Kubvunzurudza nezve CBT naDkt J. Russell Ramsay
J. Russell Ramsay, Ph.D. , ndiye Mutevedzeri Mutevedzeri uye mubatanidzwa weDhiyabhorosi ADHD Kuchengetedza uye Ongororo Purogiramu yeYunivhesiti yePennsylvania School of Medicine, uye mukuru wezvepfungwa wepancheji paPenn's Center for Cognitive Therapy. Iye ndiye munyori weCognitive Behavioral Therapy yevakuru ADHD (Routledge, 2008) uye Zvisina Kusimudzira Zvirwere zveAddd Adhidhi: Kuongorora Maitiro Anoshanda Pasi Nezuva Nezvakanaka (American Psychological Association, 2010) .
Dr Ramsay akadzidza munyika yose kuvadzidzi vehutano hwepfungwa pamunhu mukuru ADHD uye nemitemo yeCognitive Behavioral Therapy (CBT). Ndinonzwa ndine ruzivo kuti ndive nemukana wekubvunzurudza pamusoro pe CBT.
Chii chinonzi Cognitive Behavioral Therapy (CBT)?
Chii chinoita kuti CBT isabve kune dzimwe nzira dzepfungwa dzakagadziriswa ndiyo inonyanya kukoshesa basa rekushandura kwekuziva - mafungiro ega, zviratidzo, maitiro ezvitendero - uye maitiro. CBT zvechokwadi hairegi kutora manzwiro, asi pane zvinokonzera kukanganisa mafungiro nemafambisirwo emitemo sezvo inopinda pakunzwisisa nekugadzirisa zvinetso izvo vanhu vanotsvaka kurapwa.
CBT yakatanga kugadzirirwa semushonga wekuora mwoyo uye tsvakurudzo yakaratidza nguva dzose kuti iyo inobatsira kurapwa kwemaitiro ematambudziko emagariro. Zvimwe zvidzidzo zvakaratidza kuti CBT inobatsira zvimwe zvinetso zvinowanzoonekwa, zvakadai semhando dzakasiyana-siyana dzekuzvidya mwoyo, kushandiswa kwemishonga, zvimwe zvinetso zvepfungwa, nezvimwe zvekurapa, zvakadai sekutarisana nematambudziko ekurara kana kuti musoro.
Mumakore gumi adarika akaona vazhinji vatsvakurudzo vekliniki vakashanda pakushandura CBT kugadzirisa matambudziko ekubatana nevakuru vakuru veDHD.
Basa re CBT rinoita sei muurongwa hwehutano hweAdHD munhu mukuru?
Mishonga inonzi ndiyo mutsara wokurapa weDHD maererano nekurapa zviratidzo zvepakutanga zveDHD.
Kune marudzi akasiyana-siyana ekurapwa kwemishonga kune ADHD ayo maitiro anobata kuburikidza nemigumisiro yehuropi hunoita basa, kazhinji kuunza kuvandudzwa mukuchengetedza kwakasimba, kugadzirisa zvinokanganisa, nekugadzirisa kushanda. Kune vanhu vazhinji, zviratidzo izvi zvinovandudzwa zvinotungamirira pakuvandudzwa kwebasa muupenyu hwavo hwezuva nezuva, sekuva nani kukwanisa kuchengetedza zvinhu, kusava nekudzikama kwepanyama uye kunyanya kutarisira kushanda nesimba, nekukwanisa kuchengeta kuisa pfungwa pamabasa kana kuverenga kwehuwandu hwakareba nguva, kutumidza zvishomanana.
