暴露及不反應法對強迫症患者之應用

The Application of Exposure and Response Prevention in Patients with Obsessive-Compulsive Disorder

10.6974/TCNJ.200201.0016

周桂如(Kuei-Ru Chou)；翁素月(Su-Yueh Weng)

暴露及不反應法 ； 強迫症 ； Exposure and Response Prevention REP ； Obsessive-compulsive Disorder OCD

志為護理-慈濟護理雜誌

1卷1期（2002 / 01 / 01）

16 - 22

繁體中文

以流行病學的觀點來看，強迫症已成為第四常見之精神疾患，強迫症的症狀包括強迫性思考及強迫性行為，其治療模式包括藥物治療、心理治療、行為治療、電痘擎治療、神經外科手術，綜合以上對強迫症治療的利弊，發現暴露及不反應法之行為技巧是對強迫症患者最有效且最持久之治療模式，本文主要介紹暴露及不反應法對強迫症的重要性、起源、治療步驟並舉例說明在臨床上之實際運用。目前國內少見運用暴露及不反應法於強迫症個案，其原因係缺乏有經驗之行為治療師，且此治療本身需投注大量時間及精力，另外需有強烈治療動機的患者及合作的家屬才能具有實際之療效。因此在以病人為中心的照顧上，暴露及不反應法對強迫症患者在臨床上能廣泛的運用，需整個醫療團隊排除萬難所努力的目標。

From an epidemiological point of view, obsessive-compulsive disorder (OCD) is the fourth-most com-mon mental disorder among mental illnesses. The symptoms of OCD include obsessive thoughts and compulsive behaviors. Therapy primarily focuses on pharmacotherapy, psychotherapy, behavioral therapy, electroconvulsive therapy and neutral surgical treatment. Among these, the method exposure and response prevention (ERP) is one of the best therapeutic models for OCD patients. The purpose of this article is to introduce the importance of, origin of and the step comprising the exposure and response intervention therapy for OCD. At present, few practitioners have adapted exposure and response prevention for treating OCD patients in Taiwan. The major reason for this is the lack of both experienced behavioral therapists and patient motivation. Therefore, medical teams need to make an effort to expand the application of exposure and response prevention in clinics in the future.