心理咨询门诊患者正念练习坚持性的质性研究

刘津君; 段维; 郑毓晨; 肖泽萍; 吴艳茹

doi:10.19428/j.cnki.sjpm.2023.22682

心理咨询门诊患者正念练习坚持性的质性研究

Qualitative research on the adherence of mindfulness practice in psychological counseling outpatients

摘要

摘要:
目的探究心理咨询门诊患者在正念认知团体治疗（MBCT）结束后正式练习坚持性的阻碍和促进因素。
方法 15名自愿参加上海市精神卫生中心MBCT且结束治疗≥5个月的心理咨询门诊患者接受一对一访谈，采用主题分析法分析访谈文本。
结果情绪不佳、意志力薄弱、时间与空间受限、缺少陪伴与督促、不适应录音等5个因素阻碍患者坚持练习；人格特质、信任、获益、自我照顾的需要、时间/空间安排、同修者、治疗师、正念练习的简易与便捷等8个因素促进患者坚持练习。
结论能力/机会/动机⁃行为模型（COM⁃B）有助于治疗师和有练习需求的个体从整体层面理解坚持正式练习促进因素的作用机制；治疗师和有练习需求的个体应关注正式练习中可能遇到的阻碍因素。

Abstract:
Objective To explore the barriers and facilitators of the adherence of formal practice after mindfulness-based cognitive therapy （MBCT） in psychological counseling outpatients.
Methods One-on-one interview was conducted in 15 psychological counseling outpatients who attended MBCT at Shanghai Mental Health Center and had been out of treatment 5 months or more. Data was analyzed using thematic analysis.
Results Poor mood， weak willpower， limited time and space， lack of companionship and supervision， and discomfort with the recording were the five factors that prevented the patients from sticking to their practice. Personality trait， trust， benefit， need for self-care， time/space arrangement， fellow practitioners， therapists， and ease and convenience of practice were the eight factors that promoted the patients to practice.
Conclusion The COM-B model helps therapists and individuals with practice needs to understand the mechanism of formal practice facilitators at a holistic level. Therapists and individuals with practice needs should be concerned about possible barriers on the adherence of formal practice.

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