Nei CBT Inowanzopiwa Zvimwe Chikamu Chekurapa
Kuchenjerera kwehupenyu hwehutano (CBT) inzira yepfungwa inosanganisira nzira dzakasiyana-siyana. Iyi nzira inobatsira munhu kuti anzwisise kushamwaridzana pakati pemafungiro ake, manzwiro, uye maitiro uye kuvandudza maitiro ekuchinja mafungiro asina kunaka nemafambiro kuitira kuti kuvandudza mafungiro uye kushanda.
CBT pachayo haisi imwe nzira yakasiyana yokurapa uye pane maitiro akasiyana-siyana eBBC anopawo pfungwa yakafanana pamusoro pezvinhu zvinochengetedza mupfungwa mupfungwa.
Kubvuma uye Kuzvipira Therapy (ACT) uye Dialectical Behavior Therapy (DBT) mienzaniso yemhando dzakasiyana dzemishonga ye CBT.
CBT inowanzotadza nguva uye inangwa-chinangwa uye inosanganisira basa rechikoro kunze kwemasangano. CBT inotsigira kubatana pakati pechiremba uye mutengi uye kubatanidzwa kushingaira nemutengi. CBT inoshanda zvikuru kune zvinetso zvepfungwa zvepfungwa zvinosanganisira kuora mwoyo, zvinokonzera kushungurudzika kwepfungwa , phobias, uye OCD.
Nhoroondo
CBT yakagadzirwa nehutano hwepfungwa Aaron Beck uye mupfungwa wepfungwa Albert Ellis mukupera kwema1920 nema1960, uyo akasimbisa basa rekufunga mukukanganisa manzwiro nemafambiro.
CBT yezvinetso zvekudya yakagadzirwa kuma1970 apfuura naG. Terence Wilson, Christopher Fairburn, uye Stuart Agras. Vatsvakurudzi vakatsvaga kurambidzwa kwezvokudya uye maumbirwo uye zvinorema zvinoshandiswa pakuchengetedza bulimia nervosa, zvakagadzirirwa 20-sendira protocol protocol, uye yakatanga kuitisa kuongororwa kwekliniki.
Mumakore ekuma1990, CBT yakashandiswa pakudya chirwere chekudya zvakanyanya. Muna 2008, Fairburn yakabudisa bhuku rekurapa rinoshandiswa reKuvandudza Cognitive Behavioral Therapy (CBT-E) yakagadzirirwa kubata zvese zvinetso zvekudya. CBT-E inosanganisira miviri miviri: chirongwa chinonyanya kufanana nechakutanga chekushandisa, uye kuparadzanisa kwakakura kune mamwe ma modules ekugadzirisa kusagadzikana kwemafungiro, kukanganisa , kuzvidzora, kuzvidzora, uye zvinetso zvakasiyana zvinokonzera kugadzirisa zvinetso zvekudya.
CBT yakashandiswa zvakajeka mukuzvida-kubatsira uye kutungamirirwa mafomu ekusimbisa maitiro ekurapa bulimia nervosa uye binge kudya chirwere. Inogonawo kupiwa muzvikwata zveboka nepamusoro mazinga ekutarisira, zvakadai sekugara kana kuti zvirwere zvepfungwa.
Zvimwe zvinowanzoitika zvinosanganisira kushandiswa kwekombiyuta kuti kuwedzere ruzhinji rwevanhu vane ruzivo rwekurapa kunobudirira seBBCT. Kutsvakurudza kwakatanga pakuendesa kweCCTT nemishonga yakasiyana-siyana, kusanganisira email, chat, mobile app, uye internet-based self-rubatsiro.
Kubudirira
CBT inowanzoonekwa kuti ndiyo inobatsira zvikuru kurapwa kwebulimia nervosa uye inofanirwa, saka, ndiyo inofanirwa kurapwa kwepfungwa. Kwenyika yeNational Institute for Health uye Care Excellence (NICE) inokurudzira CBT seyero yekutanga yekurapa kwevanhu vakuru vane bulimia nervosa uye binge kudya chirwere uye chimwe chezvinhu zvitatu zvinogona kurapwa kuti zviongorore vanhu vakuru vane anorexia nervosa.
