跨文化背景下的 CBT 功能分析:根据 SECCA 模型的异时性和同步性;探索跨文化适应的理论模型

IF 0.5 4区 医学 Q4 PSYCHIATRY Annales medico-psychologiques Pub Date : 2024-09-01 DOI:10.1016/j.amp.2024.05.002
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引用次数: 0

摘要

引言 认知与行为疗法(CBT)根据结构化的、经过验证的方案,从认知、行为和情感层面探讨与心理障碍有关的思维模式。早在功能分析(FA)的初始阶段,患者的文化表征就会受到质疑,从而使 CBT 模式适用于跨文化情况。同步分析(Synchrony)以科特劳(Cottraux)的 SECCA 模型为基础,研究与问题情境相关的认知、情感和信念。Diachrony 收集与失调症有关的结构性数据和异常数据。通过调整 SECCA 模型和非同步阅读网格,FA 可以适应跨文化情况,考虑到与文化、流亡、迁移、病因学模型、治疗路线、疾病的传统治疗方法以及患者的表述和信仰有关的方面。讨论在跨文化背景下对 FA 的调整提出了有关表象、信仰体系、个人以及患者集体历史的问题。提高临床医生对 CBT 中文化问题的认识,有助于他们更好地理解文化问题对精神障碍的临床表现以及患者对精神障碍的概念化的影响,而不是刻板印象和治疗师自己的表述。结论以这种方式概念化的 FA 理论模型考虑到了患者的主观性,将跨文化方法与认知行为方法相结合;从而使我们能够适应全球患者及其独特性。
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L’Analyse Fonctionnelle en TCC en contexte transculturel : diachronie et synchronie selon le modèle SECCA ; exploration d’un modèle théorique d’adaptation transculturelle

Introduction

Cognitive and Behavioral Therapies (CBT) explore thought patterns related to psychological disorders, acting on the cognitive, behavioral, and emotional levels, according to structured and validated protocols. The patient's cultural representations can be questioned as early as the initial stage of Functional Analysis (FA), enabling CBT models to be adapted to transcultural situations.

Context

FA examines the disorder and its context. Synchrony, based on Cottraux's SECCA model, addresses the cognitions, emotions and beliefs associated with the problematic situation. Diachrony collects structural and anamnestic data related to the disorder. A model of FA can be proposed in a transcultural context, taking into account the social and cultural construction of the symptom, illness, disorder or crisis.

Methodology

By adapting the SECCA model and the diachronic reading grid, FA is adjusted to the transcultural situation, considering aspects relating to culture, exile, migration, the etiological model, the therapeutic itinerary, the traditional treatment of the illness, and the patient's representations and beliefs. It also questions the notion of family and affiliations, transmission, and what, for some patients, is the “invisible world”.

Discussion

The adjustment of FA in a transcultural context raises questions about representations, belief systems and the individual, and the collective history of the patient. Raising the clinicians’ awareness of the cultural issue in CBT helps them to better understand its influence on the clinical expression of psychiatric disorders and their conceptualization by patients, over and above stereotypes and the therapist's own representations.

Conclusion

The theoretical model of FA conceptualized in this way takes into account the subjectivity of the patient, combining the transcultural approach with cognitive-behavioral methodology; and thus making it possible to adapt to our global patients and their singularities.

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来源期刊
Annales medico-psychologiques
Annales medico-psychologiques 医学-精神病学
CiteScore
1.30
自引率
33.30%
发文量
196
审稿时长
4-8 weeks
期刊介绍: The Annales Médico-Psychologiques is a peer-reviewed medical journal covering the field of psychiatry. Articles are published in French or in English. The journal was established in 1843 and is published by Elsevier on behalf of the Société Médico-Psychologique. The journal publishes 10 times a year original articles covering biological, genetic, psychological, forensic and cultural issues relevant to the diagnosis and treatment of mental illness, as well as peer reviewed articles that have been presented and discussed during meetings of the Société Médico-Psychologique.To report on the major currents of thought of contemporary psychiatry, and to publish clinical and biological research of international standard, these are the aims of the Annales Médico-Psychologiques.
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