社会心理干预服务课件

PsychosocialMentalHealthAftercareServicesJohnR.Bola,Ph.D.SchoolofSocialWorkUniversityofSouthernCaliforniaUSA社会心理干预服务CausalModelsBiomedicaldisease?orBio-psycho-socialStress-vulnerabilitymodel?生理疾病？或生理-心理-社会模式还是压力应对的模式？对病原的解释AdvantagesofBiologicalDiseaseModelSimplicityChemicalimbalanceReducedresponsibilityandself-blameStigmamanagement简单由化学元素不平衡导致责任及自我指责的减少对歧视的处理生理疾病模式的优点SuppressionofsymptomsNotacureSide-effects只是抑制症状不能治愈副作用Over-RelianceonMedication过分依赖药物Advantages:MultidirectionalcausalinfluencesPrimarysocialandpsychologicalinterventions益处多方位考虑原因以社会和心理干预为主Bio-Psycho-SocialModelofMentalIllness生理-心理-社会模式ReducestressIncreasesupportComprehensiveframeworkforintervention减少压力增加支持全面的干预架构Stress-VulnerabilityModel

压力诱因模式ContinuumofMentalHealthServicesLeastrestrictiveenvironmentMaximizefunctionalrecoveryCommunity-based少受环境限制增强功能恢复以社区为依托心理健康服务的连续性UsingbestavailableevidenceMorehelpfultopeopleMoreeffectiveforsociety利用现存最佳的科学证据对患者和家人多提供有效的帮助对社会更有效益Evidence-BasedPractice循证实践UsebestevidenceTestAdaptservicestolocalconditionsandculture

使用最佳科研证据测试其可行性调整服务，使其适应本地实际情况DevelopingServices发展服务PsychosocialTreatmentsforSchizophreniaFamilymutualsupportClientself-helpAssertiveCommunityTreatment(ACT)SupportedEmployment家庭互助患者互助社区积极治疗就业支持对精神分裂症病患的其他社会心理治疗FamilyPsychoeducationReducesrelapse,improvessocialfunctioningandreducescaregiverburden.RecognizesandusesastrengthofChineseculture–thevalueofthefamily.减少复发，提高社会功能，减少照顾者的负担肯定和利用中国传统文化的力量-家庭的价值家庭心理教育CochraneSystematicReview

(Pharoahetal.2005)DecreasedrelapseRR0.72[CI:0.6-0.8]NNT7ImprovedmedicationcomplianceRR0.74[CI:0.6-0.9]NNT7Nocleareffectondropoutorsuicide减少复发机会提高接受药物治疗的程度对自杀和退出没有明显效果Cochrane系统回顾EducationalContentSchizophrenia (stress-diathesismodel)SymptomsCourse(prognosis)Treatment(medications,stressmanagement,familyandsocialrelations,stigma)Relapseprevention精神分裂症（压力诱因模式）症状病程（预后）治疗（药物，压力处理，家庭于社会关系，歧视）预防复发教育的内容EducationalContentII.Problem-solvingEmotionalsupportCrisismanagementSupportimprovedfamilyfunctioning解决问题情感支持危机处理提高家庭的功能教育的内容之二Reductionin“ExpressedEmotion”Critical/hostileOver-involved减少“表达情感”批评/责怪过分介入EducationalContentIII.教育的内容之三Inpatientdosagereductiontrial?Whatistheleaseeffectivedosageofmedications?Isitfeasibleandinstructivetoreduceinpatientdosage?Stresslikelytoincreaseupondischarge.

药物的最少剂量？减少住院病人药物剂量的可行性？出院时的压力有可能增大住院病人减少药物剂量的实验SymptomManagementSymptomrecognitionSymptom-medicationrelationshipSymptom-stressrelationship认识症状症状与药物的关系压力与症状的关系症状的处理DischargePlanningLivingarrangements?Socialandoccupationalconsiderations?Outpatientservices (medication, casemanagement)Continuityofhelpingrelationships?居住安排如何？社会及职业的考虑？门诊服务（药物，个案管理）帮助关系的延续？出院安排ContinuityofTreatmentDevelopongoing,supportive,andtrustingrelationshipwithfamily.Increaseunderstanding,compliance,likelihoodoflatercontactifneeded.

发展与家人持续的支持及信任关系增强了解,合作及以后需要时的联系治疗的延续SocialWorkand

PsychiatryFurtheringcollaborativerelationshipsRecognitionofcomplimentarystrengthsSharedcommitmenttobestclientoutcomes推动合作关系承认相互的互补性以病患的最高利益为己任社会工作者

与精神科医生PsychosocialinterventionsManagementofsocialservicesSocialscienceresearch社会心理干预社会服务管理社会科学研究SocialWork

MentalHealthProfessionalEducation社会工作和社会福利Objectives:introducetheconceptsofmentalillnessesandpsychosocialrehabilitationtosocialworkpractitionersandstudents.Fostercooperativeinter-professionalrelationships(e.g.,psychiatry,psychology,nursing..)inthetreatmentofmentalillness.目标：本课程旨在向不熟悉精神健康社会工作实践的社会工作从业者和学生介绍精神疾病和社会心理康复的基本概念。同时也希望在整合性治疗方法的学习过程中向其他专业人士，如精神科医生，心理医生，护士和职业治疗师介绍社会工作者在其中扮演的角色。SocialWorkMentalHealthCurriculum发展中国心理健康教学大纲Contents内容心理疾病：定义及流行程度

(I)心理疾病：定义及流行程度(II)社会心理康复的概念和社会工作者的角色文化在精神疾病中的角色心理健康的政策和服务MentalIllness:DefinitionsandPrevalenceEstimates(I)MentalIllness:DefinitionsandPrevalenceEstimates(II)ConceptsofPsychosocialRehabilitationandtherolesofsocialworkersTheRoleofCultureintheConceptualizationofMentalIllnessMentalHealthPolicyandServicesContents内容对心理疾病的生理干预对精神疾病的社会心理干预对心理疾病的社会态度：歧视融生理，心理和社会成分的综合干预方式家庭在照顾精神病患者中的角色在心理健康服务方面的跨领域合作（精神科医生，心理医生，社工，护士等）BiologicalInterventionsforMentalIllnessPsychosocialInterventionsforMentalIllnessSocialAttitudestowardstheMentallyIll:StigmaIntegratingBiologicalPsychologicalandSocialComponentsofMentalHealthServicesTheRoleofFamilyinCareandTreatmentoftheMentallyIllInterdisciplinaryCollaborationinMentalHealthServices(Psychiatry,Psychology,

SocialWork,Nursing,etc.)

FormatandAssessment

形式与评估方式Format:Thesessionsareconductedintheformatoflectures,roleplaysanddiscussions.Eachsessionlastsfortwohours,andcanberunonaweeklybasisorasasandwichedcourse.Assessment: Inordertobegrantedacertificatefromtheorganizers,participantsmustattendatleast80%oftheclasses,andcompletetwoassign