Cognitive and Behavioral Practice最新文献_第6页

Harm Reduction Behavioral Activation Teletherapy for People Who Inject Drugs: Development, Feasibility, and Acceptability 针对注射毒品者的减低伤害行为激活远程疗法：开发、可行性和可接受性

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-05-07 DOI: 10.1016/j.cbpra.2024.03.002

Catherine E. Paquette, Alexander Vierling, Louisa Kane, Zachary Stewart, Loftin Wilson, Flavio Frohlich, Donald Baucom, Stacey B. Daughters

People who inject drugs (PWID) experience severe substance-related harms and yet have low rates of engagement in substance use disorder treatment. Low-barrier and telepsychology interventions represent promising strategies for engaging PWID in treatment, but few studies have tested the feasibility of these approaches among non-treatment-seeking PWID. A behavioral activation (BA) treatment for substance use was adapted through a harm reduction lens to assist PWID in working toward healthy, meaningful lives and achieving their goals. This study aims to: (a) describe the development and harm reduction–focused adaptation of the BA intervention, and (b) examine the feasibility and acceptability of administering a telepsychology BA treatment for substance use among non-treatment-seeking PWID. We recruited N = 23 PWID (65.2% White; 52.2% women; mean age 35.4 ± 7.8 years) from syringe services programs into an open trial and n = 19 received up to eight sessions of BA over 4 weeks. Qualitative treatment feedback interviews occurred at posttreatment. Among those who attended ≥1 session of treatment, 84% attended a second assessment, and 58% attended ≥7 intervention sessions. Feasibility challenges were primarily related to participant vulnerabilities (e.g., hospitalization, incarceration, loss of access to technology). Participants indicated high acceptance of the intervention and its telepsychology format. In conclusion, while PWID face significant barriers to engaging in treatment, some also demonstrate a desire, willingness, and capacity for psychological intervention. Remote interventions may help increase feasibility of treatment participation. Future studies should examine longer harm reduction-focused treatments for PWID that balance barriers to initial engagement with the need to reinforce treatment gains and improve long-term outcomes.

注射吸毒者（PWID）经历了严重的物质相关伤害，但参与物质使用障碍治疗的比例很低。低障碍和远程心理干预是让PWID参与治疗的有希望的策略，但很少有研究测试这些方法在非寻求治疗的PWID中的可行性。通过减少伤害的视角，对药物使用的行为激活（BA）治疗进行了调整，以帮助PWID朝着健康、有意义的生活和实现他们的目标努力。本研究旨在：(a)描述BA干预的发展和以减少伤害为重点的适应，以及(b)检查在不寻求治疗的PWID中实施远程心理学BA治疗的可行性和可接受性。我们从注射器服务项目中招募了N = 23名PWID患者（白人占65.2%，女性占52.2%，平均年龄35.4±7.8岁）进入公开试验，N = 19名患者在4周内接受了8次BA治疗。定性治疗反馈访谈在治疗后进行。在参加≥1次治疗的患者中，84%参加了第二次评估，58%参加了≥7次干预。可行性方面的挑战主要与参与者的脆弱性有关（例如，住院、监禁、无法获得技术）。参与者对干预及其远程心理学形式表示高度接受。综上所述，尽管PWID患者在接受治疗方面面临着巨大的障碍，但一些人也表现出了心理干预的愿望、意愿和能力。远程干预可能有助于提高治疗参与的可行性。未来的研究应该检查长期的以减少危害为重点的PWID治疗方法，以平衡最初参与的障碍与加强治疗收益和改善长期结果的需要。

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引用次数: 0

Written Exposure Therapy and Dialectical Behavior Therapy Skills Training as a Novel Integrated Intervention for Women With Co-Occurring PTSD and Eating Disorders: Two Case Studies 将书面暴露疗法和辩证行为疗法技能培训作为一种新型综合干预措施，用于治疗同时患有创伤后应激障碍和进食障碍的女性：两个案例研究

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-05-01 DOI: 10.1016/j.cbpra.2024.02.004