Zvisinei, vanhu vakawanda vanoramba vachirwisana nemigumisiro yeAdHD pasinei nokurapa mishonga yakakwana. Izvi zvinoreva kuti vanhu vanogona kuramba vachiwana zviratidzo zvekugarisa zveDHD uye / kana kuti vane dambudziko rinoramba riripo kushandisa nzira dzinoshandiswa nadzo dzavanoziva kuti dzinobatsira. Uyezve, vanhu vane ADHD vanogona kuoma nematambudziko ekugadzirisa manzwiro avo muupenyu hwezuva nezuva, chichiwedzera chichizivikanwa cheAdHD, kana kuti inogona kuve nenhamo dzakaoma dzemanzwiro akaora mwoyo, kuzvidya mwoyo, kushandiswa kwemishonga, kana kuderedza kuzvidzora. Vakuru ava vane ADHD vanoda humwe rubatsiro rwekuvandudza hukama hwakanaka nekushanda muupenyu hwavo hwezuva nezuva.
CBT yakawanikwa ichiratidza kushandiswa kwechirwere chinoshandiswa zvakananga kune zvakasiyana-siyana zvekuremara uye kukonzera nyaya dzinobatanidza nevakuru vakuru veDHD avo vakatsanangurwa pamusoro apa.
Kunyange zvazvo mhinduro dzinogona kuonekwa dziri nyore - shandisa urongwa hwezuva nezuva, tanga kushanda pamabasa zvakanaka nguva isati yasvika, kuputsa mabasa makuru kuita mabasa maduku - zvinogona kuva zvakaoma kuita. Kutarisana nematambudziko aya kwenguva refu kunogonawo kukonzera mafungiro asina kunaka, kusava nehanya, kuzvidzora, uye manzwiro ekugumburwa izvo zvinogadzirisa zvipingamupinyi zvekutevera-kuburikidza. Imwewo inogona kunge iine vanhu vashoma vane ADHD vasingakwanisi kutora mishonga nekuda kwezvokurapa kwezvokurapa, kusagadzikana migumisiro, kwete-mhinduro, kana kuti vanongorambidza mishonga iyo CBT inogona kunge iri nzira yakakura yekurapa.
Nokudaro, CBT inogona kukurudzirwa munyaya umo mishonga chete isina kukwana kugadzirisa matambudziko anowanikwa neAdHD.
CBT inotaurira sei mamwe matambudziko ezuva rimwe nerimwe anokonzerwa neDHD zviratidzo?
Muenzaniso wakafanana murwere anouya kusvika purogiramu yekutanga - achitaura kuti kutaura "kutarisira nguva yakashata" chinangwa cheBBCT. Zviitiko zvakadaro zvinoshandiswa "kuchinja unyanzvi" izvo zvakasiyana-siyana zvikamu zve dambudziko kuitira kuti iwedzere kunzwisisa kwokuti ADHD (nezvimwe zvikonzero) zvinogona kubatsira pakugadzirisa nekugadzirisa zvinetso zvebasa ravo, munyaya iyi, "nguva isina kunaka , "uye kupa mamwe mazano ekutanga ekugadzirisa maitiro. Kuongorora kwakadaro kunobvumirawo kurapwa kuve munhu mumwechete kune mamiriro evanhu, zvichiita kuti uve mukana wakakodzera uye unokosha wekugadzirisa kushandiswa kwekugadzirisa unyanzvi.
Kuenderera mberi nemuenzaniso wataurwa pamusoro apa, nyaya ye "nguva yekugadzirisa" yakabatana nekuderedzwa kwekugadziriswa kunogona kuva mugumisiro wekushaya nguva-kuchengetedza (semuenzaniso, kusava neurongwa hwezuva nezuva nehuwandu hwekugadzwa), kusanganisa (semuenzaniso, kusakwanisa kuwana papepa nemusi wekugadzwa uye nguva), kusagadzirisa matambudziko (semuenzaniso, kusafunga kuburikidza nekusarudza kwekuwana nguva yakatarwa, zvakadai sekutsvakurudza nhamba yehofisi uye kushevedza kusimbisa), kuronga kusina kunaka (semuenzaniso, kusaisa nguva chaiyo yekusimuka pakusangana, kuitisa pakufambisa, kupaka motokari, nezvimwewo), uye kunyanya kuisa pfungwa pamabasa ekuvhiringidza (semuenzaniso, kushanda pakombiyuta), zvinoreva asi zvishoma. Nhaurirano dzakabatana nezvinodiwa zvekugadzwa zvinogona kuitawo zvipingamupinyi zvekutevera-kuburikidza, semanzwiro ekuzvidya mwoyo (izvo zvinogona kuvhiringidza uye zvinotungamirira kumadziviriro asina kudzivirira) uye maitiro ekuvhiringidza basa, zvisingaiti (semuenzaniso, "Chiremba uyu haazondiudze chero chinhu chandisina kumbozvinzwa ") kana chakanaka (semuenzaniso," Ndine chokwadi kuti pachava nokupaka zvakawanda "kana" Hazvina basa nazvo kana ndanonoka ").