Chimwe chidzidzo chakaenzanisa mwedzi mitanhatu yeBBCT (masangano 20) kuvakadzi vane bulimia nervosa nemakore maviri evhiki nepamwe psychoanalytic psychotherapy. Vanomwe makumi manomwe varwere vakanga vachiendeswa kune rimwe remapoka aya maviri. Pashure pemwedzi mishanu yekurapa (kuguma kwechirwere cheBBCT), 42 muzana yevarwere muboka reC CBT uye 6 muzana yevarwere vari mu psychoanalytic therapy boka vakanga varega kubata-kudya uye kuchenesa.
Pakapera kwemakore maviri (kupedzisa kwepfungwa yepanchianalytic), 44 muzana yeboka reBBCT uye 15 muzana yeboka repfungwa dzepfungwa rakange risina zviratidzo.
Chimwe chidzidzo chakafananidza CBT-E ne interpersonal therapy (IPT), imwe nzira inotungamirira kurapwa kune vanhu vakuru vane chirwere chekudya. Muchidzidzo chacho, 130 varwere vakura vane chirwere chekudya vaisarudzwa kuti vawane CBT-E kana IPT. Zvirwere zvose zvakabatanidzwa zvidzidzo makumi maviri pamasvondo makumi maviri, zvichienzaniswa nemakore makumi matanhatu ekuzotevera. Pamushure pekurapa, 66 muzana yevadzidzi veC CBT-E vakawana nzira dzekuregererwa, zvichienzaniswa ne 33% chete yevadzidzi ve IPT.
Pamusoro penguva yekutevera, chirongwa chekuregererwa kwe CBT-E chakasimudzika (69 muzana kusvika 49%).
Kuziva kwekufananidzira kwekudya kwekushungurudzika
Nzira yekufungidzira yezvinetso zvekudya inokurudzira kuti dambudziko guru mumatambudziko ose ekudya rinopfuura kupfuura nehuwandu uye huremu. Nzira chaiyo iyi inonyanya kuonekwa inogona kusiyana. Inogona kutyaira chimwe chezvinotevera:
- Kunyanya kudya
- Low weight
- Binge kudya
- Maitiro ekupa mvumo akadai sokuzvitsvaira-kuzviita, kunyanya kushandiswa , uye kushandisa muviri zvakanyanya
Uyezve, izvi zvikamu zvinogona kuwirirana kuita zviratidzo zvekudya kwekudya. Kunyanya kudya-kusanganisira kudya kudya, kudya zvokudya zvishomanana, nekudzivirira zvokudya zvisingabvumirwi-kunogona kutungamirira kuhotera yakaderera uye / kana kudya zvakadzama. Kuderedza kuderera kunogona kutungamirira kukushaya zvokudya zvinovaka muviri uyewo kunogona kuita kuti munhu adye kudya. Kuzvinyima kunogona kutungamirira kumhosva yakakura uye kunyadziswa uye kuedza patsva kudya. Inogonawo kutungamirira kumabasa ekuderedza kushambidzika kuburikidza nemitemo yekudzikinura. Varwere vanowanzobatwa mumhepo.
Zvikamu zve CBT
CBT yakarapwa. Mune maitiro ayo akazara, inoumbwa nemasangano 20. Zvinangwa zvakagadzirirwa. Misangano inoshandiswa kuenzanisa murwere, kuongorora basa rechikoro, kubvunzurudza kuumbwa kwemhosva, unyanzvi hwokudzidzisa, nekugadzirisa matambudziko.
CBT inowanzobatanidza zvikamu zvinotevera:
- Mafungiro ekuti anzwisise chii chinochengetedza chirwere chekudya uye nemigumisiro yepfungwa uye yezvoutano.
- Kudzorerwa kwekudya nekudya zvinowanzopedza-zvekudya zvitatu uye kudya kwemaviri kusvika katatu pazuva. Murwere anogona kusarudza kuti adyei chero bedzi iyo yakafanana nekudya kana kunwa.
- Kudya kudya . Murwere anofanirwa kuronga kudya nguva isati yasvika uye nguva dzose anoziva "chii uye rini" kudya kwake kuchazove.
