SkillsforPsychologicalRecovery-ZC-双语.ppt

Skills for Psychological Recovery 心理康复技能 Field Operations Guide 实际操作指南,National Center for PTSD 美国创伤后应激障碍中心 National Child Traumatic Stress Network 国力儿童创伤医疗网 SAMHSA 药物滥用和心理健康管理局,Skills for Psychological Recovery (SPR) 心理康复技术（SPR),Developed from professional literature and experience at times of disaster. 源于专业文献和从多次灾难中总结出的经验 Designed to improve resilience and helping recovery. 旨在促进和帮助恢复。 Help children, adolescents, adults, and families in the weeks and months after disaster. 在灾后数周和数月内帮助受灾的儿童、青少年、成年人以及家人。,Skills for Psychological Recovery 心理康复技术,Used after the time period of Psychological First Aid. 在心理急救期的有效期后使用。 Is used when more intensive intervention is needed. 在需要集中治疗的情况下使用。 Helps survivors gain skills to reduce ongoing distress and cope more effectively. 帮助幸存者找到释放和有效缓解心里压力的技巧。,Skills for Psychological Recovery 心理康复技术,Designed to speed up recovery and increase self-care. 用于加速恢复并加强自我照顾。 Skills building is often more effective than counselling at this time. 此时培养技巧通常比心理咨询更为有效。 It does not assume pathology instead emphasizes helping survivor gain a sense of control and competence. 不属于病理学的范畴，而是强调帮助幸存者获得控制感和胜任感。,Skills of Psychological Recovery 心理康复技术,Is designed to be effective with just one session with a survivor, if necessary. 如果必要的话，对幸存者仅仅在一 个疗程内产生效果。 Is better if can be done for three to five sessions. 如果能治疗3-5个疗程会更好。,Skills for Psychological Recovery: Goals 心理康复技术：目的,Protect mental health of disaster survivors. 保护灾后幸存者的精神健康。 Improve survivors abilities to address their needs and concerns. 提高幸存者满足自身需要和自我关心的能力。 Teach skills to promote the recovery. 传授促进恢复的技巧。 Prevent maladaptive behaviors while supporting adaptive behaviors. 阻止不良行为，鼓励良好行为。,Skills for Psychological Recovery: Methods 心理康复技术：方法,Building Problem-Solving Skills 培养解决问题的技巧 Promoting Positive Activities 促进积极的行为 Managing Distressing Reactions 调节痛苦的情绪 Promoting Helpful Thinking 促进有益的想法 Rebuild Healthy Social Connections 重新建立健康的社会关系,Skills for Psychological Recovery 心理康复技术,It is not meant to be formal mental health 不是正式的精神健康恢复技巧 It is a more specialized intervention designed to: 它更多是一种专业的干预治疗，用于： reduce distress 减轻痛苦 identify existing coping skills 确定目前的适应技能 Improve functioning 提高能力 Potentially lower need for formal mental health treatment 可能比正式的精神治疗需求少 If possible, try to have at least 45-minutes with the person you are helping. 可以的话不妨试下与你帮助的人共处45分钟。,Delivering Assistance 传递帮助,Develop good rapport. 发展友好的关系。 Gather information about a survivors reactions, needs and resources. 采集幸存者情绪、需求和物资方面的信息。 Teach core skills to survivors. 给幸存者传授核心技巧。 Tailor the skills taught to address their specific concerns. 对传授的技巧做灵活的处理，以解决他们的特殊的担忧。 Try to schedule more than one session if possible. 如果可能试着多安排几个疗程。,Delivering Assistance 传递帮助,Goal is to respond to survivors in a compassionate and helpful manner. 目的是用饱含同情心的或者是有益的方式来满足幸存者需要。 Establish a practical, skills-oriented approach. 形成一个切合实际的、以技巧为导向的方法。 Prepare individuals to participate. 个人做好参与的准备。 Practice active listening, validate concerns, and demonstrate empathy. 积极倾听、有效的关心和表示同情。,Delivering Assistance 传递帮助,Goal is to respond to survivors in a compassionate and helpful manner. 目的是用饱含同情心的或者是有用的方式来满足幸存者需要。 Encourage perseverance and motivation. 鼓励坚持不懈和积极性的信心。 Identify and strengthen existing positive traits and coping skills. 识别并加强现存的正面信号和相适应的技巧。 Do remember you can only do so much in a short time. Do the best you can with the time you have with the survivor. 切记，在短时间内你能做的只有这么多，在你与幸存者在一起的时间内，尽力做好。