Mtengo Wonyalanyaza Chikhalidwe Pazithandizo

Zamkati

• Therapy Yofunika Kuwerenga
• Dziwani Chithandizo Cha Kuyenda

Kalatayi inalembedwa ndi Marie Gillespie, yemwe ndi dokotala pachipatala cha University of Southern California.

“Chithandizo? Kodi sizangokhala za ana Achizungu omwe sangathe kudziwa zenizeni? ” adati wazaka 14 waku Africa-American ali m'ndende pafupifupi zaka sikisi zapitazo. Panthawiyo, ndinali wophunzira wongoyamba kumene kumene akuchita zamankhwala mndende za ana. Ndinazindikira mwachangu kuti kuyankha mafunso anga kunali kofala kwambiri komanso kuti mitundu ndi zikhalidwe zina zikusowa. Kuyandikira kwathu ana ovutikaku sikuyenera kuchitika mwaubwino, koma potengera chilengedwe, mawonekedwe, zikhulupiriro, komanso ubale. Mnyamata ameneyo, monga ena ambiri, sanayenera kutsekedwa ndikutsekedwa ndi matenda amisala omwe anali asanawonepo. Agogo ake aakazi anandiuza kuti anali mwana wazaka 4 wokoma, wazaka 8 wankhanza, ndipo pofika zaka 11, anali atagwera m'gulu la anyamata achikulire omwe adamuyambitsa gulu lachiwawa. Malingana ndi agogo ake, mwayi wake wokha wopeza chithandizo chamankhwala wotsika mtengo, adachokera kwa "mayi wina wa yuppie yemwe adatiuza kuti tibwere kuofesi yake kamodzi pamlungu. Sanatibweretse kapena komwe timachokera. ”

Monga mlendo wochokera ku zikhalidwe zosiyanasiyana inemwini, ndikutha kumvetsetsa kukhumudwitsidwa komwe kumadza chifukwa chokhala munjira yosweka. Ndinkaona kuti ndikufunika kwambiri kuti ndithandizire banjali kupeza chithandizo choyenera. Pa nthawiyo ndinalibe mayankho, koma ndidapereka maphunziro anga a udokotala kuti athane ndi kusiyana kumeneku pantchito zamankhwala amisala.

Achinyamata omwe ali ndi mavuto okhudzana ndi mayendedwe (mwachitsanzo, kugwiritsa ntchito mankhwala osokoneza bongo, kusokoneza machitidwe awo) atenga nawo gawo pazochitika zamilandu m'miyoyo yawo yonse - Khalani ndi Zovuta zina (monga nkhanza, chinyengo, kuwononga katundu, kuphwanya malamulo ndi ufulu ya ena) kumawonjezera kwambiri mwayi wachinyamata womangidwa mtsogolo. Kuphatikiza pa zovuta zoyipa m'moyo uno, izi mwachidziwikire zimakhala ndi ndalama zambiri za okhometsa msonkho kumakhothi, mabungwe oyang'anira zamalamulo, komanso mapulogalamu obwezeretsa kapena obwezeretsanso pambuyo pake. Ndipo zovuta zamaganizidwe sizimayimilira pazipata za ndende: theka la akaidi amakumana ndi zovuta zamisala kapena kulimbana ndi vuto losokoneza bongo. Chodabwitsanso ndichakuti amitundu ochepa amafotokozedweratu m'ndondomeko zamilandu. Ngakhale 30% ya anthu aku US si azungu, mafuko ochepa amawerengera anthu opitilira 60% omwe ali mndende. M'modzi mwa amuna 10 aku Africa-America pano amakhala mndende kapena ndende. Popeza kufunikira kosafunikira kwamathandizidwe oyambilira, zovuta zamakhalidwe aubwana zimayenera kusamalidwa, monganso ana ochokera kumidzi yoperewera.

Tsoka ilo, ana ndi mabanja amitundu yosiyana, mitundu, chikhalidwe, komanso chikhalidwe chawo pazachuma akhala akuwonetsedwa kale m'maphunziro omwe amayang'ana chithandizo chamankhwala. Pali zotsutsana zambiri zakuti kuchitapo kanthu komwe kumawoneka ngati kotheka kwa ana aku Caucasus kungakhale kopindulitsa kwa anzawo ochepa, omwe nthawi zambiri amaganiza kuti ali ndi zosowa zosiyanasiyana komanso mayankho amathandizidwe.