Chimwe nechimwe chezvikamu zve "nguva yakashata yekugadzirisa" inopa mukana wekuchinja. Sezvo zvinetso zvakasiyana-siyana zvinosangana neAAD zvinowanikwa, pachava nemitambo inowanzoitika uye hutano hwakasiyana-siyana hunokurukurwa hunogona kushandiswa kumamiriro akasiyana-siyana kuvandudza kushanda kwese. Haisi "kukurumidza kugadzirisa" uye unyanzvi hunofanira kushandiswa nenzira yakafanana, asi kusanganiswa kwekuwedzera kuzivikanwa kwemigumisiro ye ADHD uye chirongwa chekugadzirisa chinopa temberi kuti ive nechinangwa chezvakave zvakamboitika sezvinhu zvinopfuura kudzora kwomunhu.
Kushandisa CBT kuchinja mararamiro anoita maradaptive mune imwe inobereka
Kuzvipira ndeimwe yezvinetso zvinowanzoonekwa nevakuru vane ADHD. Kunyange zvazvo anenge ari murwere wose ane ADHD anotaura kudengesa semhirizhonga, kutambura kwemunhu mumwe nomumwe kwakasiyana.
Mushure mokunge tsanangudzo yekuzvidzivirira sechinangwa cherapa, murwere anokurudzirwa kugovera mienzaniso chaiyo, kunyanya ichangobva kuitika, yekudzivisa muhupenyu hwake hwezuva nezuva. Tine zvishoma nezvishoma uye tichishanda pamwe nekubvumirana mumashoko akanangana chinangwa chikuru chebasa racho, zvingave zviri nyore, zvakadai sokuronga rutsva rwekutengesa, kana kuti zvakaoma, zvakadai sokunyora pepa yekirasi yechikoro. Isu tinozoongorora hukama hwemumwe nomumwe nebasa, kana zviitiko zvenguva ichangopfuura yekudzivisa kana kutarisira kwezvino kwebasa racho. Izvi zvinoreva kuti tinokurukura chirongwa chebasa racho, chikamu chikamu chebasa racho kuitira kuti riparadze muzviito (rinowanziwo sekuti "chunking"), kuratidza chero zvipingamupinyi zvingangodaro kana zvikonzero zvingakanganisa kutevera. Chimwe chinhu chinokosha chekuita izvi ndechekutsanangura zvakajeka kukanganisa kwemunhu nemanzwiro ake pane tarisiro yebasa iri. Iko ndiko, kubvunza "pfungwa dzipi dzinoenda mupfungwa dzako pamusoro pekuita basa iri?" uye "unoona sei kana iwe uchifunga nezvebasa iri?" Mumwe mubvunzo watinowanzobvunza kuti "Chii chakaita kuva mucheka rako kana uri kutarisana nebasa iri?" Chinangwa chemibvunzo iyi ndechokutsvaga basa remafungiro asina kunaka uye manzwiro angaita kuti zvidzivirire. Isu tinodawo kuziva "manhuro ekupukunyuka" emunhu uye maonero, akadai sekuti "Ndichatarisa e-mail yangu yekutanga uye ini ndichawana kodzero yekushanda."
Maitiro eBCT anoshanda nenzira iyo mitemo yehutungamiri yakagadzirirwa kushanda, kubatsira vanhu kuti vagone kuronga, kuronga, uye choreograph nguva yavo, simba, nekuedza kuti vaite mabasa angave asingakurumidze kubhadhara (kunyange mubayiro muduku yekuzadza matanho maduku kunowanzoderedzwa) asi iyo inobatanidza nemakuro makuru, anogutsa zvikuru.