Emily L, Tilstra-Ferrell, Selime R. Salim, Cristina López, Anna Foster, Christine K. Hahn

Approximately one quarter of people with posttraumatic stress disorder (PTSD) also have an eating disorder (ED). Yet, there is very limited research on interventions addressing PTSD and EDs (PTSD-ED) simultaneously. Two case studies illustrate the treatment of two women with PTSD-ED using Written Exposure Therapy (WET) for PTSD combined with targeted skills from Dialectical Behavior Therapy (DBT) for Eating Disorders (i.e., dialectical abstinence, self-soothing, pro/cons, mindful urge-surfing, coping ahead). Data include pre-, posttreatment, and 6- to 8-week follow-up scores of PTSD and ED symptoms. Client One completed five sessions. At intake, she met criteria for PTSD and Other Specified Feeding and Eating Disorder based on information gathered in a clinical interview and self-report measures. She reported reductions in both PTSD and ED symptoms at posttreatment and at a 6- to 8-week follow-up. Client Two completed seven sessions. At intake, she met criteria for PTSD and Binge Eating Disorder (BED) based on information gathered in a clinical interview and self-report measures. She reported reductions in symptoms of PTSD and BED at her final session and at a 6- to 8-week follow-up. Results from the presented case studies suggest WET for PTSD combined with DBT skills for EDs holds strong promise for reducing co-occurring PTSD and ED symptoms. Future studies should formally assess the feasibility, acceptability, and effectiveness of integrated WET and DBT skills for the treatment of PTSD-ED.

大约四分之一的创伤后应激障碍（PTSD）患者同时患有饮食失调（ED）。然而，目前关于同时治疗PTSD和ed （PTSD- ed）的研究非常有限。两个案例研究说明了使用书面暴露疗法（WET）治疗PTSD与辩证行为疗法（DBT）治疗饮食失调的针对性技巧（即辩证戒断、自我抚慰、赞成/反对、正念冲动冲浪、提前应对）相结合的方法治疗两名女性PTSD。数据包括治疗前、治疗后以及6至8周的PTSD和ED症状随访评分。客户1完成了5次治疗。在入院时，根据临床访谈和自我报告收集的信息，她符合创伤后应激障碍和其他特定进食障碍的标准。她报告在治疗后和6至8周的随访中，PTSD和ED症状均有所减轻。2号病人完成了7次治疗。在入院时，根据临床访谈和自我报告收集的信息，她符合创伤后应激障碍和暴食症（BED）的标准。在最后一次治疗和6至8周的随访中，她报告了PTSD和BED症状的减轻。案例研究的结果表明，创伤后应激障碍的WET结合ED的DBT技能，对于减少并发的PTSD和ED症状有很大的希望。未来的研究应该正式评估综合WET和DBT技能治疗ptsd的可行性、可接受性和有效性。

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引用次数: 0

Use of an Augmented Exposure and Response Prevention Procedure in the Treatment of Obsessive-Compulsive Disorder: A Case Report 在强迫症治疗中使用增强暴露和反应预防程序：病例报告

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-05-01 DOI: 10.1016/j.cbpra.2024.02.003

Emily D. Pogue, Matthew L. Edelstein

This case report describes the assessment and treatment of a 21-year-old male with obsessive-compulsive disorder (OCD) using an intensive exposure and response prevention (ERP) treatment program. The patient and his father received daily 2-hour ERP sessions delivered across 10 consecutive weekdays, and monthly follow-up appointments. In addition to the condensed treatment schedule, ERP procedures were augmented to address ongoing family conflict and depressive symptoms. To the best of the our knowledge, this is the first study to include such treatment adaptations within the context of intensive ERP for an adult with OCD. Results indicated target behaviors decreased over the 2-week intensive treatment phase and were maintained during 4 months of follow-up. Ancillary outcomes reported by the patient and his father included more frequent engagement in activities of daily living and improved family communication. Outcomes of this study provide an important step toward establishing recommendations regarding ERP session frequency, especially among patients with comorbid disorders.

