摘要
目的:剖析一名心理咨询师对由配偶及儿子陪同的一位老年痴呆中期男性进行心理咨询的全程,更有效地帮助老年痴呆男性改善症状,提高晚年生活质量。方法:在重庆市对一位老年痴呆中期男性由家人陪同咨询面谈,求助者,男性,79岁,高中文化水平,两年前出现迷路、记忆减退,2014年春节单位体检结果示无重大躯体疾病。1969年曾有短期精神异常,家族无精神疾病史。根据收集的资料,该求助者老年痴呆症明显;从情绪、行为、认知的反应判断,情绪表现为抑郁状态;行为表现无意识重复行为增多、捡拾烟头、吐痰,不愿与人交往;认知上与人交流回应冷漠。简明智能精神评定量表、社会自主生活能力以及汉密尔顿抑郁量表等心理测验结果分别为16,44和11分,综合分析所获得的资料,求助者目前的表现属于老年痴呆精神障碍的范畴。咨询师主要采用丰富环境的理论,充分利用环境的舒缓与有益刺激反馈作用,从认知、情绪、行为上对求助者以及对求助者有重大影响的配偶及儿子进行干预和心理咨询。结果:经过6个月以丰富环境理论指导下的心理干预,求助者精神上得到尊重,抑郁情绪减少,无意识的重复行为明显减少,再次做简明智能精神评定量表、社会自主生活能力以及汉密尔顿抑郁量表等心理测验得分为23,39和9分,测试结果表明咨询者处于接近健康人的抑郁情绪状态;定向能力评分增高3分,与家人的交流互动回应正确率提高。结论:应用丰富环境理论,在家人亲密关系的配合下,可能是一种有效、低风险、低支出的改善老年痴呆的心理干预手段。
Objective：To analyze the whole process of a psychological consultation in which a male senile dementia patient accompanied by his spouse and son.The aim is to help the senile patent ameliorate the symptoms and improve the quality of life in the following years.Methods：From March to September in 2014,a consultant made a consultation to a male senile dementia at the middle stage from Chongqing and accompanied by his family members.The senile dementia patient was 79 years old,and graduated from high-middle school.He lost his way in two years ago and experienced the progressive memory decrease.He has no history of major physical disease;he ever had emotional disturbance for two months in 1969,but no family psychiatry history.According to collected information on client,the judge is the client has the senile dementia,at the same time,the mood is in depression,he has many unconscious and repeated behaviors,such as picking up cigarette head,spitting,zipping and so on.He had no willing to contact with family member or others.The client was evaluated by scales of mini-mental state examination（MMSE）,Activity of daily living（ADL）and Hamilton depression scale（HAMD）before and after the consultation.The score of Mini-mental state examination（MMSE）,Activity of daily living（ADL）and Hamilton depression scale（HAMD）were 16,44 and 11,respectively.The psychiatric diagnosis is mental disorder of senile dementia.The consultant mainly used enriched environment theory,introduced the family member to make the best use of the effective stimulus of comfort surrounding to help the client to response positively with the remanent cognitive ability.Results：After 6months psychiatric introduction of enriched environment theory,the client have the feeling of respect,the mood of depression is decrease,and the unconscious behaviors significantly reduced.The score of Mini-mental state examination（MMSE）,Activity of daily living（ADL）and Hamilton depression scale（HAMD）were 23,39 and 9.The symptoms of client amel
出处
《中国健康心理学杂志》
2016年第2期317-320,F0003,共5页
China Journal of Health Psychology
基金
国家自然基金项目(编号:30800299)
关键词
心理咨询
丰富环境
心理干预
老年痴呆
Consultation
Enriched environment
Psychological intervention
Senile dementia
