Poliklinikte Kullanılabilecek Bazı ACT Terapi Teknikleri
Özet
Kabul ve Kararlılık Terapisi (ACT), ilişkisel çerçeve kuramı ve işlevsel bağlamcılık temellerine dayanan, semptomları doğrudan azaltmak yerine onlarla kurulan ilişkiyi değiştirerek psikolojik esnekliği artırmayı hedefleyen kanıta dayalı, transdiyagnostik bir üçüncü kuşak davranışçı psikoterapi yöntemidir. ACT, insan yaşamında kaçınılmaz olan acı, kaygı ve olumsuz deneyimleri kabul ederek, bireyin belirlenmiş değerleri doğrultusunda anlamlı, zengin ve canlı bir yaşam sürmesini amaçlar. Terapinin psikopatoloji modeli; bilişsel birleşme, yaşantısal kaçınma, bağlamsal benliğe bağlanma, an ile temasın kaybolması, değerlerle kurulan bağın zayıflaması ve işlevsiz davranışlar olmak üzere altı temel psikolojik katılık bileşeninden oluşur. Buna karşılık geliştirilen psikolojik esneklik modeli ise bilişsel ayrışma, duyguların kabulü, bağlamsal benlik, anda olma, değerler ve değer odaklı eylemler süreçlerini içerir. Poliklinik uygulamalarında psikolojik katılığı kırıp esnekliği pekiştirmek amacıyla bataklıkla mücadele, canavarla halat çekme, yarıklı lamba ve gökyüzü gibi metaforların yanı sıra bir ağaç gibi ol ile on nefes gibi pratik farkındalık egzersizlerinden yararlanılır. Yapılan çalışmalar, ACT müdahalelerinin depresyon, anksiyete bozuklukları, migren, kronik ağrı, madde bağımlılığı ve borderline kişilik bozukluğu gibi pek çok ruhsal hastalıkta klinik olarak anlamlı iyileşmeler sağladığını, işlevselliği ve yaşam kalitesini artırdığını göstermektedir.
Acceptance and Commitment Therapy (ACT) is an evidence-based, transdiagnostic third-wave behavioral psychotherapy method based on relational frame theory and functional contextualism, aiming to increase psychological flexibility by altering the relationship built with symptoms rather than directly reducing them. ACT aims for individuals to lead a meaningful, rich, and vital life guided by their identified values by accepting the pain, anxiety, and negative experiences that are inevitable in human life. The psychopathology model of the therapy consists of six core components of psychological inflexibility: cognitive fusion, experiential avoidance, attachment to the conceptualized self, loss of contact with the present moment, weakening connection to values, and dysfunctional behaviors. Conversely, the psychological flexibility model includes the processes of cognitive defusion, acceptance of emotions, self-as-context, being present, values, and committed actions. In polyclinic applications, to break psychological inflexibility and reinforce flexibility, metaphors such as struggling with quicksand, tug-of-war with a monster, the slit lamp, and the sky are utilized, along with practical mindfulness exercises like being like a tree and ten breaths. Studies demonstrate that ACT interventions provide clinically significant improvements, enhance functionality, and boost the quality of life in many mental health conditions such as depression, anxiety disorders, migraine, chronic pain, substance abuse, and borderline personality disorder.
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Terapi Materyalleri, 2021. (29.12.2021 tarihinde www.baglamsalbilimler.org adresinden ulaşılmıştır).