本病例报告描述了一名21岁男性强迫症（OCD）的评估和治疗，采用强化暴露和反应预防（ERP）治疗方案。患者及其父亲在连续10个工作日每天接受2小时的ERP治疗，并每月进行随访。除了精简的治疗计划外，ERP程序也被用于处理持续的家庭冲突和抑郁症状。据我们所知，这是第一个将这种治疗适应纳入强迫症成人强化ERP背景下的研究。结果表明，目标行为在2周强化治疗期间有所下降，并在4个月的随访期间保持不变。患者及其父亲报告的辅助结果包括更频繁地参与日常生活活动和改善家庭沟通。这项研究的结果为建立ERP会话频率的建议提供了重要的一步，特别是在有合并症的患者中。

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引用次数: 0

Promoting Healthy Screen Media Use in Young Children With Externalizing Behavior Problems Through an Adapted Parenting Intervention: Results of an Open Trial 通过调整育儿干预措施促进有外化行为问题的幼儿健康使用屏幕媒体：公开试验结果

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-04-23 DOI: 10.1016/j.cbpra.2024.02.002

Shayl F. Griffith, Katie C. Hart, Samantha M. Casanova, Allison C. Goodman, Jenny S. Radesky, Rex Forehand, Daniel M. Bagner

In this article, we describe the development of an adapted parenting intervention for caregivers of preschoolers with externalizing behavior problems, which integrates content around screen media use into an existing evidence-based parenting intervention. We also present results of an open trial examining the feasibility, acceptability, and initial outcomes of the adapted intervention in a sample of 10 low-income caregivers of children with externalizing behavior problems who were attending a community-based therapeutic summer program. Caregivers attended a once weekly (1.5-hour) intervention group, which was embedded in an 8-week community-based therapeutic program for children with externalizing behavior, and completed questionnaires at pretest, posttest, and 1 month following the intervention, and completed interviews about their experiences. Caregiver satisfaction with the adapted intervention was high, and fidelity and attendance measures suggested the intervention was feasible. Preliminary results showed postintervention improvements in caregivers’ skills in managing screen media use, including increases in caregiver self-efficacy to manage and set limits around screen media use. Results suggest that leveraging existing parenting interventions to promote healthy media use habits may be a promising avenue to maximize reach to families with children with externalizing behavior.

在这篇文章中，我们描述了一种针对有外化行为问题的学龄前儿童照顾者的适应性育儿干预措施的发展，该措施将有关屏幕媒体使用的内容整合到现有的循证育儿干预措施中。我们还提供了一项公开试验的结果，该试验检验了适应性干预的可行性、可接受性和初步结果，样本为10名参加社区治疗性暑期项目的外化行为问题儿童的低收入照顾者。护理人员参加每周一次（1.5小时）的干预组，该干预组被纳入为期8周的外化行为儿童社区治疗计划，并在干预前、后测试和干预后1个月完成问卷调查，并完成有关其经历的访谈。照顾者对适应性干预的满意度很高，保真度和出勤率表明干预是可行的。初步结果显示，干预后护理人员管理屏幕媒体使用的技能有所改善，包括管理和限制屏幕媒体使用的护理人员自我效能的提高。结果表明，利用现有的育儿干预措施来促进健康的媒体使用习惯可能是最大限度地接触有外化行为儿童的家庭的有希望的途径。

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引用次数: 0

Implementation and Adaptations of Written Exposure Therapy: Lessons Learned Across Settings 书面暴露疗法的实施与调整：不同环境下的经验教训

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-04-20 DOI: 10.1016/j.cbpra.2024.02.001

Sadie E. Larsen, Arthur R. Andrews III , Millie C. Astin , Kristen E. Lamp , Jenny Y. Lee , Stephen E. Melka, Samuel J. Shepard , Nancy A. Skopp

Written Exposure Therapy (WET) is a promising evidence-based psychotherapy (EBP) for posttraumatic stress disorder (PTSD), in part because it is less time-intensive (i.e., five sessions with no between-session assignments) and has lower dropout than other first-line PTSD psychotherapies. As such, WET has the potential to improve access to quality care and reduce attrition, particularly among difficult-to-reach populations (e.g., veterans, military service members, and minoritized groups). The process of effectively translating WET to diverse practice settings is likely to require the development of customized treatment-congruent adaptations to facilitate access to care and the uptake of the intervention.