- Kugadziriswa kwezvinyorwa zvekudya pakarepo mushure mekudya nekucherechedza pfungwa uye manzwiro pamwe nemafambiro.
- Kuyera nguva dzose (kazhinji kamwe kamwe pavhiki) kuitira kutarisa kufambira mberi uye kuedza miedzo.
- Kuvandudza nzira dzekudzivirira binges uye kuzvipa mhosva , sekushandiswa kwekukanganisika uye dzimwe nzira uye mazano ekugadzirisa matambudziko.
- Dambudziko remitemo yekudya. Izvi zvinosanganisira kuzivisa mitemo uye kuvhiringidza ivo maitiro (sekudya kudya mushure me8 masikati kana kudya sandwich kwemasikati).
- Kubudirira kwekuenderera mberi kufunga kufambisa zvose-kana-pasina-kufunga .
- Kushandiswa kwezviito zvekuita. Somuenzaniso, kana muteresi anotenda kuti kudya mukombe kunokonzera mazana mashanu-pound kuwedzera, iye angada kukurudzirwa kuti adye kapu uye aone kana ichiita. Aya maitiro ekuzvibata anowanzobudirira zvikuru kupfuura kugadzirisa kugadziriswa chete.
- Kuratidza kutyisa zvokudya . Mushure mekudya nguva dzose zvakanyatsogadziriswa uye maitiro ekuregererwa ari pasi pekutarisira, varwere zvishoma nezvishoma vanodzorerazve zvokudya zvavanotya.
- Dzokorora kudzivisa kuziva nzira mbiri dzakange dzakabatsira uye kuti ungagadzirisa sei zvinogona kugumburwa munguva yemberi. Nemhaka yokuti kurapwa inguva-isina kukwana, chinangwa ndechokuti murwere ave mushandi wake.
Zvimwe zvikamu zvinowanzobatanidzwa:
- Kupera kwekuongorora muviri
- Kuderedza kuderedza muviri
- Kubudirira kwezvinhu zvitsva zvekuzviremekedza
- Dambudziko rekudya chirwere chepfungwa
Kuvandudza unyanzvi hwevanhu
Vadzidzi Vakanaka veBBCT
Vanhu vakuru vane bulimia nervosa , binge kudya chirwere , nezvimwe zvinorondedzerwa chirwere chinokonzera (OSFED) vanogona kunge vakatsvaga CBT. Vechiduku vakwegura vane bulimia uye binge kudya chirwere vanogonawo kubatsirwa neBBCT.
Mhinduro Kurapa
Vanachiremba vanoita CBT vane chinangwa chekuzivisa kuchinja kwehupenyu nekukurumidza. Kutsvakurudza kwakaratidza kuti varwere vanogona kuita maitiro ekutanga maitiro ekuti kuisa kudya nguva dzose uye kuderedza kuwanda kwekuchenesa maitiro kunowanzobudirira kurapwa pamugumo wemishonga.
Kana CBT Isingashande
CBT inowanzokurudzirwa semutambo wekutanga. Kana kuedza kwe CBT kusingabudiriri, vanhu vanogona kutumidzwa kuDBT (rudzi rwakasiyana rweBBCT nekuwedzera simba) kana kune imwe nzvimbo yepamusoro yekuchengetedza zvakadai sechirongwa chechipatara kana chirongwa chekugara.
> Sources:
> Agras, W. Stewart, Ellen E. Fitzsimmons-Craft, uye Denise E. Wilfley. 2017. "Kuchinja-shanduka kweKutenda-Kuita Maitiro Okuda Kudya Zvirwere." Kuongorora uye Kurapa Kwetsika , Kuwedzera kukanganisa kwehutano hwehutano hwehutano: Bhuku rinokosha mukukudza G. Terence Wilson, 88 (January): 26-36. doi: 10.1016 / j.brat.2016.09.004.
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> Waller, Glenn, Helen Cordery, Emma Corstorphine, Hendrik Hinrichsen, Rachel Lawson, Victoria Mountford, uye Katie Russell. 2013. Kuchengetedza Maitiro ekurapa kwekudya zvinetso . Cambridge: Cambridge University Press.
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