,Introduction to Adults 对成年人做的介绍,“I would like to describe how we might work together today. You may have seen a therapist, but I will be more like a teacher. I am going to help you learn a set of skills that have been found to help people after difficult events. You and I are only going to meet a few times, so we will choose skills that meet your top priorities.” “今天我将描述我们是如何在一起工作的。 你可能见过临床医学家，但是我更像是一名老师。 我会帮助你学习一套为了帮助受灾人群而创立的技巧。 我和你们见面的机会不多， 因此我会选择能满足你们最迫切需要的技巧”。,Introduction: Adults 对成年人做的介绍,“First, well figure out together what are your most important needs and concerns. Then Ill introduce the skills, and youll choose which skill you think will make things better. Youll also decide how much time you have to learn these skills so you are in charge. I hope we can meet more than once, so we can check in on how you are doing and help you practice. How does that sound?” “首先， 我们需要一起找出你们重要的需求和担忧。 然后我就会给你们介绍技巧，并且你们要挑选出你们认为能够起到作用的技巧。 并且你们将决定自己在学习这些技巧上面花的时间-因此你们自己掌握。我希望我们还能够见面，这样我们就能检查你们学习的情况并且帮助你们练习。听起来怎么样？”,Introduction: Children 对儿童做的介绍,“Im glad you are here today. Im like a teacher or a coach and, because of what youve been through, Im going to teach you new ways to help your body be more relaxed, to feel stronger, and to have more fun again. First, I want to learn more about you and how youve been, and then we can start learning together.” “我很高兴你们能来到这里，我就像是一名老师或者是教练。考虑到你们的经历， 我将教你们学习新的方法，这样可以使你们的身体放松并且感到更强壮，也能让你们体会到乐趣。 首先， 我想更多的了解你们和你们已经经历的情况， 然后我们就能够一起开始学习了。”,Things to Consider 需要考虑的事情,How many contacts with the survivor will I have? 我与幸存者有多少次会面的机会? Do not plan too much for each visit. Teach one skill well. Do not overload the survivor. 不要对一次拜访的内容安排的太多。教一种技巧就行了。不要让幸存者超负荷的学习。 Should I work with an individual or group? 我应该是以个人还是群体为单位的方式工作？ Individual contact provides more focused intervention; Group classes can promote mutual support. 以个人为单位会提供更多集中的干预治疗，以群体为单位则能够促进相互支持。,Things to Consider 需要考虑的事情,Do I have parent permission? 我有经过父母的准许吗？ Is the survivor a good candidate for this approach? 幸存者会选择这种方法吗？ Not the best for: 不太适合于： Suicidal 有自杀倾向的 Danger to others 对他人有危害的 Psychotic 精神病患者 Severe cognitive impairment 认知功能损害严重者,Skill 1: Gathering Information and Prioritizing Assistance 技巧1： 采集信息， 按优先顺序提供帮助,Goal: To gather information to determine if there is a need for immediate referral within your agency or to other services, to understand the survivors most pressing needs and concerns, and to prioritize and plan intervention strategies 目的：采集信息，决定该信息是否对你所在的机构或其他服务机构急需。了解幸存者最紧迫的需要和担忧， 并按着轻重缓急计划干预策略。,Skill 1: Rationale 技巧1：基本原理,In the post-disaster period, survivors often deal with ongoing distress due to their disaster experiences and losses. 灾难后期，幸存者通常会因为灾难经历以及带来的损失 而遭受挥之不去的悲痛。 They may need assistance with immediate or long term medical or mental health conditions, be faced with a range of hardships and adversities, have concerns about safety, and experience difficulties in interpersonal and role functioning. 他们可能需要马上或者长期的治疗或者精神健康恢复， 面对着多种困难和逆境、 担忧自身的安全并且经历着人际交往方面的困难。,Skill 1: Steps 技巧1：步骤,After Explaining the Rationale for Information Gathering, actions to take include: 在阐释了信息采集的基本的原理后， 要采取如下行动： 1. Identify Current Needs and Concerns 识别此时的需要和担忧 2. Prioritize Areas to Address 解决问题的先后顺序 3. Make an Action Plan 制定行动计划 Handouts: SPR Screening Form; Skills Flowsheet 宣传品：心理恢复技巧审查记录表； 技巧流程图 Should take about 10 15 minutes to do this step. 这个步骤需要花费10-15分钟。,Skill 1: Explain Rationale 技巧1：阐述基本原理,To find out how I can best help you, may I ask you a few questions? If we identify the areas most important to you, then we can work together to address your most pressing concerns. Ill also ask how big each problem is for you now. But first, is there something you are really concerned about right now, that we should talk about first? 