본 사례는 29세의 강박장애 환자를 대상으로 한 인지행동치료의 과정을 요약한 것이다. 치료는 2003년 2월부터 6월까지 모두 16회기에 걸쳐 진행되었으며, 노출 및 반응방지훈련을 위주로 한 행동적 접근 및 환자의 완벽주의적 신념을 수정하기 위한 인지적 접근이 시도되었다. 치료 효과를 BDI, BAI, Y-BOCS 및 환자의 주관적 보고를 토대로 평정한 결과, 중등도의 호전을 보인 것으로 평가되었다. 본 치료 사례를 통해 집단치료와 개인치료를 동시에 실시하는 경우에 발생하는 문제점, 행동적 접근과 인지적 접근의 구분이 가져오는 긍정적․부정적 효과, 그리고 인지행동치료에서 간과하기 쉬운 핵심정서의 개입에 대한 문제를 논의하였다.
This case report describes the cognitive behavioral therapy(CBT) of 29-year-old female who was referred for obsessive compulsive disorder(OCD). Therapy consisted of 16 sessions and both the manual-based group therapy and the patient\'s idiosyncratic symptom-focused individual therapy were performed. CBT included the behavioral approach, mainly based on exposure and response prevention(ERP) and the cognitive approach which was designed to modify patient\'s negative appraisals and perfectionism. At post-therapy assessment, the patient\'s OCD symptoms were evaluated as moderately improved. In discussion, three issues addressed. Firstly, manual-based group therapy did not attend to all possible situations encountered in therapy, especially with OCD patients who had heterogeneous symptoms. Secondly, positive and negative effects of the strict distinction between behavioral and cognitive treatments were considered. Finally, the limitation of short-term CBT was discussed in terms of the difficulties in interventions for the patient\'s core emotion. Key words : Obsessive compulsive disorder, cognitive behavioral therapy
사례보고 결 과 논 의 참고문헌