This article outlines several recent efforts to implement WET in novel ways, while maintaining an emphasis on fidelity to the core mechanisms of the treatment. Implementation efforts include a cultural center with Spanish-speaking immigrants, active-duty military behavioral health, technology-based approaches, and group format in residential and outpatient Veterans Affairs (VA) settings. We will review lessons learned and program evaluation data from the included sites and will offer suggestions for clinic administrators and providers hoping to implement WET.

书面暴露疗法（WET）是治疗创伤后应激障碍（PTSD）的一种很有前途的循证心理疗法（EBP），部分原因是它比其他一线创伤后应激障碍心理疗法需要更少的时间（即5个疗程，没有间歇任务）和更低的退出率。因此，WET有可能改善获得优质护理的机会，减少人员流失，特别是在难以接触到的人群中（例如，退伍军人、军人和少数民族群体）。有效地将WET转化为不同实践环境的过程可能需要开发与治疗一致的定制适应，以促进获得护理和采取干预措施。本文概述了最近以新颖方式实施WET的几项努力，同时强调对治疗核心机制的忠诚。实施工作包括建立一个西班牙语移民文化中心、现役军人行为健康、以技术为基础的方法，以及在退伍军人事务部（VA）的住宿和门诊环境中建立小组形式。我们将回顾从纳入的站点获得的经验教训和项目评估数据，并为希望实施WET的诊所管理者和提供者提供建议。

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引用次数: 0

Using an App-Based Mindfulness Intervention: A Mixed Methods Approach 使用基于应用程序的正念干预：混合方法

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-04-09 DOI: 10.1016/j.cbpra.2024.03.001

Stephen L. Wright, Emily Bach, Stephen P. Bryson, Sarah Schaller, Dorothy Wright

Mindfulness-based practices are often utilized and substantial research supports the continued use of these practices as effective interventions. Mindfulness interventions that utilize focused breathing, app-based guidance, and brief duration may present mental health benefits. However, examining individuals’ unique experiences from continued engagement in brief app-based mindfulness interventions over time, as well as identifying potential barriers preventing the use, is understudied. The current study utilized a longitudinal mixed method design to understand the experiences of individuals using a widely available app-based (i.e., Apple Watch) mindfulness breathing intervention over a 2-week period by identifying the thematic patterns common among the individuals and how this affected their levels of depression, anxiety, and coping skills over time. Qualitative analysis revealed a general positive experience among the participants, as well as the importance of personalization related to mindfulness interventions. Quantitative findings indicated a significant increase in coping skills, but no substantial change in their levels of depression or anxiety after 2 weeks. Researchers should continue examining interventions that include the core aspects of mindfulness, while exploring variations of mindfulness duration, frequency, total length, and breath rate to determine maximum efficacy. Practice-based interventions should focus on the effective ways to implement app-based self-guided mindfulness interventions, such as being short in duration, personalized for daily use, and aligning the practice with key components of mindfulness.

基于正念的练习经常被使用，大量的研究支持继续使用这些练习作为有效的干预措施。正念干预利用集中呼吸、基于应用程序的指导和短暂的持续时间可能会带来心理健康益处。然而，随着时间的推移，通过持续参与基于应用程序的简短正念干预来检查个人的独特体验，以及识别阻止使用的潜在障碍，目前还没有得到充分的研究。目前的研究采用纵向混合方法设计，通过确定个体之间常见的主题模式，以及随着时间的推移，这如何影响他们的抑郁、焦虑水平和应对技能，了解个体在两周内使用广泛使用的基于应用程序（即Apple Watch）的正念呼吸干预的体验。定性分析揭示了参与者普遍的积极体验，以及与正念干预相关的个性化的重要性。定量研究结果表明，两周后，他们的应对技能显著提高，但抑郁或焦虑水平没有实质性变化。研究人员应该继续研究包括正念核心方面的干预措施，同时探索正念持续时间、频率、总长度和呼吸频率的变化，以确定最大功效。基于实践的干预应侧重于实施基于应用程序的自我引导正念干预的有效方法，例如持续时间短，日常使用个性化，以及将练习与正念的关键组成部分相结合。