为了我能够最好地帮助你们，我可以问你们一些问题吗？如果我们能找到那些对你们最重要的问题所在，我们就能够一起处理你们最急切的担忧。我还会问你，每个问题对你来说现在有多严重。但是首先，我们应该讨论的是，现在你们真正很担忧的事情。,Step 1: Identify Needs and Concerns 步骤1：确认需要和担忧,Step 2: Prioritize Areas to Address 技巧2：解决问题的先后顺序,“Weve talked about a number of things. Let me try to summarize what weve said. It sounds like your major concerns right now are _. Have I got that right?” 我们已经 讨论了一些事情，让我试着总结我们之前所说的。 你们现在主要担忧的事情是_。 我说的对吗？ As the survivor what concern is most important at present. 对幸存者来说现在主要的担忧是什么。,Prioritize Areas to Address 解决问题的先后顺序,If they identify several high priority areas, help them decide which to work on first. 如果他们能够确定一些急切需要解决的问题，帮助他们确定哪个是需要首先解决的。 You may want to ask: 你们可能想问： Which one is bothering you the most? 哪个问题最困扰你？ Is there one which needs to be dealt with sooner than the others? 有比其他问题更需要尽快解决的吗？ Is there one that seems to be getting worse? 有正在变得严重的问题吗？,Prioritize Areas to Address 解决问题的先后顺序,Ask: 问题: Is there one you are most comfortable working with today? 今天你与谁在工作中相处的更融洽？ Is there something happening soon which might make things difficult for you that we should address first? 对你们来说有会使问题变得困难而且即将发生的我们首先要处理的事情吗？ Is there anything that has happened recently that made things worse, that would be helpful to address? 发生的事件最近有恶化的趋势吗？这将有助于问题的解决。,Prioritize Areas to Address 解决问题的先后顺序,To help decide what to focus on: 用来帮助确定重要的问题 What do they identify as being a major one? 他们认同的最主要的问题是什么？ What is causing serious distress or impairment? 什么导致了严重的悲痛和损害 Which one needs to be addressed sooner than the others? 相比其他问题，哪个问题是需要尽快处理的？ Is it worsening over time? 随着时间的过去，问题变得更糟糕了吗？,Prioritize Areas to Address 解决问题的先后顺序,To help decide what to focus on: 用来帮助确定重要的问题: Will addressing this problem reduce the other problems? 处理这个问题有助于解决其他问题吗？ Do they prefer to help this problem first? 他们更愿意首先解决这个问题吗? The survivor feels they have the strength to work on this problem now. 幸存者感觉到现在他们更加有能量处理这个问题了。,Step 3: Make An Action Plan 步骤3：制定行动计划,Determine if this problem can be helped with these skills, or if they have any other urgent medical or mental health concerns which should be addressed immediately. 决定这些技巧是否对解决这个问题有帮助，或者是有其他需要立即处理的健康或精神问题。,Make an Action Plan: 制定行动计划： Choose a Strategy 选择一种策略,Building Problem-Solving Skills A method to define a problem and goal, brainstorm a number of ways to solve it, evaluate those ways, then try out the solution that seems most likely to help. 培养解决问题的技巧-一种明确问题和目标的方法，集体讨论出解决问题的几种方法，评估这些方法，然后尝试最有用的方法。 Promoting Positive Activities A way to improve mood and functioning by identifying and engaging in positive and pleasurable activities. 促进积极的活动-一种通过参与到积极而令人愉悦的活动从而改善情绪和人际关系的方法。,Make an Action Plan: 制定行动计划： Choose a Strategy 选择一种策略,Managing Reactions Skills to cope with and reduce distressing physical and emotional reactions to upsetting situations 控制情绪-处理并缓解身体上和精神上的对令人厌倦的局面的痛苦反应的技巧 Promoting Helpful Thinking Steps to identify upsetting thoughts and to counter these thoughts with less upsetting ones 促进有益的想法-找出令人苦恼的想法并用相对好的想法来否定它们 Rebuilding Healthy Social Connections A way to rebuild positive relationships and community supports 建立健康的社会关系-一种重建积极关系和群众支持的方法。,Skill Flowchart 技巧工作表,Skill 2: Building Problem-Solving Skills 技巧2：培养解决问题的技巧,Goal: To help survivors prioritize and solve difficulties or problems. 目的：帮助幸存者找到优先需要解决的困难和问题，并解决,Skill 2: Building Problem-Solving Skills 技巧2：培养解决问题的技巧,Disasters often create many difficulties that can make survivors feel helpless or even immobilized in the face of numerous problems. Ongoing stress and pressures to “do something” can make it hard to step back and think effectively about the best way to handle a situation. Having a systematic way to solve problems can help survivors address problems more effectively, and regain a sense of control. 