焦点解决短期治疗在失眠症中的应用

Application of solution focused brief therapy in insomnia

失眠症有着高患病率、高复发率、病情迁延的特征,是严重的健康负担。失眠症的认知行为疗法是失眠症治疗的金标准,然而由于出勤率低及依从性差,其有效性受到阻碍。失眠患者最常见以情绪为导向的应对方式,压力反应性高于常人,培养更健康的应对方式解决睡眠问题而不纠缠于失眠相关的负性情绪,也许会带来更深入的改变。焦点解决短期治疗是一种基于优势、面向未来的心理治疗模式,其框架明确、操作简便,具有较好的成本效益,可以用作初级心理治疗、危机干预,甚至药物治疗的有益补充。首次访谈常用评量询问、预设性询问及奇迹询问,促进患者做出改变的决定;在建构失眠解决方案时,常用到关系问句、例外问句、应对问句及改变最先出现的迹象;正常化、鼓舞与赞许是重要的赋能技术。

Insomnia is characterized by high prevalence,high recurrence rate and procrastination,it has become a severe health burden in the world.Cognitive behavioral therapy for insomnia is a gold standard for insomnia treatment,however,the effectiveness has been hindered because of low attendance rate and poor adherence.Emotional-oriented coping styles are commonly seen in insomniacs,which means they have a higher response to stress than the normal.Developing a healthier coping style to solve sleep problems is superior to being embroiled in the insomnia-related negative emotions.Solution focused brief therapy is an strengths-based,future-focused cost-effective psychotherapeutic model with clear framework and brief operation.It can be used as an beneficial supplement for primary psychotherapy,crisis intervention even pharmacotherapy.Scaling questions,pre-supositional questions and miracle questions are often used at the first interview to boost insomniacs to make decisions about change.Relationship questions,exception questions,coping questions and first sign are frequently used when constructing solutions of solving insomnia problems.Normalizing,cheerleading and compliment are techniques to empower patients.