswa kwi-ADHD yabantu abadala: Ukuphonononga Impembelelo kwiMisebenzi yemihla ngemihla kunye noBomi (i-American Psychological Association, 2010) .
UDkt. Ramsay uye wafundiswa ngamazwe kwiingcali zempilo yengqondo kwi-ADHD yabantu abadala kunye nemigaqo yeChnitive Behavioral Treatment (CBT). Ndivakalelwa kukuba ndibe nethamsanqa ukuba ndibe nethuba lokuthetha naye nge-CBT.
Ziyiphi i-Cognitive Behavioral Treatment (CBT)?
Yintoni ebeka i-CBT ngaphandle kwezinye iimeko zengqondo ye-psychotherapy kukugxininisa kwendima ebandakanyekayo yeengcamango - iingcamango ezizenzekelayo, imifanekiso, iinkqubo zenkolelo-kunye nokuziphatha. I-CBT ngokuqinisekileyo ayiyikunyamekela imvakalelo, kodwa kunoko ijolise kwiindlela zokucinga kunye neendlela zokuziphatha njengengeniso yokungena ekuqondeni nasekujonganeni nobunzima abantu abafuna unyango.
I-CBT yayilungiselelwe okokuqala njengonyango loxinzelelo kwaye uphando luye lwabonisa ukuba luyindlela efanelekileyo yokwelapha iingxaki zengqondo. Uphando olulandelayo lubonise i-CBT ukuba luncedo kwezinye iingxaki eziqhelekileyo, ezinjengeentlobo ezahlukeneyo zokuxhalabisa, ukusetyenziswa kweziyobisi, ezinye iingxaki zengqondo, kunye neengxaki ezithile zonyango, ezifana nokujongana neengxaki zokulala okanye iintloko.
Ilishumi elishumi elidluleyo libone abaninzi abaphandi bekliniki abaye basebenza ekuguquleni i-CBT ukujongana nobunzima bokuhlangabezana ne-ADHD yabantu abadala.
Iyiphi indima eyenziwa yi-CBT kwisicwangciso sonyango se-ADHD yabantu abadala?
Amachiza athathwa njengowomgca wokuqala wonyango kwi-ADHD ngokuphatha iimpawu eziphambili ze-ADHD.
Kukho iindlela ezahlukeneyo zonyango lwezonyango ze-ADHD ezineenzuzo ezisebenzayo ngenxa yeempembelelo zentsebenzo yengqondo, ngokubanzi zivelisa ukuphuculwa kwenkxalabo eqhubekayo, ukulawula iziphazamiso kunye nokulawulwa komgudu. Kubantu abaninzi, ezi ziphumo ziphucula ukuphucula ukusebenza kwimpilo yabo yemihla ngemihla, njengokungcono ukukwazi ukugcina umkhondo wezinto, ukufumana ukungaphumeleli komzimba kunye nokulawula okukhulu, nokukwazi ukugxila ekugxileni emsebenzini okanye ngokufunda ubude obufanelekileyo ixesha, ukubiza ezimbalwa.
Nangona kunjalo, abantu abaninzi banokuqhubeka bezama ukulwa nemiphumo ye-ADHD nangona unyango olufanelekileyo lweyeza. Okokuthi, abantu ngabanye baqhubeka nokufumana iimpawu zokuhlala ezidityanisiweyo ze-ADHD kunye / okanye ukuba nobunzima obuqhubekayo ukuphunyezwa kwezicwangciso zokuziphatha abazi ukuba kuya kuba luncedo. Ngaphezu koko, abantu abane-ADHD banokulwa nobunzima bokulawula iimvakalelo zabo zobomi bemihla ngemihla, i-featured eyaziwayo ngokubanzi ye-ADHD, okanye unokufumana ubunzima obukhulu beemeko ezixinezelekileyo, uxhalaba, ukusetyenziswa kweziyobisi okanye ukuzithemba. Aba bantu abadala abane-ADHD bafuna uncedo olongezelelweyo ukufumana uphuculo oluphuculweyo kunye nokusebenza kwimpilo yabo yemihla ngemihla.
