Consortium PSYCHIATRICUMConsortium PSYCHIATRICUMConsortium PSYCHIATRICUM2712-76722713-2919Eco-Vector9710.17816/CP97REVIEWОБЗОРReview ArticleAcceptance and Commitment Therapy for Patients with a First Psychotic EpisodeПрименение психотерапевтического подхода «Терапия принятия и ответственности» у пациентов с первым психотическим эпизодомhttps://orcid.org/0000-0001-5347-0231ChernovNikita V.ЧерновНикита Владимирович
Russian Federation

Head of the Department of Psychotherapy and Social Rehabilitation

Заведующий отделением Психотерапевтической помощи и социальной реабилитации

n.Chernov.psy@bk.ruhttps://orcid.org/0000-0002-0279-5180MoiseevaTatiana V.МоисееваТатьяна Валентиновна
Russian Federation

PhD in psychology, psychologist

медицинский психолог, кандидат психологических наук

tmoiseeva@mail.ruBelyakovaMaria A.БеляковаМария Александровна
Russian Federation

Psychologist

медицинский психолог

Marya.belyakova@gmail.comhttps://orcid.org/0000-0002-7520-0168PolyakovaMaria D.ПоляковаМария Дмитриевна
Russian Federation

Psychologist

медицинский психолог

Maria2088@yandex.ruhttps://orcid.org/0000-0003-4990-8725SozinovaMarta V.СозиноваМарта Владимировна
Russian Federation
sozinova2014@yandex.ruMental-health clinic No.1 named after N.A. AlexeevГБУЗ ПКБ № 1 им. Н.А. Алексеева ДЗМ16122021311220212430392107202108092021Copyright ©; 2021, Chernov N.V., Moiseeva T.V., Belyakova M.A., Polyakova M.D., Sozinova M.V.Copyright ©; 2021, Чернов Н.В., Моисеева Т.В., Белякова М.А., Полякова М.Д., Созинова М.В.2021Chernov N.V., Moiseeva T.V., Belyakova M.A., Polyakova M.D., Sozinova M.V.Чернов Н.В., Моисеева Т.В., Белякова М.А., Полякова М.Д., Созинова М.В.https://creativecommons.org/licenses/by/4.0https://consortium-psy.com/jour/article/view/97

The search for the most effective methods of therapy for mental disorders is a priority for modern psychiatry. An approach to the early diagnostics and rehabilitation of patients experiencing psychotic episodes for the first time is proposed in the present article. The proposed approach is based on the combination of drug therapy and acceptance and commitment therapy (ACT) characterized by the development of the patient’s psychological flexibility, rather than controlling the disease symptoms. The article describes the main processes of the ACT model: acceptance, cognitive defusion, contact with the present moment, understanding of the inner world, awareness of significant values, and the regulation of purposeful behaviour for the implementation of these values. Recommendations for different stages of treatment were also developed by specialists of the First Psychotic Episode Clinic at the Mental Health Сlinic No.1 named after N.A. Alexeev. The psychological rehabilitation of patients with the use of ACT in the case of psychotic disorders with both negative and positive symptoms was elaborated. The application of acceptance and commitment therapy in the early diagnostics and treatment of patients experiencing a first psychotic episode results in fewer readmissions and improved psychosocial functioning in both inpatient and outpatient care.

Поиск наиболее эффективных методов лечения больных с психическими расстройствами имеет приоритетное значение для современной психиатрии. В статье рассматривается подход к ранней диагностике и реабилитации пациентов, впервые переживающих психотический эпизод. В основе него лежит сочетание медикаментозной терапии и психотерапевтического подхода «Терапия принятия и ответственности» (ТПО), отличительной особенностью которого является не борьба с симптомами заболевания, а развитие психологической гибкости пациента. В статье описаны основные мишени психотерапевтической работы в рамках модели ТПО: принятие, когнитивное распутывание, связь с настоящим моментом, понимание внутреннего мира, осознание значимых ценностей и регуляция целенаправленного поведения по реализации этих ценностей. Разработаны также рекомендации для разных этапов лечения в Клинике первого психотического эпизода на базе ГБУЗ «ПКБ № 1 им. Н.А. Алексеева ДЗМ». Конкретизирована психологическая реабилитация пациентов с применением ТПО при психотических расстройствах как с негативной, так и с продуктивной симптоматикой. Результатом применения ТПО в ранней диагностике и лечении пациентов с первым психотическим эпизодом является снижение количества повторных госпитализаций и улучшение психосоциального функционирования как при стационарном, так и при амбулаторном лечении.

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