灾难往往会导致很多困境，这会让幸存者感到无助甚至在面对许多问题时会手足无措。 持续不断地感到要“做点啥”的这种压力，会使他们感到不能后退，并且产生有效地思考控制局面的最好方法。解决问题的系统的方法能够帮助幸存者很有效的处理问题，并且重新获得控制感。,Skill 2: Building Problem-Solving Skills 技巧2：培养解决问题的技巧,Use for: Survivors who identify concerns about: 作用于：有如下担忧的幸存者: Feeling overwhelmed or immobilized by multiple problems 面对重重问题感到不堪重负或者手足无措 Feeling helpless to come up with solutions that can solve their problems 想不到问题的解决办法，感到很无助 Feeling demoralized or lacking control over their situation 感到很泄气或者在局势面前失去控制 Family members who are having difficulty solving problems 家人中，有困难的人。,Skill 2: Building Problem-Solving Skills 技巧2：培养问题解决技巧,Handouts 宣传品 Adults: Problem-Solving Worksheet 成年人：问题解决的工作表 Children: Problem Busters Worksheet 儿童:问题解决的Busters工作表 Skill Steps After Explaining the Rationale for Problem-Solving: 阐述问题解决基本原理后的技巧步骤 1. Define the Problem/Decide Ownership 明确问题/决定的所有权 2. Set the Goal 制定目标 3. Brainstorm 集体讨论 4. Evaluate and Choose the Best Solutions 评估并选出最有效的解决方案,Problem-Solving Skills: Rationale 问题解决技巧：基本原理,Ongoing problems can lead to increased stress, cause negative mood, and negatively affect relationships with others (e.g., increased anger). 不断出现的问题会导致压力增大，从而产生负面情绪，给人际关系带来消极的影响。 The inability to solve problems could lead to people feeling hopeless and demoralized. 没有能力解决问题，会使人感到无助和泄气 Problem-solving allows survivors to break problems down into manageable chunks, helps them to decide which to work on first, and allows them to thoughtfully select the action to take. 允许幸存者把解决问题分成很多容易处理的小问题，从而帮助他们决定哪个是首先需要解决的，让他们思考行动方式的选择。,Problem-Solving Skills 问题解决技巧,Say to survivor: “A disaster creates so many difficulties that survivors often feel bad or helpless in the face of the many challenges. Today, we will discuss some steps that you can use to tackle your problems successfully. This approach allows you to think of a number of solutions to one problem, so you have a choice of what to do.” 告诉幸存者：“灾难会带来许多困难，常常会使幸存者在面临各种挑战的时候感到沮丧和无助。现在，我们来讨论一下能成功解决你问题的步骤。这种方法允许你针对一个问题想出多种解决方法。从而，你就能对该做什么做出选择。”,Problem Solving Skills 问题解决技巧,Next have them identify a problem to work on, then say: “ Im going to teach you a simple four-step way to tackle any problem that you want. If you use it, you can cut problems down to a manageable size. To show you how it works, lets tackle your problem using the four steps. While we come up with some things you can do to work on that problem, at the same time youll be learning a tool that you can use for any other kind of problem that youre facing. Any questions? 接下来，让幸存者确定一个问题并试着解决它。然后，告诉他/她：“我会教你一种简单的、用于解决任何你想解决问题的“四步法”。如果你采用这种方法，你能将问题减轻到可控制的范围内。为了演示这种方法是怎样起作用的，我们采用这四个步骤来解决你的问题。当遇到一些事情的时候，你就能解决相关的问题；同时，你还会学到一种方法，用于解决你面临的任何其他类型的问题。有任何疑问吗？,Problem Solving Skills 问题解决技巧,Then say: 然后说： “OK, the four steps are: (1) Define the Problem and Decide Ownership, (2) Set the Goal, (3) Brainstorm, and (4) Evaluate and Choose the Best Solutions.” “这四个步骤是： (1) 确定问题并决定归属； (2) 设定目标； (3) 集体讨论； (4) 评选出最佳解决方法。” Hand the survivor the Problem-Solving Worksheet 将问题解决工作表发给幸存者 Then say, “Now well work through the steps of problem-solving.” 然后说：“现在，我们来执行解决问题的四个步骤。”,Step 1: Define the Problem 第1步：明确问题,Use Problem-Solving Worksheets. 使用问题解决工作表 Have the survivor clearly define what he/she wants to work on in as much detail, and as concretely, as possible. Ask as many questions as you need to understand enough about the problem. 