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Plan de interventie
Student:
Negrut ( Ovanescu) Elena
2. Pacienta se prezinta cu acuze de tipul: neliniste, ritm cardiac crescut, senzatie de nod in
gat, si ganduri automate de genul nu sunt o mama buna , senzatie de gol in stomac.
3. I se explica pacientului diagnosticul si i se prezinta modelul cognitiv al atacului de
panica.
4. I se explica pacientei pentru inceput o serie de tehnici menite sa reduca amplitudinea
atacului de panica: sa respire intr-o punga de hartie pentru a evita hiperventilatia, precum
si o alta tehnica: masarea globilor oculari (reflexul oculo-cardiac, prin care frecarea
globilor oculari conduce la reducerea ritmului cardiac), urmate de expiratii cat mai
puternice (pentru a nu se hiperventila, sa existe o concentratie mai scazuta de oxigen in
creier), incheind cu frecarea muschilor gatului (pentru relaxare, pacientul fiind intr-o
permanenta stare de incordare in timpul atacului de panica si in afara lui).
5. I se explica de asemenea ca un adult tanar poate suporta un puls de pana la 240
batai/minut fara a i se intampla nimic.
6. Se realizeaza alianta terapeutica, incercand sa obtinem o relatie de incredere cu
pacienta, aratandu-i acesteia ca nu este singura care trece prin asa ceva.
7. Se realizeaza interviul clinic structurat, impreuna cu terapeutul si se identifica
problema tinta prin intrebari de genul: Ce te supara cel mai tare in prezent?", Cand au
aparut prima data aceste simptome?"
8. Se stabilesc scopurile terapeutice: reducerea atacurilor de panica, reducerea gandirii
distorsionate negative, cu impact asupra anxietatii generalizate , stimularea asertivitatii si
dezvoltarea abilitatilor de rezolvare de probleme in vederea imbunatatirii relatiei cu
familia, colegii si a capacitatii de solutionare a problemelor practice.
9. Planul de tratament presupune deci:
reducerea atacurilor de panica.
diminuarea anxietatii generalizate.
training asertiv, lucrul asupra stimei de sine si a abilitatilor sociale.
spre finalul terapiei ne propunem un program de prevenire a recaderilor.
Pe parcursul tratamentului, pot fi folosite urmatoarele tehnici:
1. Pacientului I se propune sa intocmeasca un jurnal al atacurilor de panica.
MODELUL JURNALULUI.
JURNALUL ATACURILOR DE PANICA
Data
Situatia
Luni
Marti
Miercuri
Principalele Ganduri
senzatii
negative
fiziologice
4
Raspunsuri
rationale
alternative
-
Numarul
atacurilor de
panica
-
Joi
Vineri
Sambata
Duminica Nr. Total atacuri de panica pe saptamana
2. Modelul ABC:
Management comportamental
Model ABC comportamental
determina
mentin
A___________B_______________C
another person. I will not talk about your answers to your friends or family. However, I
will hand in what you say to my own teacher at the University of Oradea. Your name
will not be on the paper I hand in, so no one will know that it was you who gave the
answers.
Thanks for helping me. Do you have any questions? Okay, lets begin.
Page |2
This is a GIRL
Age of child : 10
Page |3
what I want.
D1) The other person (s) does lots of things. I like some of them and I dont like
other things.
D2) The other person (s) is a really and totally bad person.
OK, now, I want to learn about exactly what you felt. Lets continue.
6) How angry were you? (read the four choices and circle one)
NOT VERY ANGRY,
A LITTLE ANGRY,
EXTREMELY ANGRY
VERY ANGRY,
7) For how long were you angry? (read the four choices and circle one)
Was it A FEW MINUTES, A FEW HOURS, A FEW DAYS,
or MORE THAN A FEW DAYS
8) When you were angry, what did your body feel like? What happened in your body?
(write exactly what the child said)
Am plans mult, am fost foarte suparata.
Now, I want to learn about exactly what you did.
9) When you were angry, did you
NO a) yell or scream.
_YES
YES
YES
b) cry
c) make a bad face or stare at the other person
_sad
afraid
_satisfied
This is a BOY
what I want.
D1) The other person (s) does lots of things. I like some of them and I dont like
other things.
D2) The other person (s) is a really and totally bad person.
OK, now, I want to learn about exactly what you felt. Lets
continue.
6) How angry were you? (read the four choices and circle one)
NOT VERY ANGRY,
A LITTLE ANGRY,
EXTREMELY ANGRY
VERY ANGRY,
7) For how long were you angry? (read the four choices and circle one)
Was it A FEW MINUTES, A FEW HOURS,
THAN A FEW DAYS
8) When you were angry, what did your body feel like? What happened in your body?
(write exactly what the adolescent said)
Am inceput sa fiu nervos, si sa ma gandesc mult la ea.
argue. b) cry
NO c) cross your arms, stare at the other person, or frown, or give a
_YES
What
was it?
NO e) hit, kick, push, or shove the other person
_YES
f) just keep your anger inside, boil inside, and not tell anyone you
_YES
were angry. g) plan to get even later on. You held a grudge and
_NO
wanted revenge
h) just leave, or do something else to calm down. What did you
_YES
_YES
i) try to make it better, or talk to the person about what you wanted.
j) have something to eat or drink, to help you forget about your
_sad
_afraid
_satisfied
This is a WOMAN
Age of adult 25
D1) The other person (s) does lots of things. I like some of them and I dont like
other things.
D2) The other person (s) is a really and totally bad person.
OK, now, I want to learn about exactly what you felt. Lets continue.
6) How angry were you? (read the four choices and circle one)
NOT VERY ANGRY,
A LITTLE ANGRY,
EXTREMELY ANGRY
VERY ANGRY,
7) For how long were you angry? (read the four choices and circle one)
Was it A FEW MINUTES, A FEW HOURS, A FEW DAYS, or MORE
THAN A FEW DAYS
8) When you were angry, what did your body feel like? What happened in your body?
(write exactly what the adult said)
Am fost extrem de dezamagita
Now, I want to learn about exactly what you did.
9) When you were angry, did you
NO a) yell or scream or
NO
argue. b) cry
What
was it?
NO e) hit, kick, push, or shove the other person
NO f) just keep your anger inside, boil inside, and not tell anyone you
NO were angry. g) plan to get even later on. You held a grudge and
NO wanted revenge
h) just leave, or do something else to calm down. What did you
YES
NO
_YES
_sad
_afraid
_satisfied
(Record exactly what was said) Ma simt foarte bine, am un nou job unde sunt apreciata
11) What was the best part about getting angry?
Am invatat multe din acea experienta
12) What was the worst part about getting angry?
Pentru cateva zile, mi-am pierdut increderea in fortele proprii
13) How did your anger affect your relationship with the other person or persons?
This episode had a generally (check one) negative or