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Четвертая сессия - Аарон Бек, А. Раш, Брайан Шо, Гэри Эмери Когнитивная терапия депрессии


Четвертая сессия


1. Следовать схеме третьей сессии.
2. Продолжать обучать пациента распознавать неадаптивные когниции (при необходимости используя технику «индуцированных образов» или ролевые игры).
3. Объяснить пациенту, как эти автоматические когниции искажают его восприятие реальности и приводят к развитию депрессии.
4. Выявление автоматических мыслей, особенно тех, что препятствуют выполнению домашних заданий.

Пятая сессия


1. Следовать схеме четвертой сессии.
2. Обсудить выполненные пациентом поведенческие задания.
3. Просмотреть и обсудить записанные пациентом негативные мысли.
4. Продемонстрировать пациенту способы оценки и корректирования когнитивных искажений (автоматических мыслей).
5. Обучить пациента ведению «Протокола дисфункциональных мыслей»; объяснить, как заполнять колонки 4-6.

Сессии 6-8


1. Общая схема та же, что и для пятой сессии.
2. Продолжать устранять психологические барьеры, препятствующие восстановлению преморбидного уровня функционирования.
3. Продолжать выявлять негативные автоматические мысли.
4. Продолжать обучать пациента находить рациональные ответы на автоматические мысли.
5. Разработка новых домашних заданий.
6. Обсуждение концепции депрессогенных базовых убеждений (глава 12).

Сессии 8-12


1. Возложить на пациента бОльшую ответственность за определение повестки дня.
2. Делегировать пациенту ответственность за разработку и выполнение домашних заданий.
3. Выявление и обсуждение базовых убеждений. Проверка валидности убеждений.

Заключительные сессии 13-15 (вплоть до 20)


1. Готовить пациента к завершению терапии.
2. Делать упор на том, что и по завершении терапии пациент должен практиковаться в применении поведенческих и когнитивных техник. Объяснять пациенту, что психотерапия — это обучающий процесс, который продолжается всю жизнь.
3. Обговорить с пациентом, какие проблемы он предвидит в будущем и как он может разрешить их.

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