Mwambiri, tikudziwa kuti chithandizo chimagwira bwino ntchito kwa ana. Kodi tikudziwa bwanji? Timagwiritsa ntchito Mayeso a Randomized Controlled (RCTs) - izi zimaphatikizapo kusanja (monga kuponyera ndalama) za ana ndi mabanja mgulu lolamulira (palibe chithandizo kapena kuyikidwa pagulu la oyembekezera kuti adzalandire chithandizo chamtsogolo) kapena gulu limodzi kapena angapo oyeserera (psychotherapy), ndi kuyeza mosamala zinthu zingapo (mwachitsanzo, kukhumudwa, kusokoneza machitidwe) asanachitike kapena pambuyo pake. Njirayi imagwiritsidwa ntchito poyesa mitundu yosiyanasiyana ya mankhwala omwe amathandizira pazinthu zingapo. Mankhwala omwe awonetsedwa kuti ndi othandiza amagawidwa ngati Evidence-based Treatment (EBT) kapena pansi pa Evidence-based Practices (EBP). Zotsatira zamayesero angapo odziyimira pawokha amatha kuphatikizidwa pogwiritsa ntchito kusanthula meta, njira yochulukirapo yomwe imagwiritsidwa ntchito poyesa kuthandizira kwachipatala pamaphunziro ambiri. Komabe, popatsidwa chithunzithunzi cha achinyamata ochepa amtundu wa RCTs, sitikudziwa zambiri zakuchitira anthu osiyanasiyana momwe tiyenera kuchitira.

Kafukufuku wa meta-analytic wagwiritsidwa ntchito poyankha funso lofunika kwambiri m'munda mwathu: Kodi mankhwalawa angasinthidwe kuti agwirizane ndi chikhalidwe cha makasitomala? Kusintha kwachikhalidwe - kusintha momwe ma EBTs amaperekedwera m'njira yokhudzana ndi chikhalidwe chapadera cha kasitomala - zitha kuyambira pakugwiritsa ntchito zida zamankhwala mchilankhulo cha kasitomala, poganizira zofunikira, zikhulupiriro, malingaliro, zikhalidwe, ndi machitidwe polimbana ndi zolinga zamankhwala, kapena kuchitira chithandizo m'banja. Kunyalanyaza chikhalidwe ndi zosowa za munthu m'mankhwala amisala kumatha kuyambitsa kusamvana, kusapeza bwino, komanso kusakhulupirirana kwa kasitomala. Zotsatira zake, makasitomala sangachite nawo chithandizo chamankhwala. Chifukwa chake zikuwoneka mwanzeru kuti mankhwalawa atha kukhala othandiza, sichoncho? Tsoka ilo, kafukufuku wama meta-analytic, omwe mwachidziwikire amagwiritsa ntchito njira zowerengera zowoneka bwino, amaphatikizidwa pamutuwu). Ofufuza ena amalimbikitsa kugwiritsa ntchito kusintha kwachikhalidwe, pomwe ena amakayikira za chithandizo chokomera. Ngakhale gawo lazikhalidwe zamankhwala lingakhale losavuta tikayang'ana ana akuwonetsa mavuto osiyanasiyana, kafukufuku yemwe wabwera pamavuto amachitidwe achichepere amatha kunena zosiyana.

