丧偶致急性创伤应激障碍的心理咨询案例

A Consultation of Acute Post-traumatic Stress Disorder for Bereaved Spouse

来访者是中年妇女,因丈夫罹患癌症去世,她认为是由于自己坚持住院治疗导致丈夫迅速死亡,出现严重应激反应一月,随后出现闯入性记忆、回避社交和易觉醒等严重心理创伤应激症状。咨询师通过对来访者摄入性会谈、SCL-90症状清单和创伤后应激障碍检查表,并与复杂性哀伤、急性应激障碍、抑郁症、以及焦虑症等相鉴别,诊断为急性创伤后应激障。然后采用认知治疗和放松、眼动脱敏干预治疗,通过4次来访,促进来访者正确认识死亡、回归现实、重新融入社会交际圈。最终,来访者的创伤性再体验、高警觉等症状基本消失,基本恢复正常社会交往和日常生活。

This paper was based on one case of acute post-traumatic stress disorder （PTSD）, who was traumatized by the death of her husband for cancer and suffered from intrusive memory, avoidance in social life and hyper vigilance during sleep. The women unforgived herself for poor decision on sending her husband to hospital leading to death. The consulter made the diagnosis of acute PTSD after intake interviewing, testing positively by the symptom checklist 90 （SCL-90） and PTSD checklist （PCL） and distinguished from the acute stress disorder, complicated grief, depression and anxiety. The rational emotive muscles relax, eye movement desensitization and reproeessing therapies were adopted to help the visitor change the unreasonable cognition and relieve symptoms. Finally, the visitor achieved the expected targets after four times of regular consultation.