让幸存者尽可能详细、具体并清楚地定义他/她想要做的事情。问尽可能多的问题以便充分理解问题。 Help the survivor break big problems down into smaller problems. Focus on solving one part at a time 帮助幸存者将大问题分解成小问题。一次只集中解决一部分。,Many times people take on problems which are not theirs to fix. 很多时候人们会去承受一些并不属于他们承担范围内的问题。 Teach them how to determine if it is their problem to take on. How much of it is actually in their control? 应教会他们确定这些问题是不是他们应当承担的问题的方法。有多少是在他们实际控制能力范围之内的？ Teach them how to determine if it is their problem to take on. How much of it is actually in their control? 如果是其他人应当承受的问题，应让这些幸存者把注意力放在其他问题上。,Step 1: Define the Problem 第1步：明确问题,Step 2: Set the Goal 第2步：设定目标,Help them decide what they really want to happen or be different, or what they are concerned about. 帮助他们确定他们真的想要发生什么，或者什么应不同，或者他们担心什么。 Help them determine a goal that is clear and concrete. 帮助他们设定一个清晰并且具体的目标。 Example: “My family argues too much.” “I want more harmony in the family.” “I want to enjoy my breakfast in the morning with out arguing.” 示例：“我们家经常争吵。”“我希望家庭和谐。”“我希望早上吃饭的时候家人不要争吵。”,Step 3: Brainstorm 第3步：头脑风暴,Have the survivor come up with a number of possible options for meeting the goal. 让幸存者提出大量可实现目标的可能选项。 Brainstorming means spontaneously coming up with as many options as you can for solving the problem. While you may keep the potential consequences of each solution in mind, do not make judgments about any of the solutions. Simply write down each one on the Problem-Solving Worksheet. 头脑风暴是指自发提出你可以用于解决问题的尽可能多的选项。尽管你可以在大脑里记住每种解决方案的可能结果，但是不要对任何解决方案作出判断。你只需要将每种方案记录在问题解决工作表上。 If the survivor has difficulty identifying options, ask him/her to tell you how a respected friend, teacher, coworker, or family member, would handle the problem. 如果幸存者对确定选项有困难，请他/她向自己尊敬的朋友、老师、同事、或家人求助怎样解决。,Suggested Ideas to Assist 暗示可以协助的想法,Ways the person has solved this in the past 这个人在过去解决这种问题的方法 Ways of changing the situation 改变状况的方法 Learning new skills for difficult situations 学会处理困境的新技巧。 Getting help or support from other people 获得其他人的帮助或支持。 Getting additional services (have a list of available services to help you generate solutions) 获得额外服务（列出可用的服务清单以帮助你想出解决方案）,Suggested Ideas to Assist 暗示可以协助的想法,Ways of calming oneself 使自己平静下来的方法 Taking action on parts of the problem that are controllable 对问题可以控制的部分采取行动 Helpful things to say to oneself 对自己说有帮助的话 Solutions that extend or build on things that are already helping 在有益的事情上延伸或建立解决方案,Evaluate and Choose the Best Solution 评估和选择最佳解决方案,Have a discussion of the pros and cons of the various choices. 对多选择的正面和反面理由进行讨论 While the survivor could choose several solutions, encourage him/her to take small steps and to avoid an unrealistic plan of action. 尽管幸存者可以选择几种解决方案，应鼓励他/她采取较小步骤，避免不现实的行动方案,Evaluate and Choose the Best Solution 评估和选择最佳解决方案,Your role is to help shape his/her choices so that they are doable, practical, and beneficial, even if only partially, in solving the problem. 你的角色是帮助他们形成自己的选择，以使这些选择在解决问题时，具有或部分具有可行性、实际性和有益性。 Involve family members in the problem-solving if wanted. 如果家庭成员愿意，就让他们到问题解决中。 Ask them to commit to an action in the days ahead. 让他们在以后的日子里将行动付诸实践。,Follow-up Session: Review 后续跟踪治疗：评审,1. Which of the planned actions was the survivor able to take? What happenedwhat was the outcome? Was a short-term goal met, even partially? (If the survivor did not take steps to try out the solutions, explore the reasons for lack of follow-through, and consider changing the plan to make it more practical or doable.) 1.幸存者能够采取哪种规划方案？发生了什么-结果是什么？短期目标是否实现，或者部分实现？（如果幸存者未采取尝试解决方案措施，调查其不跟进的原因，并考虑改变方案以使方案更加实际和可行。）,Follow-up Session: Review 后续跟踪治疗：评审,2. What is the next step needed to address