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17 寻解治疗

17 寻解治疗

7.在解决问题的目标上,案主是值得信赖的。
基本理念
1、事出并非定有因。 2、“问题症状”同样也具有正向功能。 3、合作与沟通是解决问题的关键。 4、不当的解决方法是造成问题的根本。 5、来访者是自身问题的专家。
6、从正向的意义出发。
7、雪球效应 8、找到例外,解决就在其中。
9、重新建构个案的问题,创造改变。
它是由Steve de Shazer(史提夫.笛.夏德)及其韩国裔夫人
Insoo Kim Berg(茵素.金.柏格)以及一群有多元训练背 景(包括心理、社工、教育、哲学、医学等等)的工作成员, 于1987年在美国威斯康辛州的密尔瓦基(Milwaukee)短期家 庭治疗中心所发展出来的。
• 核心思路?寻解治疗聚焦于解决办法,而非问题。社工认 为案主的问题只是某个时间段脱离了正常生活轨道的一种 不良现象
13.因应询问(coping questions)
1.一般化(normalizing)
理念背景
– 来访者的情况具有普遍性。 – 来访者的情况是一种发展阶段常见的暂时性的困境, 而不是病态的、变态的、无法控制的灾难。
本技术核心:把来访者的问题非问题化,企图 用严重程度较低的辞句,重述个案的语言,以 减降个案的负面情绪。

• 咨2:当你先生比较愿意和你沟通的时候,你有些什么不一 样的地方?(着重在个案的改变与责任,而不是如个案所期 待的去改变对方) • 陈3:我会比较不紧张一点。
• 咨4:听起来,不紧张会让你看起来好一点。当你不这么紧张的时候
,你的行为会有什么不同? 或者至少在你先生的眼中,你会有什么不 同? (假设解决架构,以他人立场来看)
五、重要技术
8. 奇迹询问(miracle questions) 9. 关系询问(relationship questions) 10.例外询问(exception questions) 11.任务/家庭作业(tasks/homework)

加速康复外科理念及其应用

加速康复外科理念及其应用
快速 康复 … 。
外科 、眼外科、整形外科 、腹腔镜胆 囊切除手术、
疝手术 、胃癌根治 术 、结直肠手 术等等 。各类手 术 、各个中心都有各 自拟订的系列措施 ,在普通外
科范畴内 ,文献报道较 多的是应用于 结直肠外科。 我国对 F s T 这一新理 念研 究应用较早 的是南京军 区总医院黎介寿院士的团队 ,他们在结直肠手术 、 疝手术 、胃癌手术病人中的研究表明,F s T 治疗安
中的具 体应 用情 况 , 包括积 极采 用微 创技 术 、合理 的液 体补 充 、术后 镇静 与镇 痛 、术后 早期 肠
内营养与血糖的有效控制、防止围手术期体温过低等等 。 [ 关键词 ] 加速 康 复外科 外科 重症监 护 室 手 术
应 激
微创 技 术
1 引 言
近年来 , 随着人们对围手术期病入的病理生理 认识的深 入,一些新的治疗措施 被外科领域所 采 用 ,这些措施包括尽量减少手术损伤 、应用区域麻 醉阻滞 、控制术后疼痛 、术后早期下床活动及尽早 给予口服饮食等等。这些措施在择期手术中的联合 应用 ,可减轻手术后应激反应及器官功能损害 , 加 速手术 后 病 人 的康 复 ,被 称 为 “ 速 康 复 外 科 加 ( s tc r r,丌s ” f tr ks g y a a u e ) ,也有学者称之 为术后 促进康复程序或快速康复外科 ,它是采用循证医学 证据的围手术期处理的一系列优化措施 ,以减少或 降低手术病人的生理及心理创伤应激 ,使病人获得
新 医学 20 o 9年 4月第 4 o卷第 4期
2l 1
述 评
加 速 康 复 外 科 理 念 及 其 应 用
中山大学 附属 第一 医院 外科 重 症监 护 室( 10 0 刘 勇军 管 向 东 50 8 )