Vanhu vanoona chirongwa chakanaka chekushandisa unyanzvi huripo pane rimwe zuva uye nguva pane rimwe basa rinowedzera mukana wekutevera kuburikidza (semuenzaniso, "Paunofamba musuo mushure mebasa, unogona kuenda kune terevhizheni uye kujekesa kuti unoda 'kuvhara kunze;' chii chaungaita nenzira yakasiyana kuti uone kuti unowana tsamba yako usati wagara? Ndeipi iwe unogona kutarisa kuburikidza netsamba yezuva iroro? Ko iwe ungati kudini kune izvozvi maonero ekudzivisa? "). Izvi hazvisi nyore nguva dzose uye zvinowanzoitika kuti kuchinja kunowanikwa mu "matanho maviri mberi, imwe nhanho shure," asi hutano hwemhando dzakapiwa mumamiriro ezvinhu ehukama nemutano anonzwisisa munhu mukuru ADHD inogona kubatsira kune vanhu vazhinji. Chinangwa ndechekuita maitiro ekugadzirisa "zvakasimba" kuitira kuti vaende nemurwere uye zvinogona kuyeukwa uye kushandiswa muupenyu hwezuva nezuva.
Kuwana nyanzvi inowanikwa mune zvose CBT uye ADHD
Iyi ndiyo chikamu chinonyengera ikozvino. Iko kune masangano akazvipira pakuparidzirwa kweCBC, zvakadai seChirungu Chekuita uye Mafungiro Ezvokurapa uye Academy yeCognitive Therapy iyo ine muongorori wechirangaridzo inowanikwa pawebsite dzavo. Zvisinei, vashandi vakawanda avo vane ruzivo rwakanyanya muC CBT vangave vasingazivi nezvezvinhu zvinotarisana nevakuru vane ADHD. Saizvozvowo, kune masangano akazvipira kuna ADHD ane mazoro ezvidzidzo pawebsite dzavo dzinosanganisira dzakasiyana-siyana dzehutano hwepfungwa asi ava vanachiremba vangave vasingazivi nezvekufamba kweBBCT. National Resource Center (inobatanidza nevana nevakuru nevane ADHD [CHADD] ine mazita evanhu vakuru veAdHD uye mapurogiramu uye Attention Deficit Disorder Association (ADDA), iyo sangano rakagadzirirwa nyaya dzine chokuita nevakuru vekare, rinopawo mazita yevashandi.
Kune huwandu huri kukura hwevakuru vakuru vemakiriniki eAdHD munyika yose yeUnited States uye nyika, kusanganisira vazhinji vanopa mazano ekurapa ma CBT. Harvard University / Massachusetts General Hospital neMat. Chikoro cheMinese cheSinai, NYU ine zvirongwa zvekuita muUnited States. Pane zvirongwa zvakanaka kwazvo zvekuongorora kurapwa kwepfungwa nezvehutano hweAADHD muCanada, Finland, neGermany.
Kazhinji vanhu vanoziva nezvemaremba akanaka munharaunda yavo kuburikidza nekutaurirana nemhando idzi kana makiriniki munharaunda yavo uye kuona kana kune avo vanogona kurapwa avo vanogona kubvunzurudzwa. Zvinosuruvarisa, nokuti CBT yevakuru ADHD inyanzvi yekliniki iyo makiriniki ose asingatauri pachena, panogona kunge kune dzimwe nzvimbo pasina vane ruzivo rwechiremba. Zvisinei, pane kuwedzera kwenhamba yezvinyorwa zvekurapa zvakabudiswa uye mabhuku ezvidzidzo zvakagadzirwa nemakiriniki anokwanisa kushanda semari inobatsira kuvakiriniki.
> Kwakabva:
> J. Russell Ramsay, Ph.D. Imeyiri mutsara / kubvunzurudzwa. February 4, 2011.