Obsesif Kompulsif Bozuklukta; Klasik Bilişsel Davranışçı Terapi ve Yeni Nesil Kabul ve Kararlılık Terapisi, Karşılaştırmalı Müdahale Yaklaşımları

Year 2024, , 45 - 61, 30.01.2024

Ayşin Akdağ

https://doi.org/10.56955/bpd.1370907

Abstract

Obsesif Kompulsif Bozukluk (OKB), bireylerin yaşamlarını ve hayata dair yaşamsal işlevlerini farklı düzeylerde olumsuz etkileyen bir düşünce bozukluğudur. Bu derlemede, OKB' nin anlaşılması ve tedavisinde, klasik Bilişsel Davranışçı Terapi (BDT) ile BDT temelli yeni nesil çağdaş terapilerden Kabul ve Kararlılık Terapisi (KKT)’ nin temel özellikleri ve müdahalelerinin karşılaştırmalı gözden geçirilmesi amaçlanmıştır. Bu amaçla alanyazın incelenerek bu derleme yazılmıştır. Derlemede OKB’ nin tanımı ve yaygınlığına değinilmiş olup, OKB’ nin oluşumuna dair, birinci kuşak Davranışçı Terapi, ikinci kuşak Bilişsel Terapi ve yeni nesil /3.Kuşak terapi kuramlarından Kabul ve Kararlılık Terapisi (KKT)’ nin açıklamalarına ve kuramların karşılaştırmalı etkinlik araştırmalarına yer verilmiştir. OKB’ nin tedavisinde, birinci ve ikinci kuşağın bir arada ifade edildiği Klasik Bilişsel Davranışçı Terapi (BDT)’ de başat davranışçı teknik Maruz Bırakma ve Tepki Önleme (MBTÖ) , bilişsel müdahaleler için bilişsel çarpıtmalar, abartılmış sorumluluk, Düşünce Eylem Kaynaşma (DEK) ile ilişkili bilişsel yeniden yapılandırma çalışmaları ele alınmıştır. Kabul ve Kararlılık Terapisi (KKT), İlişkisel Çerçeve Kuramını esas alarak, bağlamsal zeminde altı psikolojik süreci kullanmaktadır. Bunlar; kabul, bilişsel ayrışma, bağlamsal benlik, şimdiki an ile temas, değerler, taahüt edilen eylemlerdir. KKT, klinik düzeyde sorunlu davranışları sadece biçimsel yönleriyle değil bunların işlevsel yönleriyle de ele alarak tedaviye yeni bir felsefi ve hümanistik yaklaşım sunar. Bu nedenle de bireye özel uygulamalar içerir. KKT’ inde terapist, BDT’de olduğu öğretici ve rehber konumundan, eşlik eden, bireye hayatının dümeninin kendinde olduğunu fark ettiren, bireyi tedaviye davet eden pozisyonda yer alır.

Keywords

Obesesif Kompulsif Bozukluk, Bilişsel Davranışçı Terapi, Bilişsel Terapi, Davranışçı Terapi, Kabul ve Kararlılık Terapisi

Classical Cognitive Behavioral Therapy and New Generation Acceptance and Commitment Therapy, Comparative Intervention Approaches in Obsessive Compulsive Disorder

Abstract

Obsessive Compulsive Disorder (OCD) is a thought disorder that negatively affects individuals' lives and vital functions at different levels. In this review, it is aimed to provide a comparative review of the basic features and interventions of classical Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT), one of the new generation contemporary therapies based on CBT, in the understanding and treatment of OCD. For this purpose, this review was written by reviewing the literature. In the review, the definition and prevalence of OCD are mentioned, and the explanations of first generation Behavioral Therapy, second generation Cognitive Therapy and Acceptance and Commitment Therapy (ACT) from the new generation / 3rd generation therapy theories and comparative effectiveness studies of the theories are included. In the treatment of OCD, the dominant behavioral technique in Classical Cognitive Behavioral Therapy (CBT), in which the first and second generations are expressed together, is Exposure and Response Prevention (ERP), and cognitive restructuring studies related to cognitive distortions, exaggerated responsibility, Thought Action Fusion (TAF) for cognitive interventions are discussed. Acceptance and Commitment Therapy (ACT), based on Relational Frame Theory, utilizes six psychological processes on a contextual basis. These are acceptance, cognitive dissociation, contextual self, contact with the present moment, values, and committed actions. ACT offers a new philosophical and humanistic approach to treatment by addressing problematic behaviors at the clinical level not only with their formal aspects but also with their functional aspects. Therefore, it includes individualized practices. In ACT, the therapist is in the position of accompanying the individual, making him/her realize that he/she is at the helm of his/her life and inviting the individual to treatment, instead of being the instructor and guide in CBT.

Keywords

Acceptance and Commitment Therapy, Behavioral Therapy, Cognitive Behavioral Therapy, Cognitive Therapy, Obessive Compulsive Disorder

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