焦点解决短期治疗SFBT简介

焦点解决短期治疗SFBT简介

.简介焦点解决短期治疗(SFBT)一、SFBT 产生背景焦点解决短期治疗( Solution -fo2 cused Brief Therapy SFBT) 是指以寻找解决问题的方法为核心的短程心理治疗技术。

它是近二十年逐步发展成熟的心理治疗模式, 是在二十世纪八十年代由美国威斯康星州米华基(Milwaukee) 的短期家庭治疗中心(Brief Family Therapy Center) 的创办者Steve de Shazer 及其韩国裔夫人Inn Berg Kim 共同发展起来的。

传统心理治疗深受分析学派和行为学派的影响, 习惯把人的行为切割成许多部分再赋予一个新的意义, 心理治疗者期待从这样的过程中协助个案产生洞察或自我觉察, 进而能采取新的行为而获得“治疗。

同时, 传统的心理治疗通常认为人的行为存在着“因--果”的直线关系, 只要找出一个人行为的病理因素, 并且让他们认知自己的病理,人便有改善自我的可能。

但是, 这种从旧经验中寻找自我存在的根据, 这种发现问题取向的治疗策略, 很难使个案有能力响应相对的、变动的环境, 从而不但使个案无法脱离自我的限制, 也使他们在现实环境中无法找到改善自己的行动能量。

而后现代哲学思维的出现, 为这种发现问题取向的治疗策略的转变开辟了一条新的途径。

后现代思维认为剔除或修正个人对自我歪曲的认知或调整个人的情绪经验并不能达到治疗的目的, 人必须经由自我的创造与环境的互动才能建构真实的主体经验。

正如要回答建构主义所提出人的存在意义是如何被建构的?”这个问题时, 人不能单纯地被视为环境中的被动反应者, 人要有能力把自己视为主动创造者, 从主体经验中超越内外自我的限制。

这正是后现代..焦点解决短期治疗正是受到后现代思维影响而产生社会的主体精神与价值。

而是通过认为个案的问题并非是独立的客观事实, 的一种新的治疗模式,这个建构出来的互为主观的现实, 与个案的交谈, 在言谈间逐渐呈现出来才是重要的。

短期焦点心理疗法

短期焦点心理疗法

制定解决方案
制定计划
根据目标和问题,制定具体的治疗计划,包括治疗时间、治疗方式、治疗内容 等。
确定技术
选择适合的治疗技术,如认知行为疗法、解决问题疗法、家庭治疗等。
实施解决方案
01
02
03
实施治疗
按照计划实施治疗,包括 进行心理教育、技能训练 、家庭作业等。
调整方案
根据治疗效果和来访者的 反馈,及时调整治疗方案 ,确保治疗效果最大化。
06
短期焦点心理疗法的未来发展 与展望
结合其他心理治疗方法,形成综合治疗方案
短期焦点心理疗法与认知行为疗法结合
01
认知行为疗法可以帮助患者识别和改变负面思维模式,与短期
焦点心理疗法的目标一致,可以结合使用。
短期焦点心理疗法与心理动力治疗结合
02
心理动力治疗关注个体内心深处的心理过程,与短期焦点心理
04
短期焦点心理疗法的实施步骤
建立治疗关系
建立信任
治疗师与来访者之间建立信任关系, 为后续治疗打下基础。
明确角色
明确治疗师和来访者的角色和责任, 以便更好地合作。
明确问题与目标
评估问题
对来访者的问题进行评估,包括问题的性质、严重程度和持 续时间等。
确定目标
根据评估结果,确定治疗的目标,如减轻症状、改善情绪、 提高应对能力等。
短期焦点心理疗法
汇报人: 日期:
目录
• 引言 • 短期焦点心理疗法的基本原理 • 短期焦点心理疗法的应用领域 • 短期焦点心理疗法的实施步骤 • 短期焦点心理疗法的优势与局
限性 • 短期焦点心理疗法的未来发展
与展望
01
引言
定义与背景
定义
短期焦点心理疗法是一种以问题 解决为导向的心理治疗方法,强 调在有限的时间内集中解决来访 者的核心问题。

