在强迫症中运用动机式访谈技巧

The effectiveness ofpsychological treatments对于强迫症（OCD），如暴露和反应预防治疗，已经很成熟。但是，鉴于暴露疗法要求患者直接面对他们最害怕的事情，许多人拒绝接受治疗，在治疗开始后不久就退出，或者没有跟上家庭作业。因此，据估计只有50%的强迫症能够从基于暴露的治疗中获益，尽管其有效性。

但是研究一直在寻找使暴露疗法对更多人更有吸引力的方法，而动机式访谈技术在这方面显示出相当大的前景。

动机式访谈技术的历史与目的

最初，动机式访谈技术的发展是为了帮助人们提高改变的动机，并减少在与治疗斗争的个体中对治疗的负面情绪物质使用障碍. Recently, motivational interviewing has been explored as a way of addressing these same issues inanxiety disorders, such as OCD.

The objective of motivational interviewing is to increase your motivation to change so that you can realize your goals, such as finding a romantic partner or steady employment.

探索你的动力

动机式访谈最大的组成部分之一就是彻底探究是什么让你保持着同样的强迫症模式和想法，尽管你可能正在经历伤害和痛苦。你为什么一直做你现在做的事？例如，尽管患有强迫症的人每天可能要花两个多小时洗手，但避免被污染带来的焦虑的愿望可能会超过这种行为给他们的生活带来的痛苦和破坏。在另一个例子中，有人经历了极度痛苦的、侵扰性的和暴力的性困扰，他们可能愿意忍受这些折磨，以避免不得不向治疗师、家庭成员或配偶透露这些潜在的尴尬和可耻的想法。

识别你的障碍

Motivational interviewing techniques can be used to help you become ready for more targeted exposure-based treatment. Barriers that could get in the way of your starting or completing therapy are identified and discussed in depth. Your therapist will usually use open-ended questions that are designed to help you arrive at your own conclusions. Remember, it is not uncommon to be unaware of or even to want to avoid thinking about the reasons you do not want to change. This is normal, particularly if your reasons for avoiding change are potentially distressing.

Once the barriers to change are identified, your therapist will work with you to identify both the advantages and disadvantages associated with participating in an exposure-based therapy. Following this, you and your therapist may have extensive discussions about your goals and whether the disadvantages of participating in therapy outweigh the goals you want to achieve or not.

动机式访谈技巧是否能改善结果？

Overall, clinical research suggests that motivational interviewing techniques help more people benefit from exposure-based treatments for OCD. As well, there is some evidence that motivational interviewing may help patients gain moreinsight他们的严重性symptoms强迫症真正扰乱了他们的生活。

If you are interested in behavioral therapy but also have strong reservations about such treatment, it may be helpful to try to find a therapist who specializes in motivational interviewing to help you along this treatment path.