阅读疗法在儿童抑郁症治疗中的适合性研究

发布时间：2018-11-08 10:20

【摘要】：阅读疗法是由高尔特(Galt)于1848年在美国精神病学年会上首先提出来的,1916年开始逐渐被应用于焦虑症、攻击行为、恐惧症等问题的治疗,显示出其独特的心理治疗效果,这主要是与其以下理论基础及特点有关。阅读疗法的理论基础是精神分析学派提出的认同、净化及领悟三大机制说。该种心理治疗方法具有契合儿童身心发展水平、有效针对儿童抑郁症的独特症状表现、帮助儿童更好地发现与表达自己、安全经济等特点和优势。本研究提出,在儿童抑郁症治疗中引入阅读疗法的构想,主要是基于抑郁症儿童的患病率较高、现有治疗方法疗效不佳、阅读治疗在儿童心理治疗中已经取得较好效果等原因。为了验证阅读疗法在儿童抑郁症治疗中的作用,并将其疗效与认知疗法进行对比,研究选取36名10～15岁儿童抑郁症患者,将其随机分为三个组,每组12人,分别为阅读治疗组、认知治疗组、控制治疗组,其中控制治疗组被试接受的心理治疗延迟到实验组心理治疗结束时才开始。所有被试组在心理治疗完成后3个月均接受了追踪测试。结果显示:阅读治疗组和认知治疗组的抑郁测评指标,以及症状恶化程度后测结果均有明显下降,而且疗效稳定;阅读治疗组的疗效更为明显和更为稳定,其在3个月后追踪测评结果基本都处于最低分值;控制组的各项指标变化不大或略有下降。从验证实验看,阅读治疗对儿童抑郁症具有较好的疗效和适合性。为了进一步验证治疗的有效性,并对阅读治疗的机制进行深入分析,实验同时开展了一系列的质化研究。具体做法是选取完成阅读治疗的16名患者,通过录音、观察和访谈等方式收集各种研究资料,采用类属分析的方法,对资料文本进行深入分析,经过开放式编码、主轴编码和核心编码,构建出治疗师、治疗过程、阅读材料三大影响治疗效果的核心类属。从质化研究的结果可以看到,儿童阅读材料的适合性、治疗师的态度和专业性以及阅读治疗过程中认同、净化和领悟机制的作用共同促成了治疗效果的出现。综合来看,阅读疗法在儿童抑郁症治疗中具有适合性及良好疗效,符合儿童心理发展及认知水平,是未来值得推广的儿童抑郁症治疗的有效方法。
[Abstract]:Reading therapy was first proposed by Galt (Galt) in 1848 at the annual meeting of American Psychiatry. Since 1916, it has been gradually applied to the treatment of anxiety disorder, aggressive behavior, phobia and other problems, showing its unique psychotherapeutic effect. This is mainly related to the following theoretical basis and characteristics. The theoretical basis of reading therapy is the theory of identification, purification and comprehension proposed by psychoanalysis school. This psychotherapy method is suitable for the children's physical and mental development level, effectively aims at the special symptom manifestation of children's depression, helps the children to better discover and express themselves, safety and economic characteristics and advantages. This study suggests that the introduction of reading therapy into the treatment of depression in children is mainly due to the high prevalence of depression children, the poor curative effect of the existing treatment methods and the good effect of reading therapy in the psychological treatment of children. To verify the role of reading therapy in the treatment of childhood depression and to compare its efficacy with cognitive therapy, 36 children with depression aged 10 to 15 years were randomly divided into three groups, 12 in each group. The psychotherapy in the control group was delayed until the end of the psychotherapy in the experimental group. All the subjects underwent follow-up tests 3 months after psychotherapy. The results showed that the index of depression and the degree of symptom deterioration in the reading treatment group and the cognitive treatment group were significantly decreased and the curative effect was stable. The therapeutic effect of the reading treatment group was more obvious and stable, and the results of tracking and evaluation were basically in the lowest score after 3 months, while the indexes of the control group had little change or decreased slightly. According to the experimental results, reading therapy has good efficacy and suitability for children with depression. In order to further verify the effectiveness of the treatment and analyze the mechanism of reading therapy, a series of qualitative studies were carried out. The specific approach is to select 16 patients who have completed the reading treatment, collect all kinds of research materials by recording, observing and interviewing, and use the method of generic analysis to conduct in-depth analysis of the data text and pass through the open coding. Spindle coding and core coding were used to construct three core categories of therapists, therapeutic processes and reading materials. It can be seen from the results of qualitative research that the suitability of children's reading materials, the attitude and professionalism of therapists, and the role of identification, purification and comprehension mechanism in the process of reading therapy contributed to the emergence of therapeutic effects. In general, reading therapy is suitable and effective in the treatment of childhood depression, which is in line with the children's psychological development and cognitive level, and is an effective method for the treatment of childhood depression in the future.
【学位授予单位】：南京师范大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：B844.1

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