认知行为疗法的临床应用现状

Review of clinical aplication of cognitive behavioural therapy

认知行为治疗(cognitive behavior therapy,CBT)是由A.T.Beck在20世纪60年代提出的一种有结构、短程、认知取向的心理治疗方法,主要着眼点在患者不合理的认知问题上,通过改变患者对己、对人或对事的看法和态度来解决心理问题。其演变发展包括认知疗法(cognitive therapy,CT)、行为疗法(behavioral therapy,BT)、接受和承诺疗法(acceptance and commitment therapy,ACT)、辩证行为疗法(dialectical behavior therapy,DBT),逐渐延伸出以正念为基础的认知疗法、元认知疗法、内观认知疗法等认知行为分析系统和认知加工疗法。国外众多临床研究已表明,CBT被推荐为针对青少年心理疾病的首选治疗方式,CBT可以有效治疗非严重型的抑郁症、焦虑症、神经性厌食症、创伤后心理压力紧张症候群(post-traumatic stress disorder,PTSD)、边缘性人格障碍等,且大量文献为CBT在儿童心理疾病领域,包括社交焦虑症、自闭症、行为障碍等多种疾病中的疗效提供了有力的支持证据。本文将简要总结CBT在临床实践中的现状及其未来应用的展望。

Cognitive behaviour therapy(CBT)is a structured,short-term and cognitive-oriented psychotherapy proposed by A.T.Beck in the 1960s and mainly focuses on the unreasonable cognitive problems of patients.Psychological problems can be solved by changing patients'views and attitudes towards themselves,people or things.Its evolution includes cognitive therapy,behavioural therapy,acceptance and commitment therapy and dialectical behaviour therapy,and it has gradually extended.It developed mindfulness-based cognitive therapy,metacognitive therapy,internal cognitive therapy and other cognitive behavioural analysis systems and cognitive processing therapy.Numerous clinical studies have shown that CBT is the first-choice treatment for adolescent mental illness and can effectively treat non-severe depression,anxiety,anorexia nervosa,post-traumatic stress disorder and borderline personality disorder.Substantial literature has provided evidence of the efficacy of CBT in the field of children's mental diseases,including social anxiety disorder,autism,behavioural disorders and other diseases.This article will briefly summarise the current status of CBT in clinical practice and its prospects for future applications.