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引用次数: 0

Applications of Cognitive Processing Therapy to Post-Injury PTSD: A Case Study 认知加工疗法在受伤后创伤后应激障碍中的应用：案例研究

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-04-09 DOI: 10.1016/j.cbpra.2024.01.006

Sacha McBain, Rhea Mundle, Philip Held

Approximately one in three traumatically injured patients will go on to experience post-injury posttraumatic stress disorder (PTSD) and/or depression within a year of injury. In many cases, the nature of a traumatic injury itself constitutes a traumatic event. Traumatic injuries are often followed by subsequent potentially traumatic medical events (i.e., medical trauma) that may characterize post-injury recovery. Adequately addressing the complex biopsychosocial needs of traumatically injured patients in a traditional mental health setting can be challenging. The goal of this case study is to provide mental health professionals additional guidance to meet the needs of traumatically injured patients, including strategies to concurrently treat trauma-related symptoms and aspects of physical recovery that can elicit trauma cues. Specifically, this case study provides guidance to clinicians on the conceptualization and treatment of post-injury PTSD, with a specific focus on medical traumatic stress reactions (i.e., distress related to hospitalization, recovery, and adjustment to injury/disability). To demonstrate clinical considerations and applications of Cognitive Processing Therapy to post-injury PTSD, we focus on the experiences and treatment considerations of a fictional patient who represents an amalgamation of patients the authors have encountered in their clinical practice. Future directions for clinical practice and research to address medical traumatic stress are also discussed.

大约三分之一的创伤患者会在受伤后一年内经历创伤后应激障碍（PTSD）和/或抑郁症。在许多情况下，创伤性伤害的性质本身就构成创伤性事件。创伤性损伤之后往往伴随着随后的潜在创伤性医疗事件（即医疗创伤），这可能是损伤后恢复的特征。在传统的心理健康环境中，充分解决创伤患者复杂的生物心理社会需求可能具有挑战性。本案例研究的目的是为心理健康专业人员提供额外的指导，以满足创伤损伤患者的需求，包括同时治疗创伤相关症状和可能引发创伤线索的身体恢复方面的策略。具体而言，本案例研究为临床医生提供了创伤后应激障碍的概念化和治疗指导，特别关注医疗创伤应激反应（即与住院、康复和适应伤害/残疾相关的痛苦）。为了证明认知加工疗法在创伤后创伤后应激障碍中的临床应用，我们将重点放在一个虚构患者的经历和治疗考虑上，他代表了作者在临床实践中遇到的患者的融合。讨论了今后治疗创伤性应激的临床实践和研究方向。

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引用次数: 0

A Special Issue on Applications of Cognitive Behavioral Therapy to Psychological Disorders and Comorbid Medical Conditions in Pediatric Patients 认知行为疗法在儿科患者心理障碍和合并症中的应用特刊

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-04-05 DOI: 10.1016/j.cbpra.2024.04.001

Laura A. Payne, Robert D. Friedberg

引用次数: 0

The Application of Cognitive Behavioral Therapy for Adolescent Patients With Endometriosis: A Topical Review 认知行为疗法在青少年子宫内膜异位症患者中的应用：专题综述

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-03-06 DOI: 10.1016/j.cbpra.2024.01.005