快速康复外科理念

快速康复外科理念

快速康复外科理念
快速康复外科(FTS)是一种围手术期护理措施,旨在通
过优化措施来减少手术应激反应和术后并发症。

FTS最初由丹麦医生XXX等人于2001年提出,现已在临床诊疗中得到广
泛应用。

FTS包括术前准备、合理麻醉和手术方式、术后加快康复管理等内容,旨在缩短住院时间、降低医疗费用、促进患者快速康复。

FTS的应用需要医师、护士、理疗师、营养师等协作团队共同制定计划并共同工作。

这种团队合作结合了现代的病人教育概念、新的麻醉剂、止痛方法以及微创手术技术,最终减少机体应激反应、疼痛和不适症状。

相较于传统的围手术期护理措施,FTS的应用可以明显增强患者各器官功能的恢复能力。

在欧美地区,关于在胃肠道手术中应用FTS的文献中,
有大量的证据表明广泛采用FTS可导致住院时间的显著缩短,减少术后并发症和医疗费用,以及病人满意度的提高。

因此,FTS的应用在一些手术科室中得到了广泛的推广和应用,并且相关研究也层出不穷。

焦点解决短程治疗

焦点解决短程治疗

焦点解决短期治疗(Solution-Focused Brief Therapy,简称SFBT)就是短期治疗得一种新尝试,其主要特征就是治疗关注未来、目标明确。

SFBT兴起于20世纪80年代,就是由美国威斯康星洲密尔沃基市得短期家庭治疗中心(Brief Family Therapy Center)得创办者史蒂夫·德·沙泽尔、其韩国裔夫人因苏·金·伯格、她们得同事以及来访者共同发展起来得。

创立者用多年得时间来观察治疗过程,仔细记录来访者得行为、问题与情绪,并最终引导她们概括与完成最终可行得解决方案、一、 SFBT得基本理念SFBT得来源大体可以分为三个部分:位于美国加州得帕洛阿尔托市得心智研究所(Menta lResearch Institute,简称MRI)与催眠心理治疗大师弥尔顿·H·埃里克森得早期研究、英国哲学家维特根斯坦得观点以及佛教思想。

1。

没有问题就无需治疗、这就是SFBT最重要得理念。

如果来访者自己已经解决了问题,那么我门采取干预得理论、模式与哲学背景都不重要了。

但在现实中,尽管来访者得问题已经得到改善,很多心理疗法仍然鼓励继续治疗。

例如,为了追求“进一步得发展"而去“巩固效果”,或就是寻求“更深层次得思想与结构”,SFBT就是非常反对这种做法得、2。

如果治疗有效,那么就深入下去。

这条理念依然遵循“不干涉”原则、如果来访者已经自行解决了问题,那么治疗师得主要任务就就是鼓励来访者在原有得基础上更进一步。

SFBT得治疗师只评价来访者得方法就是否有效,而不评判其质量如何、当治疗师充分了解了来访者在改进过程中不同时期得行为与反馈,任务才算真正完成、只有充分了解就是什么起了作用,来访者才能取得更多得进步与成功、3。

治疗如果没有效果,就要及时尝试其她方法、作为最重要得三个理念之一,这一条意味着效果才就是评判一个治疗方案得真正标准、人类总就是倾向于通过重复过去得问题来寻求解决之道,然而这些问题往往就是之前就没有得到解决得。

SF-36健康评估调查

SF-36健康评估调查

SF-36健康评估调查简介调查内容SF-36健康评估调查包含8个维度,每个维度有1-12个问题,总共41个问题。

以下是各维度的名称和问题数量:1. 生理功能(Physical Functioning) - 10个问题生理功能(Physical Functioning) - 10个问题2. 认知功能(Role-Physical) - 3个问题认知功能(Role-Physical) - 3个问题3. 情绪问题(Role-Emotional) - 3个问题情绪问题(Role-Emotional) - 3个问题4. 社会功能(Social Functioning) - 2个问题社会功能(Social Functioning) - 2个问题5. 疼痛(Pain) - 2个问题疼痛(Pain) - 2个问题6. 总体健康感知/生命质量(General Health) - 5个问题总体健康感知/生命质量(General Health) - 5个问题7. 活力(Vitality) - 4个问题活力(Vitality) - 4个问题8. 精神健康(Mental Health) - 5个问题精神健康(Mental Health) - 5个问题评分方式SF-36的每个问题都采用条目得分的方式,个体对于每个问题的回答会被转化为一个0-100分的得分,其中某些条目可能会反向评分。