Mlangizi wanga wazachipatala, a Dr. Stan Huey, ndipo pakadali pano tikusanthula meta ku Yunivesite ya Southern California kuyang'ana momwe magwiridwe antchito amisala achichepere omwe ali ndi mavuto amakhalidwe. Tidaphatikizanso maphunziro omwe amagwiritsa ntchito ana, gulu, kulera, komanso chithandizo chamankhwala, chithandizo chamankhwala chosinthidwa ndimikhalidwe komanso chosasinthidwa, komanso njira zomwe zimayang'ana zovuta zamakhalidwe (mwachitsanzo, nkhanza, umbanda). Tidaphatikiza ndikuwunika zotsatira kuchokera kumayeso pafupifupi 50 osasinthika. Mwa zotsatira zathu zoyambirira, tapeza kuti, kwathunthu, chithandizo chamankhwala amisala (poyerekeza ndi chithandizo chilichonse) sichinali chothandiza kwa achinyamata ochepa omwe ali ndi mavuto amakhalidwe. Kuphatikiza apo, magulu a makolo anali apamwamba kuposa mitundu ina (monga chithandizo chamankhwala chamwana aliyense). Magawo abanja komanso magulu othandizira achinyamata adakulitsanso zotsatira zabwino. Pomaliza, chithandizo chazikhalidwe, chomwe chimapezeka mkati mwa theka la kafukufukuyu, chinali chothandiza kwambiri pakuchepetsa zovuta zamakhalidwe kuposa mankhwala omwe sanasinthidwe. Chitsanzo chimodzi chinali kusintha kwa Incredible Years (EBT yomwe idakambidwa patsamba laposachedwa la blog) yomwe imagwiritsidwa ntchito ndi Anna Lau ndi anzawo ku 2011 kuti athe kulanga zovuta za makolo ndi zovuta zamakhalidwe a mabanja m'mabanja aku China aku America. Chithandizocho chinakumbukira malingaliro azikhalidwe pa kulanga ndi kutamanda, ndikuphatikiza zoyeserera zambiri kuti makolo azitha kugwiritsa ntchito luso lawo. Kafukufuku wowonjezerabe akuyenera kuwonjezeredwa pazowunikirazi, chifukwa chake zotsatirazi sizikhala zomaliza, koma kuwunikira kumeneku kumapereka chitsogozo chabwino pankhani yama psychology.

Kodi mtengo wakunyalanyaza chikhalidwe ndi chithandizo ndi chiyani? Mtengo utha kuchitika lero mwana wanu akasiya mankhwala atangomaliza kumene kuphunzira akazindikira kuti, "Mlangizi wanga samandilandira." Mtengo utha kupezeka kwa zaka zambiri, pamene ana omwe amadzimva kuti amanyalanyazidwa ndi omwe amawapatsa amakhala achinyamata omwe amafunafuna kuvomerezedwa kwinakwake - monga pansi pa botolo la mowa kapena pagulu la zigawenga. Mtengo sikuyenera kukhala wokwera mtengo kwambiri. Popeza kuthekera kwakanthawi koyambirira kuti pakhale kusintha kwakukulu, ndikofunikira kuti tithandizire kafukufuku pazikhalidwe ndikuwonetsetsa kuti zosowa zamatenda amisempha zithandizidwa m'malo osiyanasiyana.

Kodi izi zikutanthauza chiyani ngati mukuvutikira kuthandiza mwana wanu pamavuto ake? Anthu ambiri sadziwa kumene angayambire poyesa kupeza ntchito. Funsani dokotala wanu woyang'anira chisamaliro kuti mumutumizire komwe kumagwira ntchito zachuma chanu kapena kugwiritsa ntchito zothandizila mdera lanu (mwachitsanzo, kufufuza pa intaneti kwa zipatala zamaphunziro oyunivesite, malo achichepere, kapena malo ammudzi, ambiri omwe amakhala ndi zolipiritsa). Kodi chimachitika ndi chiyani mukachepetsa zosankha zanu? Choyamba, kumbukirani kuti chithandizo chogwiritsa ntchito umboni chingathandize mwana wanu, chifukwa chake funsani othandizira / othandizira ngati njira yawo ikugwirizana ndi kafukufuku. Chachiwiri, kutenga nawo mbali pachipatala kungakhale kofunikira kwambiri, popeza ndinu munthu wofunikira kwambiri m'malo a mwana wanu (ndipo kumbukirani kuti magulu a makolo ndi njira zochiritsira mabanja awonetsedwa kuti ndi mankhwala othandiza kwambiri kwa ana). Chachitatu, ganizirani kusintha kwachikhalidwe posankha mankhwala oyenera. Kafukufuku wathu wapano wasakanikirana pankhaniyi, chifukwa chake khalani oyeserera - funsani pazomwe mungasinthe ndikukambirana zakufunika kwa zikhulupiriro ndi zikhalidwe zamabanja anu ndi othandizira.

Therapy Yofunika Kuwerenga

Dziwani Chithandizo Cha Kuyenda