Family consultation for psychiatrically complicated health problems.
Family consultation for psychiatrically complicated health problems.
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针对复杂的精神健康问题的家庭咨询。
DOI：
10.1002/jclp.21856
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发表时间：
2012
影响因子：
3
通讯作者：
Shoham,Varda
中科院分区：
文献类型：
--
作者：
Rohrbaugh,MichaelJ;Kogan,AnyaV;Shoham,Varda
我们描述了健康行为问题的社会控制论观点以及基于该观点的战略干预的基于团队的家庭咨询（FAMCON）格式。这种方法以关系而不是个人作为分析的主要单位，并且更重视问题的维护而不是病因学。治疗的目的是中断两种类型的人际问题维持——反讽过程和症状系统契合（分别概念化为正反馈循环和负反馈循环）——并动员公共应对作为变革的关系资源。一个案例是一位抑郁的丈夫和躁郁症妻子抱怨与丈夫的肾癌和糖尿病有关的严重沟通困难。在 6 次咨询会议中，战略干预的重点是打断讽刺性的人际模式，解决了所提出的投诉。尽管成本效益是一个悬而未决的问题，但 FAMCON 可能会在分级护理框架内提供心理教育和认知行为治疗的有用替代方案。
We describe a social cybernetic view of health behavior problems and a team‐based family consultation (FAMCON) format for strategic intervention based on that view. This approach takes relationships rather than individuals as the primary unit of analysis and attaches more importance to problem maintenance than to etiology. Treatment aims to interrupt two types of interpersonal problem maintenance—ironic processes and symptom‐system fit (conceptualized, respectively, as positive and negative feedback cycles)—and to mobilize communal coping as a relational resource for change. A case example features a depressed husband and bipolar wife complaining of severe communication difficulties related to the husband's kidney cancer and diabetes. Over 6 consultation sessions, strategic interventions focused on interrupting ironic interpersonal patterns resolved the presenting complaint. Although cost‐effectiveness is an open question, FAMCON may offer a useful alternative to psychoeducational and cognitive‐behavioral treatments in the framework of stepped care.