所有条目的得分将被用来计算每个维度的总分,维度的得分范围通常在0-100分之间,分数越高代表健康状态越好。

维度得分计算示例以生理功能维度为例,10个问题的得分将被用来计算这一维度的总分。

首先,将每个问题的得分乘以相应的权重,然后将所有乘积相加,最后将总分除以10得到生理功能的得分。

综合得分应用注意在应用SF-36健康评估调查时,应注意以下几点:- 确保调查对象理解每个问题的含义,必要时可以提供例子以帮助解释。

- 鼓励调查对象根据自己的实际情况回答,而不是他们认为社会期望的答案。

西医康复科术语英文翻译

西医康复科术语英文翻译

西医康复科术语英文翻译以下下是常见的西医康复科术语英文翻译:1. 康复治疗:Rehabilitation Therapy2. 物理疗法:Physical Therapy (PT)3. 职业疗法:Occupational Therapy (OT)4. 语言疗法:Speech Therapy (ST)5. 康复评估:Rehabilitation Assessment6. 功能独立性评估:Functional Independence Measure (FIM)7. 日常生活活动能力评估:Assessment of Activities of Daily Living (ADL)8. 康复目标设定:Setting Rehabilitation Goals9. 神经康复:Neurological Rehabilitation10. 骨关节康复:Musculoskeletal Rehabilitation11. 脊髓康复:Spinal Cord Rehabilitation12. 儿童康复:Pediatric Rehabilitation13. 老年康复:Geriatric Rehabilitation14. 心脏病康复:Cardiac Rehabilitation15. 糖尿病康复:Diabetic Rehabilitation16. 康复计划制定:Developing the Rehabilitation Plan17. 运动疗法:Exercise Therapy18. 被动运动疗法:Passive Exercise Therapy19. 主动运动疗法:Active Exercise Therapy20. 水疗法:Hydrotherapy21. 温热疗法:Thermotherapy22. 冷疗:Cryotherapy23. 电刺激疗法:Electrostimulation Therapy24. 高压氧治疗:Hyperbaric Oxygen Therapy (HBOT)25. 矫形器与辅助器具:Orthotics and Prosthetics26. 物理因子治疗:Physical Modalities Therapy27. 电诊断测试:Electrodiagnostic Testing28. 心肺康复运动训练:Cardiopulmonary Rehabilitation Exercise Training29. 平衡与协调训练:Balance and Coordination Training30. 步行训练:Gait Training31. 手功能训练:Hand Function Training32. 言语认知训练:Speech and Cognitive Training33. 心理康复:Psychological Rehabilitation34. 康复护理:Rehabilitation Nursing35. 康复教育:Rehabilitation Education36. 社会康复:Social Rehabilitation37. 环境改造与适应性训练:Environmental Modification and Adaptive Training38. 功能恢复评估与预测:Functional Recovery Assessment and Prediction39. 生活质量评估:Quality of Life (QOL) Assessment40. 再适应训练:Readjustment Training41. 康复工程:Rehabilitation Engineering42. 康复咨询:Rehabilitation Counseling43. 家庭康复护理计划:Home-Based Rehabilitation Care Plan44. 工作能力评估与再就业指导:Work Ability Assessment and Return-to-Work Guidance45. 长期康复护理计划与管理:Long-Term Rehabilitation Care Planning and Management46. 康复机构管理与发展规划:Rehabilitation Facility Management and Development Planning47. 社区康复服务提供与整合:Community-Based Rehabilitation Service Delivery and Integration48. 康复伦理与法律问题:Rehabilitation Ethics and Legal Issues49. 康复经济学与成本效益分析:Rehabilitation Economics and Cost-Effectiveness Analysis。

