动态解构心理疗法 Web-Based Training Program
介绍 to the Web-Based Training Program
This interactive program was developed to supplement training in dynamic deconstructive psychotherapy or DDP. DDP is an empirically supported 和 manual-based treatment initially developed for borderline personality disorder (BPD), but now applied across a broad range of chronic mental disorders, 比如慢性抑郁和焦虑, 早发性创伤后应激障碍, 饮食失调, 和上瘾. 看到 DDP培训手册.
This program includes video clips of psychotherapy sessions that illustrate principles 和 methods of DDP. Each vignette is an almost verbatim portrayal of an actual prerecorded patient-therapist interaction. 在制作电影的过程中, 我们使用了20次患者与治疗师的接触, encompassing 9 different patients 和 5 different therapists. Even though the patients have given explicit consent for the use of the recordings, I have taken the precaution of having actors play the patient roles in order to help protect their identity. So, you will see the same actor or actress playing the part of different patients in different vignettes. 此外，在每个小插图中. Georgian Mustata or I play the part of the therapist, regardless of whether or not we were the actual therapists for the patient. As a further precaution, identifying information has been edited out. So, 总之, each vignette represents a balance or compromise that provides as close approximation as possible to a previous, 实际的医患互动, 同时也要保密.
Treatment with DDP involves individual weekly sessions over 12 months 和 follows a manual-based protocol. 开始DDP前, I suggest reading all chapters in the treatment manual, 每周接受病例咨询, reviewing the vignettes in this series.
DDP targets two areas for remediation: 1) Deficits in the emotion processing system 和 2) An embedded sense of badness. 根据DDP理论, these two etiologies cause difficulties in specific neuroaffective capacities, 被称为 协会,归因, 短语. Treatment with DDP targets each of these neuroaffective capacities utilizing three sets of related techniques, i.e. 协会,归因 和 思考的技术. 看到 the first two chapters of the manual for a more comprehensive introduction.
治疗从评估开始, a formulation of difficulties 和 treatment goals, explicit written commitments to recovery (see Chapter 3, 建立框架). The goal is to foster a sense of ownership 和 autonomous motivation within patients for their own treatment 和 recovery. Clear boundaries, roles, expectations are also established early on. 在最初的几次会议之后, the principal focus is to foster verbalization of recent specific emotion-laden experiences, including identifying 和 labeling underlying emotions 和 sequencing interactions into simple narratives (协会技术). The therapist also tries to help the patient open up the meanings of these narratives by bringing in new perspectives for the patient to consider, while remaining generally non-directive 和 non-judgmental (归因技术). 除了, there is a strong experiential component to the treatment whereby emotion-laden interactions between the patient 和 therapist can either enact 和 reify the patient’s pathological schema, or can support self-other differentiation, 修复联盟的裂痕, 培养个性化的关系(思考的技术). Treatment progresses over four distinct stages, each characterized by specific therapy tasks 和 patterns of relatedness.
有问题的行为, 比如酗酒或自残, 被视为补偿性的吗, maladaptive efforts to self-soothe in the absence of verbal/symbolic 和 relational capacities. The therapist encourages verbalization of recent episodes of problematic behaviors, 包括祖先, 后果, 以及相关的情绪(参见 Managing Self-Destructive 和 Maladaptive Behaviors 在第八章中， 具体的技术).
I am hoping the video vignettes will bring to life some of the text in the treatment manual. The sequence of vignettes follows the same organization as employed 在第八章中， 特定的技术, 和 as employed in the DDP Adherence Scale in the 附录. 这是, we will begin with a group of vignettes illustrating 协会技术, 然后移动到Attributions, 理想的其他, 可能真正的,, 最后, 全景. 有关更多资源，请参阅main DDP网站.
罗伯特J. 格雷戈里,米.D.
精神病学高危项目主任
自杀预防中心主任
精神病学教授
Norton 医学院 上州医科大学