Interpersonalcommunication skills ACGME Core Competencies CONES Clinical psychology

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內容 一、人際及溝通技巧(Interpersonal＆communication skills; ACGME Core Competencies) 溝通能力：建立關係、了解、表達 � 溝通策略：CONES � 告知壞消息 � 二、臨床心理學(Clinical psychology)

內容 一、人際及溝通技巧(Interpersonal＆communication skills; ACGME Core Competencies) 溝通能力：建立關係、了解、表達 � 溝通策略：CONES � 告知壞消息 � 二、臨床心理學(Clinical psychology) 心理衡鑑(Assessment) � 心理治療(Psychotherapy) � 行為科學(Behavioral sciences) � 三、認知行為療法(Cognitive behavior therapy; CBT) Education ＆ counselling(eg. Involve 12, 90 -minute group/individual sessions) � Identify and restruct core(maladaptive)thoughts ＆ beliefs to enhance selfesteem and confidence � Usually short-term(<3 Ms) and target-oriented(focus on change) �

溝通的策略：CONES C：context O：opening shot N：narrative approach E：addressing emotions S：strategy and summary

溝通的策略：CONES C：context O：opening shot N：narrative approach E：addressing emotions S：strategy and summary

臨床心理學模式 �Psychoanalytic Model �Behavioral Model �Cognitive Model

臨床心理學模式 �Psychoanalytic Model �Behavioral Model �Cognitive Model

減緩症狀的技巧：Reducing symptoms Four basic skills for reducing anxiety 1). Cue-controlled relaxation desensitization(去敏感化) 2). Relaxation:

減緩症狀的技巧：Reducing symptoms Four basic skills for reducing anxiety 1). Cue-controlled relaxation desensitization(去敏感化) 2). Relaxation: Disphragmatic(橫隔膜) breathing-deeper ＆ slower，及muscle relaxation、Yoga stretching 3). Coping self-statements negative self-talk 4). Distraction (Redirection; 重新導向─快樂活動) a). Simple externalization: observing carefully, listening attentively, feeling texture, tasting or smelling, doing repetitive activities, changing your surrounding or activities b). Simple tasks that require concentration c). Conversation d). Work or play

Buffers緩解壓力的因素 1. 人格 Personality 2. 情緒 Mood 3. 運動 Exercise 4. 營養 Nutrition 5.

Buffers緩解壓力的因素 1. 人格 Personality 2. 情緒 Mood 3. 運動 Exercise 4. 營養 Nutrition 5. 社會支持 Social support 6. 更新環境 Restorative environments 7. 以樂觀的想法迎向生活 Meaning of life, Optimistic outlook

心理治療Psychotherapy 1. Psychodynamic psychotherapy 2. Cognitive therapy 3. Behavioral therapy 4. Exposure-based behavioral treatment

心理治療Psychotherapy 1. Psychodynamic psychotherapy 2. Cognitive therapy 3. Behavioral therapy 4. Exposure-based behavioral treatment 5. Cognitive behavioral therapy (CBT) 6. Problem solving therapy 7. Interpersonal therapy 8. Family therapy 9. Psychoeducation

CBT �at least as effective as medication with less attrition and more durable effects

CBT �at least as effective as medication with less attrition and more durable effects �CBT addresses the role of irrational thinking in how patients feel and behave 1. patient self-monitoring of worrying or related symptoms 2. cognitive restructuring, including evaluating and reconsidering interpretive and predictive thoughts/worries 3. relaxation training 4. rehearsal of coping skills 11)37 -42 J Clin Psychiatry. 2001; 62(suppl

行為技巧Behavioral skills �社交技巧訓練Social skills training �時間管理Time management �問題解決訓練Problem-solving training �認知重建Cognitive restrusturing �寬恕治療Forgiveness therapy

行為技巧Behavioral skills �社交技巧訓練Social skills training �時間管理Time management �問題解決訓練Problem-solving training �認知重建Cognitive restrusturing �寬恕治療Forgiveness therapy

Patient and family education �Most people have experienced some degree of anxiety, it might

Patient and family education �Most people have experienced some degree of anxiety, it might be helpful. �Importance of early diagnosis and treatment. �The need for ongoing management. �The needs of other family members. �The needs of family therapy. �Remissions and exacerbation will be experienced. �Patience, persistence, and a multimodal/ multiteam approach are needed

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