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A brief introduction to Solution Focused Brief Therapy through the comparison with other traditional approaches.ã2011 Eva Golding As the named suggests ‘Solution Focused Brief Therapy (SFBT)’, is an approach originally developed in the context of therapeutic practice . Due to the pragmatic nature of the approach, the SF principles have been applied in other helping contexts i.e social work, mental health, education, governmental settings and business arenas etc.How SFBT was developedThe SFBT approach took shape in the early 1980s after a period of observational studies carried out systematically by a group of practitioners in the United States, among whom were Steve De Shazer and Isoo Kim Berg (Cade, 2007). They observed life therapy sessions, gathered data about what worked or not worked well for clients during the therapist/client interactions. From this data they particularly looked out for the more useful and helpful methods of communication that would assist clients to realise their own strengths, visualise goals and see the possibility of moving forward to the preferred future.This pragmatic and simplistic investigation into the practicality of helping, that is, identifying what works and what is useful, helped form the SF assumptions (see appendix 2, available only in the Change Certificate in Solution Focused Practice Course booklet).These assumptions no doubt have helped shape the unique therapist/client interaction of the SF approach, in which certain techniques are used to assist in communicating across therapeutic goals i.e. identifying client's strengths, co-constructing goals and co-creating possibilities to achieve them etc. The result is they are collectively seen as solution orientating communications. The frequently usedcommunicating techniques are: Scaling, Miracle Questions, Exception Finding and Problem Free Talk etc. (O’Hanlon, Beadle1997)Together with few other recent approaches, SFBT has emerged from the western psychotherapy discourse where a handful of traditional approaches have been dominant for most of the 20th century. The emergence of SFBT seems inevitable for it serves to challenge existing approaches or even to bring forth a therapy model that is more appropriate for the needs of today's society. This implies the difference of SFBT from the traditional ones. Indeed, by knowing the differences between them, one would then be able to distinguish the assumptions and principles that underpin the various models, so as to understand the therapeutic objectives of each of them.Simply by comparing SFBT with the 3 main traditional models i.e. Psychodynamic, Humanistic and Cognitive Behavioural Therapy (CBT), one would then realise the ‘why and what’ of the SF approach.When a personal problem is addressed, it is only natural that attention is drawn to the person’s past and present experiences as the potential cause of the present problem, or the personhood. The mental processes (cognition), the behavioural tendencies and the biological make-up are often seen as factors that cause the present problem also. This implies that past experiences, the personal construct and the biology of the person are all possible determinisms of one’s problem, which further implies the positivistic cause of the problem. In other words, the cause of a problem is there waiting to be discovered, and presumably a matching cure to the problem would also be identified once the cause is known.The SF approach to problems does not presume any deterministic factors:The notion of positivism, of determining factors to a problem, of presuming the essentialised person and of seeking pre-identified cures to particular problems, are all characteristics of the three traditional approaches. Past experiences and the unconscious mind that determine the present behaviour is of the Psychodynamic approach. The person’s concept of self and how this person has experienced and is experiencing the self, is determinism for self-worth, which directly affects how we see the world and behave toward it, as in the case of the Humanistic approach. As for CBT, the main determinism forpresent behaviour would be the person’s cognitive functioning,pattern and style (Hirschorn, 1979). Therefore, the belief ofthe respective determinisms shape the structure of the therapy process as: seeking the cause of the problem so as to identify symptoms for diagnosing a specific condition and, finding a matching treatment that can then be administered which is analogous to the medical model.It may seem as if the SF approach is doing what the traditional approaches are not, in other words, it doesn’t focus on seeking the cause of a problem and doesn’t assume a positivistic determinism of a problem. Without the orientation of looking for the cause, there won’t be any symptoms to look out for, without which diagnosing or categorising will not be possible and therefore there won’t be a matching cure either. All in all, the SF approach seems not to pay too much attention to presumed details of the problem as the others do, which distances the SF approach from conventional therapy. What makes SF approach different from othersIt is the difference in perspective that marks SF out from the traditional ones. The traditional linear medical model of investigating a clients’ problem belongs to