Claire E. Lunde, Ziyan Wu, Andrea Reinecke, Christine B. Sieberg

Recent advances and interest in nonpharmacological treatment approaches for various chronic pain conditions in adolescent patients have increased. Cognitive behavioral therapy (CBT) is widely regarded as the leading nonpharmacological treatment for chronic pain, encompassing gynecological conditions associated with chronic pelvic pain, such as endometriosis. Adolescents with endometriosis often present with different symptoms than adults and frequently report more comorbid psychiatric disorders than the general public. This review aims to (1) justify the application of CBT interventions in the context of adolescent patients with endometriosis; (2) integrate and analyze existing empirical evidence and reviews; (3) highlight the advantages, constraints, and future research directions in CBT for this demographic; and (4) introduce a novel biopsychosocial conceptual model. This model intricately considers the interplay of thoughts, emotions, behaviors, and physical symptoms specific to adolescents with endometriosis, providing a foundation for targeted CBT interventions. This holistic approach recognizes the multifaceted nature of their experience, paving the way for comprehensive and effective nonpharmacological therapeutic strategies. Given the nuanced and intricate nature of endometriosis in adolescents, there is a pressing need for innovative conceptual models and clinical trials of behavioral interventions explicitly designed for this demographic.

最近，针对青少年患者各种慢性疼痛病症的非药物治疗方法取得了越来越多的进展，人们对这种治疗方法的兴趣也越来越浓厚。认知行为疗法（CBT）被广泛认为是治疗慢性疼痛的主要非药物疗法，包括与慢性盆腔疼痛相关的妇科疾病，如子宫内膜异位症。患有子宫内膜异位症的青少年通常表现出与成年人不同的症状，并且经常比普通人合并更多的精神疾病。本综述旨在：（1）证明在青少年子宫内膜异位症患者中应用 CBT 干预的合理性；（2）整合并分析现有的实证证据和综述；（3）强调针对该人群的 CBT 的优势、限制因素和未来研究方向；以及（4）介绍一种新的生物-心理-社会概念模型。该模型综合考虑了患有子宫内膜异位症的青少年特有的思想、情绪、行为和身体症状的相互作用，为有针对性的 CBT 干预提供了基础。这种整体方法认识到了患者经历的多面性，为全面有效的非药物治疗策略铺平了道路。鉴于青少年子宫内膜异位症的细微差别和错综复杂的性质，我们迫切需要创新的概念模型和明确针对这一人群设计的行为干预临床试验。

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引用次数: 0

Applying Principles of Cognitive Behavioral Therapy to Support Caregivers of Children With Cancer 运用认知行为疗法的原则为癌症儿童护理者提供支持

IF 2.9 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice

Pub Date : 2024-02-29 DOI: 10.1016/j.cbpra.2024.01.004

Christina G. Salley, Glynnis A. McDonnell, Kendra R. Parris

Caregivers of children with cancer face a myriad of stressors related to caring for their child that can place them at risk for mental health concerns above and beyond that of the average adult. Additionally, they grapple with the existential distress caused by the possibility that they may outlive their child. Caregiver distress is not only problematic for their own emotional, spiritual, social, and physical well-being, but also affects the family unit and can interfere with aspects of the child’s treatment. Clinicians trained in cognitive behavioral therapy (CBT) are well suited to support caregivers. Moreover, there is a strong evidence base for using interventions that incorporate cognitive and behavioral approaches with caregivers of children with cancer. We describe CBT’s application to this population through several case examples and also highlight important special considerations.

癌症患儿的照顾者在照顾孩子的过程中面临着无数的压力，这些压力会使他们面临比普通成年人更多的心理健康问题。此外，他们还要努力应对因自己可能比孩子长寿而造成的生存困扰。照顾者的苦恼不仅会影响他们自身的情绪、精神、社交和身体健康，还会影响家庭单元，并可能干扰孩子的治疗。接受过认知行为疗法 (CBT) 培训的临床医生非常适合为照顾者提供支持。此外，对癌症患儿的照顾者采取结合认知和行为方法的干预措施也有很强的证据基础。我们将通过几个案例介绍 CBT 在这一人群中的应用，并强调一些重要的特别注意事项。

引用次数: 0