“积分悖论干预法”的操作技术与临床应用

Manipulating Skill of Accumulative Scoring Paradoxical Intervention in Psychotherapy

目的 :介绍一种在实践中形成的悖论干预取向的治疗技巧——积分悖论干预法。方法 :“积分悖论干预法”的操作特点是在治疗初期不但不寻求消除症状 ,相反而要主动发动和加重症状 ,最终消除症状。操作原则 :定时、定量主动发动和体验症状 ,或者在现实情境中主动诱发症状 ,加重和扩大症状 ,假装或表演症状 ,操纵症状 ,对诱发的症状进行评分 ,积累症状分数 ,达到消除症状。积累分数的评估过程具有使自我把症状痛苦“客体化”的效果。结果 :通过对 4 2例咨客实施治疗 ,取得不同程度疗效 ,并报告了两个案例的典型治疗过程。结论 :“积分悖论干预法”适合治疗大中小学生的各种心理问题 ,特别对轻度强迫思维、强迫意象及学校恐怖等问题疗效较好。

Objective: To introduce the Accumulative Scoring Skill of paradoxical intervention in China. Methods: For removing the symptoms of mental disorders, we applied the method of actively eliciting and aggravating the underlying unpleasant experience. The therapist and the patient construct a symptom hierarchy in which the points of symptom were rated from the most to the least upsetting. The more the clients gain the points, the more severe symptoms were actively evoked. Through accumulating the scores, the attention of the clients were distracted from self to the objective world, so that the patients ultimately would be free of suffering from the symptoms. Results: The skill was very effective for the 42 case reported in this article. Conclusion: The Accumulative Scoring Skill of paradoxical intervention has the advantage that the changes it produced in a short time and the cost of psychotherapy is greatly reduced. The skill is applied to a variety of problems in adolescents, especially for obsessive thinking, obsessive image and school phobia.