上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2018, Vol. 38 ›› Issue (1): 57-.doi: 10.3969/j.issn.1674-8115.2018.01.010

• 论著（临床研究） • 上一篇    下一篇

团体正念认知疗法治疗强迫症中的治疗关系

陆璐，张天然，范青#，张海音#   

  1. 上海交通大学 医学院附属精神卫生中心，上海200030
  • 出版日期:2018-01-28 发布日期:2018-03-09
  • 通讯作者: 张海音，电子信箱：haiyinz2001@126.com。范 青，电子信箱：fanqing_98@sina.com。
  • 作者简介:陆 璐（1990—），女，硕士生；电子信箱：lulupsy90@163.com。
  • 基金资助:
    国家自然科学基金（81771460）；上海市科学技术委员会“科技创新行动计划”医学和农业领域科技支撑项目子课题（15411950203）；上海市卫
    生和计划生育委员会科研课题（201740086）；上海市精神卫生中心重点特色专科（2013-YJTSZK-02）；上海交通大学医学院转化医学协同创新中心合作研究项目（TM201614）

Psychotherapy relationship in group mindfulness-based cognitive therapy for obsessive-compulsive disorder

LU Lu, ZHANG Tian-ran, FAN Qing#, ZHANG Hai-yin#   

  1. Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
  • Online:2018-01-28 Published:2018-03-09
  • Supported by:
    National Natural Science Foundation of China, 81771460; Shanghai Science and Technology Commission“ Science and Technology Innovation Action Plan” Supporting Project Sub Topics in the Field of Medicine and Agriculture, 15411950203; Foundation of Shanghai Municipal Commission of Health and Family Planning, 201740086; Key Characteristic Specialist Department of Shanghai Mental Health Center, 2013-YJTSZK-02; Collaborative Innovation Research Project in Translational Medicine of Shanghai Jiao Tong University School of Medicine, TM201614

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摘要： 目的· 探讨运用团体正念认知疗法治疗强迫症患者时，心理治疗师和强迫症患者之间治疗关系的表现特征及促进疗效的策略。
方法· 选取上海交通大学医学院附属精神卫生中心3 位心理治疗师和其所带领的2 组强迫症正念认知治疗团体（共11 人完成治疗，2
人脱落）。团体成员皆为轻至中度强迫症患者。运用质性研究方法对治疗师和来访者进行半结构式访谈，对逐字转录所获得的访谈资
料进行编码，运用类属分析的方法进行分析。结果· 强迫症患者眼中的治疗关系表现为温暖的情感支持、专业权威性、个性化需求。
治疗师眼中的治疗关系表现为平等的陪伴、相对温和、模糊而有距离。从治疗关系角度促进疗效的策略包括专业性带来信任（特别是
举例讲解）、促进情感体验、接纳失望和负面情绪。结论· 增加有效策略的运用，可促进正念认知疗法治疗强迫症患者时治疗关系的
建立和积极发展，提高治疗的有效性。

关键词: 正念认知疗法, 强迫症, 治疗关系, 质性研究

Abstract:

Objective · To explore the performance characteristics of the psychotherapy relationship in mindfulness-based cognitive therapy between the
psychotherapists and patients with obsessive-compulsive disorder (OCD), and the strategies to promote the curative effect in mindfulness-based cognitive
therapy. Methods · Three psychotherapists in Shanghai Mental Health Center and two groups of mindfulness-based cognitive therapy for OCD groups
(a total of 11 people who completed treatment and 2 people dropped off) were selected. All the patients had mild to moderate OCD. The transcripts were
transcribed into verbatim and coded using interpretative phenomenological analysis. Results · The psychotherapy relationship in subjective experience
of patients with OCD showed warm emotional support, professional authority and individual requirements. The psychotherapy relationship in subjective
experience of the therapist was manifested as equal companion, relatively mild and fuzzy distance. Strategies to promote efficacy from a therapeutic
relationship perspective was profession to trust (especially for example), to promote emotional experience and to accept disappointment and negative
emotions. Conclusion · Increasing the use of effective strategies can promote the establishment and positive development of therapeutic relationship
in mindfulness-based cognitive therapy for OCD and promote the effectiveness of treatment.

Key words: mindfulness-based cognitive therapy, obsessive-compulsive disorder, psychotherapy relationship, qualitative research