the psychological perspective, which is characterised by positivism and essentialism (Holyoake & Golding, 2010). Whereas SF is from the sociological perspective, rather than from the perspective of looking inside the person or at the essentialised person. The SF approach concerns more the social aspect of the person, the forms of interactions that the person has with the world and with the therapist. The fluidity of the social interactions opens up possibilities for clients that otherwise would not have been realised had it been conducted within a predefined framework.So rather than relying on the expertness and privileged knowledge of the therapist to help the clients as in the traditional approaches, the SF approach sees practitioner and client as partners embarking on an unknown journey together in which they play the role of constructing the paths as they go about searching for the destination. The paths are constructed through their utilisation of forms of language, out of which emerge a clearer destination that becomes more and more tangible to the client. That is, specific meaning has been brought into existence within this therapist/client interaction, this is then the reality for the client (Golding, 2007). In other words, a discourse has been developed between the two social actors.It seems, through dialoguing, the client and therapist jointly invent a social reality that can be the goal(s) for creating ways to achieve them. This indicates that language is a form of social action within which both objects and people are constructed. So SF therapeutic interactions utilise the property of language to bring about a state that is favourable for the clients. In order to achieve this state, the context in which the therapy sessions are carried out has also been taken in consideration. By this, the client is seen as someone who is resourceful, and that the therapists do not hold a definitive truth, but together they create a solution to fit the particular needs of the client.The SFBT model may have tried to shed the notion of a regime of knowledge (Foucault, 1980), so that the practice would not be constrained by its own episteme and promote a re-negotiation of the feeling of a power imbalance between therapists and clients. In order to do so, SFBT does not seem to show preferences in any of the psychological fields such as the unconscious experience, learning processes, cognitive processes and the experiencing person. However, it cannot escape the fact that each therapeutic encounter is a discursive event by which knowledge and meaning are produced. Nevertheless, SFBT seems to utilise this very nature of discursiveness as the fundamental framework by which the conversations between therapists and clients are constructed in a way that will bring a ‘cure’ for the clients.ConclusionTherefore, the emerging contrasts between the SF approach and others are obvious to see. The contrasts that come into being are mainly because of the differing underpinning theoretical assumptions between the SF approach and the‘others’. It is as if the SF has occupied a privileged position of being the latecomer whose practice has not been restricted and limited by the established regime of knowledge the others have. In light of the restrictions and limitations they have enabled them to seek more effective ways of approaching the therapeutic practice.Whilst the traditional approaches became the regime of knowledge in the psychotherapy field, the SF approach emerges in the 1980s, moving away from the restriction of the traditional diagnostic and cure approach to problems. Instead, it focuseson the solution and emphasises goal setting, achieving it by wayreality for the client.The SF is a relatively new approach that seems to be born out ofthe ideological currency of the time in similar manner to itspredecessors. The beginning of the 21st century heralds a breakwith the effect of the last century politically and socially as real-time communications, together with a globalisation of disciplinesand ideas carried by homogenised computer technologies etc.have compressed time and geographic-cultural distancesbetween countries. Different cultures, values and beliefs arebrought together through borrowed time and space. WhetherSFBT, or indeed all the other therapy practices, is ready for thecultural change in society, would be dependent on whether anyof them has the potential for change. The jury is still outconsidering the verdict.References:Cade, B. (2007). A history of the brief, solution-focusedapproach. In: Nelson, T. & Thomas, F. Handbook of solution-focused brief therapy. Clinical Applications (Eds.).The HaworthPress.Foucault, M. (1980),Power/Knowledge, Brighton, Harvester. Golding, E. (2007),A journey envisioned through communication, University of Birmingham, D06C310SSC, 4th Jan. 2007.Hirschorn, P., in Medcof, J., & Roth, J., (eds), (1979),Approaches to Psychology, Open University Press, MiltonKeynes.Holyoake, D.D.: Golding, E. (2010)The ‘uncanny sense of self’,Solution FocusedPractice and a theoretical re-thinking of ‘the self’ inpsychotherapy, Asia Pacific Journal of Counselling andPsychotherapy, Vol. 1, No. 1, March 2010, 87–96O’Hanlon, B. ; Beadle, S. (1997)Guide to Possibility Land: 51Methods for DoingBrief Respectful Therapy, New York, Norton.。

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