I-CBT ifunyenwe yonyango oluncedo oluchazayo olujongana ngqo neentlobo zokukhubazeka kunye nemiba yokuhlangabezana ne-AdHD yabantu abadala abachazwe ngasentla.
Nangona iisombululo ezinokubambisana zingabonakala zilula - sebenzisa isicwangciso somhla ngemihla, qalisa ukusebenza kwimisebenzi ngaphambi kwexesha elidlulileyo, yenza imisebenzi emikhulu ibe yimisebenzi emincinci - kunokuba nzima ukuphumeza. Ukujongana nale mingeni edeleleko kunokubangela iingcamango ezingathandekiyo, ukukhathazeka, ukugxeka, kunye nemizwa yokukhungatheka eyenza imingcele eyongezelelweyo yokulandela. Kukho nokuba kuncinci lwabantu abane-ADHD abangenakuthabatha imishanguzo ngenxa yokungqinisiswa kwezonyango, iziphumo ezingekho phantsi, ezingaphenduliyo, okanye abayeka nje ukunyanga amayeza enokuthi i-CBT ingaba yinkqubo engundoqo yokunyanga.
Ngenxa yoko, i-CBT inokucetyiswa kwimeko apho imithi yodwa ayinelanga ukulungisa iingxaki ezinxulumene ne-ADHD.
I-CBT idibanisa njani ezinye iingxaki zemihla ngemihla ezibangelwa yimpawu ze-ADHD?
Umzekelo oqhelekileyo isigulane esifikile emva kweeseshoni yokuqala - ekubaleni ukuba "ukuphathwa kwexesha elibi" kuyinjongo ye-CBT. Iziganeko ezinjalo zisetyenziselwa "ukubuyisela injini" kwiindawo ezahlukileyo zeengxaki ukuze kunikwe ukuqonda okunyanisekileyo malunga nendlela i-ADHD (kunye nezinye izinto) ezinokubangela ukuphuhliswa nokugcinwa kweengxaki zabo zokusebenza, kulo mzekelo, "ixesha elifanelekileyo lokulawula , "kunye nokubonelela ngeengcamango zokuqala zokucwangcisa. Olu hlobo lokuphonononga luvumela ukuba unyango lube ngumntu ngokwawo kwiimeko zomntu, ngokwenza kube yithuba elifanelekileyo kunye nelilungelo lokuqulunqa izakhono zokusetyenziswa.
Ukuqhubeka nomzekelo okhankanywe ngasentla, imbambano "yolawulo lwexesha" ehambelana nokukhawuleza ukuba kuqeshwe ingabangela umgangatho wokugcinwa kwexesha elibi (umz., Ungenaso isicwangciso somhla ngemihla yokuqeshwa), ukulungiswa (umzekelo, akakwazi ukufumana isiqwenga samaphepha kunye nomhla wokuqeshwa kunye nexesha), ukusombulula iingxaki (ingxaki, ukucinga ngeendlela zokufumana ixesha lokutyunjwa, njengokuphanda inombolo kwiofisi kunye nokubiza ukuba uqinisekise), ukucwangcisa okungalunganga (umz., ungafaki ixesha elifanelekileyo lokushiya ukuqeshwa, ukuhamba ngeendlela zokupaka, ukupaka, njl njl.), kwaye ugxininise kakhulu kwimisebenzi ephazamisayo (umz., ukusebenza kwikhompyutheni), ukubiza nje izinto ezimbalwa. Imiba ehambelana nokulindela ukuqeshwa ingabangela nemingcele yokulandelelana, njengemvakalelo yokuxhalabisa (leyo inokuphazamisa kwaye iholele ekuziphatheni okukhuselekileyo) kunye neengxaki zokuphazamisa umsebenzi, kungakhathaliseki ukuthi zibi (umzekelo, "Lo ugqirha akayi kundixelela nantoni na engazange ndive ngayo ") okanye i-positive (umzekelo," Ndiqinisekile ukuba kuya kuba nokutya okubanzi "okanye" Akuyi kuba lukhulu xa ndihamba ").
