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Korean Journal of Schizophrenia Research 2011;14(1):5-12.
간간정신분열병 인지 치료의 이론과 치료 기법들
Dong-Eun Lee, MD, PhD
Abstract
Objects : The cognitive therapy of schizophrenia has been developed as a psychological therapy for the drug resistant patients with schizophrenia. Nowadays the therapy also is being applied to acute phase patients with psychotic disorder and prodromal stage of early psychosis. This article aims to introduce the theory and therapeutic techniques of cognitive therapy of schizophrenia to Korean psychiatrist and mental health professionals.
Methods: Published books and international and domestic articles are referred to explain the basic concepts and therapeutic techniques of cognitive therapy for schizophrenia in detail.
Results: Firstly the cognitive therapists should engage and develop the therapeutic alliance with patients, and then deal with the psychotic symptoms of them based on this relationship. Usually the cognitive therapists use some conversation and therapeutic skills to prompt the reality testing to deal with delusion. There are some techniques such as inductive questioning and reasoning to attenuate delusional beliefs. In the case of persistent delusion, the therapist should be able to deal with the main psychological issues of patient which are discovered during the sessions through the techniques like inference chaining. In the cognitive therapy of schizophrenia, hallucinations are conceptualized as automatic thoughts. When the cognitive therapists work with the hallucinations, they should get through two steps. The first step is to reattribute the origin of hallucination and the second is to develop the coping strategies. There are some specific cognitive coping strategies such as voice record and developing a dialogue with hallucinations.
Conclusions : The cognitive therapists who are well-trained can work with patients who have delusions and hallucinations based on good therapeutic alliance very successfully. The cognitive therapy of schizophrenia will be able to reduce the distress of patients with schizophrenia. (Korean J Schizophr Res 2011;14:5-12)
Key Words: Schizophrenia , Cognitive therapy , Normalization , Socratic questioning , Inference chaining.
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