INDIVIDUAL PSYCHOTHERAPY AND PERSONS WITH SERIOUS MENTAL-ILLNESS - THE CLIENTS PERSPECTIVE
INDIVIDUAL PSYCHOTHERAPY AND PERSONS WITH SERIOUS MENTAL-ILLNESS - THE CLIENTS PERSPECTIVE
复制标题
DOI：
10.1093/schbul/21.2.283
复制
发表时间：
1995-01-01
影响因子：
6.6
通讯作者：
FARRELL, EW
中科院分区：
文献类型：
--
作者：
COURSEY, RD;KELLER, AB;FARRELL, EW
从马里兰州所有中心的12个心理社会康复中心的分层随机样本中获得了严重精神疾病患者对个人心理治疗经验的看法。反应和完成率，重测信度和概括数据是积极的。探讨了八个领域：（1）利用率和持续时间：在212名受访者中，90%的人接受治疗的中位数为12个月（平均= 3年）;只有三分之一的人预计在5年内结束治疗。(2)治疗效果：大多数受访者（72%）报告说，个人心理治疗给他们的生活带来了积极的变化，14%的人报告说有消极的变化，14%的人报告说治疗没有效果。(3)首选干预措施和参数：16%的人认为药物治疗最有用，25%的人认为谈话治疗最有用，60%的人支持两者结合。在诊断和心理治疗方面，84%的精神分裂症患者更喜欢简短、不太频繁的现实导向治疗，而不是更长、更频繁的洞察力治疗。双相情感障碍和重性抑郁症的受访者在这两个方面平分秋色。(4)治疗问题：人的问题更经常被评为重要的，并被评为比疾病的具体症状更高的重要性。(5)客户对疾病的看法：只有8%的人认为他们的病是脑部疾病，三分之一的人认为是心理问题，四分之一的人认为是两者兼而有之;三分之一的人回答说：“我不知道。几乎一半的人不知道他们的治疗师是怎么想的。(6)治疗关系：诚实是治疗师最需要的品质。(7)信心：大多数人认为治疗师通常会保持客户的信心。(8)赋权：那些在治疗中感到有力量的人在医院呆的时间更少，期望在治疗中停留的时间更短，并且对他们的问题了解更多。建议提出了一个更客户端响应模式的个人心理治疗的人有严重的精神疾病。
The perspectives of persons with serious mental illness about their experiences with individual psychotherapy were obtained from a stratified random sample of 12 psychosocial rehabilitation centers from all centers in Maryland. Response and completion rates, test-retest reliability, and generalization data were positive. Eight areas were explored: (1) Utilization and duration: of the 212 respondents, 90 percent had been in therapy for a median of 12 months (mean = 3 years); only a third expected to end their therapy within 5 years. (2) Therapeutic effectiveness: most of the respondents (72%) reported that individual psychotherapy had brought positive changes to their lives, 14 percent reported negative changes, and 14 percent reported that therapy had had no effect. (3) Preferred interventions and parameters: sixteen percent felt that medication was most useful, 25 percent felt that talking therapy was most useful, and 60 percent endorsed a combination of the two. With respect to diagnosis and psychotherapy, 84 percent of respondents with schizophrenia preferred brief, less frequent sessions of reality-oriented therapy over longer, more frequent sessions of insight therapy. Respondents with bipolar and major depression were equally split between the two. (4) Therapeutic issues: human concerns were more frequently rated as important and were rated higher in importance than illness-specific symptoms. (5) Clients' view of illness: Only 8 percent thought their illness was a brain disease, a third thought it was a psychological problem, and a quarter thought it was a combination of both; a third answered, ''I don't know.'' Almost half did not know what their therapists thought. (6) Therapeutic relationship: Friendliness was the quality most desired in a therapist. (7) Confidentiality: Most felt that therapists generally kept the clients' confidences. (8) Empowerment: Persons who felt empowered in therapy spent less time in hospitals, expected a shorter stay in therapy, and knew more about their problems. Suggestions are made about a more client-responsive model of individual psychotherapy for persons with serious mental illness.