Ngalinye lala macandelo "ukuphathwa kwexesha elibi" linika ithuba lokutshintsha. Njengoko iingxaki ezahlukeneyo ezinxulumene ne-ADHD zichongiwe, kuya kuba nemixholo ephindaphindayo kwaye ezi zakhono ezixutyushwa ngazo zingasetyenziswa kwiimeko ezahlukeneyo ukuphucula ukusebenza ngokubanzi. Akusiyo "ukulungiswa ngokukhawuleza" kunye nezakhono kufuneka ziphunyezwe ngendlela ehambelanayo, kodwa ukudibanisa ukunyuka kwimiba ye-ADHD kunye nesicwangciso sokusingatha sibonelela i-template ukuba yenze ingqiqo yento ebeyenzi ngaphambili lawulo lomntu.
Ukusebenzisa i-CBT ukutshintsha ukuziphatha kakubi kwi-maladaptive ibe yinto evelisa ngakumbi
Ukuhlaziya ngenye yeengxaki eziqhelekileyo ezichazwe ngabantu abadala abane-ADHD. Nangona zonke izigulane ezine-ADHD zikhankanya ukukhawuleza njengento, umzabalazo ngamnye umntu uhlukile.
Emva kokuchazela ukukhawuleza njengento ekujoliswe ngayo kunyango, isigulane sikhuthazwa ukuba yabelane ngemibandela ethile, ngokukhethekileyo okutsha nje, yokuzibambezela kwimpilo yakhe yemihla ngemihla. Sihamba ngokuthe ngcembe kwaye sihlolisane ngokubambisana ngokubhekiselele kwimigqaliselo ethile ekujoliswe kuyo, makube lula, njengokuhlela uluhlu lokuthengwa, okanye oluyinkimbinkimbi, njengokubhala iphepha kwiklasi yeekholeji. Emva koko sihlola ubudlelwane bomntu kunye nomsebenzi, mhlawumbi amava amva nje wokumiswa okanye ukulindela kwangoku msebenzi. Okokuthi, sixubusha isicwangciso somsebenzi, inxalenye yecandelo lomsebenzi ukuze liphule phantsi kumanyathelo (eyaziwa nangokuthi "ukuxhunyelelwa"), ukuchonga nayiphi na imiqobo okanye izinto ezinokuchaphazela ukulandelelana. Inxalenye ebalulekileyo yale nkqubo kukuphinda ucacise ngokucacileyo ingcamango yomntu kunye nokuvakalelwa kwimizwelo kwithuba lo msebenzi. Okokuthi, ukubuza "ziphi iingcamango ezingqondweni yakho ngokukwenza lo msebenzi?" kwaye "yiyiphi imvakalelo oyibona xa ucinga ngalo msebenzi?" Omnye umbuzo esiwubuza ngokuqhelekileyo ukuba "yintoni efana nesikhumba sakho xa ujongene nalo msebenzi?" Injongo yale mibuzo ukufumanisa indima yeengcamango ezingathandekiyo neemvakalelo ezinokuba negalelo ekunciphiseni. Sifuna nokuchonga "indlela yokuziphatha yokuphepha" kunye neengcamango, ezifana nokuthi "Ndiza kujonga i-imeyile yam kuqala, kwaye ke ndiza kusebenza."
Amanyathelo angenelelo lwe-CBT asebenza ngendlela yokulawula imisebenzi eyenzelwe ukuba isebenze, ukunceda abantu bakwazi ukucwangcisa, ukuququzelela kunye nokuchithwa kwexesha labo, amandla kunye nomzamo ukwenzela ukufezekisa imisebenzi engenakho ukukhawuleza ngokukhawuleza (nangona umvuzo omncinci lokugqiba amanyathelo amancinci kaninzi kuncitshiswa) kodwa ezo zihambelana neziphumo ezinkulu, ezivuyisayo.
Abantu ngabanye bachonga isicwangciso esithile sokuzalisekisa izakhono ezithile ngosuku nemini ethile kwimisebenzi ethile yokwandisa amathuba okulandelwayo (umzekelo, "Xa uhamba emnyango emva komsebenzi, unokuthi uqhubekele kumabonakude uze uqikelele ukuba ufuna 'ungagqiba;' yintoni ongayenza ngokungafaniyo ukuze uqinisekise ukuba ufumana iimeyile ngaphambi kokuba uhlale phantsi? Ungayilungisela phi iposi ngelo suku? Uza kuxela ntoni kulezo zizathu zokubambelela? "). Inkqubo ayisoloko ilula kwaye yinto eqhelekileyo ukuba utshintsho lwenzeka "ngamanyathelo amabini ahamba phambili, enye inyawo", kodwa ezi ntlobo zobungcali ezithunyelwa kumxholo wobudlelwane kunye nomgqirha oqonda ukuba umntu omdala u-ADHD unokunceda abantu abaninzi. Injongo kukukwenza izicwangciso zokujamelana "ezinamathele" ukuze zihambe kunye nesigulane kwaye ziyakhunjulwa kwaye zisetyenziswe kwimpilo yemihla ngemihla.
Ukufumanisa uchwepheshe ojongene nawo kwi-CBT ne-ADHD
Le ngxenye ekhohlisayo ngoku. Kukho imibutho ezinikele ekuhanjisweni kwe-CBT, njengeMbutho weZenzo zokuziphatha kunye neCognitive Therapies kunye ne-Academy yeChnitive Treatment eneenkcukacha zendawo yokufumana indawo kwiwebhusayithi yazo. Nangona kunjalo, oogqirha abaninzi abanezakhono kwi-CBT abanako ukuqhelana neengxaki ezijongene nabantu abadala abane-ADHD. Ngokufanayo, kukho imibutho enikezelwe kwi-ADHD eneenkcukacha zengcali kwiiwebhsayithi zazo ezibandakanya iintlobo zeengcali zempilo yengqondo kodwa ezi zonyango ziyakwazi ukuqonda iindlela ze-CBT. I-National Resource Centre (edibene nezingane kunye nabantu abadala abane-ADHD [i-CHADD] iqulethwe ngabanikeli be-ADHD abadala kunye neenkqubo kunye ne-Attention Deficit Disorder Association (ADDA), inhlangano enikezelwe kwimicimbi enxulumene ne-ADHD yabantu abadala, inika kwakhona uludwe zabanikezeli.
Kukho inani elikhulayo leekliniki ezizodwa ze-ADHD ezizodwa kwi-United States kunye nehlabathi, kubandakanywa amaninzi anika unyango olujoliswe kwi-CBT. I-Harvard Yunivesithi / iSibhedlele jikelele saseMassachusetts kunye neMat. Isikolo seSinayi seMithiya, i-NYU ineenkqubo ezisebenzayo e-United States. Kukho iinkqubo ezibalaseleyo zokuhlola unyango lweengqondo kumntu omdala we-ADHD eCanada, eFinland naseJamani.
Ngokuqhelekileyo abantu bafumanisa ngabachaphazelekayo abahlala kwindawo yabo ngokuqhagamshelana nezixhobo okanye iikliniki kwindawo yabo kwaye bafumanisa ukuba kukho abagqirha abafanelekileyo abaza kuthethwa nabo. Ngelishwa, ngenxa yokuba i-CBT yabantu abadala be-ADHD yinkonzo yekliniki apho zonke iiklinikhi zingabonakali, kunokukho indawo ethile ngaphandle kweengcali zengcali. Nangona kunjalo, kukho inani elinyukayo leencwadi zonyango ezishicilelweyo kunye neencwadi zengcali ezijoliswe kwiiklinikhi ezingabakhonza njengezixhobo ezincedo kwiikliniki.
> Umthombo:
> J. Russell Ramsay, Ph.D. I-imeyile yokubhala / udliwano-ndlebe. Fe bruwari 4, 2011.