问题 问答题

一般资料:求助者,女性,56岁,本科学历,中学退休教师。
求助者自述:我原来是中学老师,白天上课,晚上批作业,每天总要忙到十一二点才能休息。对身体健康有些忽视,但总体来说身体还可以。四十岁时曾发现子宫肌瘤,经过手术早已痊愈,心脑肝肾等重要器官都没什么毛病。去年我丈夫突发心脏病去世了,对我打击很大,他平时身体那么好,怎么说没就没了呢我丈夫也是中学老师,还带着毕业班,比我更忙更累,难道他的心脏病是累出来的半年前,我去参加一位朋友的葬礼,这朋友五十多岁,也是突发心脏病死的。我很伤感,回来时在车上突然胸闷,憋得出不来气,心慌,出汗,浑身无力,有一种快要死了的感觉。我很害怕,让车上的朋友直接把我送到医院急诊室。医生给做了心电图等检查,说没什么事,建议我详查。为此我专门住院,做了各种检查,医生说心脏没什么大事,主要是情绪太敏感,太紧张。出院后又有几次犯病,还是心慌,胸闷,出不来气,又到其他医院做了检查,但报告都说没有明显的问题。我觉得很怪,明明我很难受,医生却总说没问题,按说医生也很负责,但怎么就查不出我的病呢也许是医生水平比较低,为此我又去了更多的医院,但是还是没人能查出我的病。城里的大医院我都去过了,能做的检查差不多都做过了,就是检查不出问题来,我都快烦死了。现在我明显感觉比以前迟钝了,经常丢三落四,不敢出门。一天到晚总想着这件事,白天不舒服,注意力不集中,食欲也差。每晚也就能睡四五个小时,噩梦不断,自己非常着急,心情很不好,很烦,没有心思干其他的事,怎么也摆脱不了内心的痛苦,所以我就来了,您一定要帮帮我。
心理咨询师了解到的情况:求助者退休前为中学高级教师,性格较内向,敏感,工作勤奋,人际关系良好。家庭经济状况较好,平时身体健康,丈夫因心脏病去世,有一子一女,都已成家。
请依据以上案例,回答以下问题:
一、请对该求助者做出初步诊断,并说明依据。
二、针对该求助者的摄入性谈话,需注意哪些内容
三、该求助者产生心理问题的原因是什么
四、心理咨询师与求助者商定的咨询目标应包括哪些特征
五、针对本案例,心理咨询师使用了贝克和雷米的认知疗法帮助求助者改变了认知,该疗法的工作程序是什么
六、针对本案例,心理咨询师使用了面质技术,请说出面质技术使用的注意事项。
七、心理咨询师在本案例中可使用求助者中心疗法,简述求助者中心疗法的人性观。
八、咨询结束一年后,应该对该求助者进行效果评估,请说出远期疗效评估时自我接纳程度评估的内容和方法。

答案

参考答案:对该求助者的诊断是:疑病性神经症。
诊断依据如下:
1)排除精神病按区分心理正常与异常的三项心理学原则,该求助者主客观世界统一,精神活动内在协调一致,人格相对稳定,说明该求助者不属于精神病。
2)症状表现:认知错误,没有根据地认为自己有心脏病行为,反反复复地就医行为情绪,因自己不能得到明确诊断而焦虑、痛苦躯体症状,心慌、胸闷、憋气、失眠、多梦、注意力不集中、食欲差等。
3)存在变形冲突。
4)病程:症状持续时间长,已超过三个月,但不到一年。
5)严重程度:求助者的症状影响了社会功能,工作效率明显下降,有泛化、回避出现。
6)根据许又新教授神经症的评分标准,该求助者在内心痛苦、严重程度、病程上的得分大于6分,神经症的诊断成立。

阅读理解

阅读理解。

     From the earliest times, man has been interested in art. People have often worked together to collect and

save the world's art treasures.

     Fine art treasures from many countries are kept in an art museum called the Louvre in Paris, France. The

works of art have been collected by the people of France over many centuries. The Louvre has not always

been a museum. The first building was a fort (炮台). In 1190, it was the king's castle with high walls and a

round tower. It had a moat to prevent his enemies from walking in.

     Over the years, the number of buildings around the castle grew. By 1350, the castle was no longer needed

as a fort. The Louvre became a palace home for French kings and queens.

     During times of peace, new treasures were brought in. During days of war, many treasures were stolen,

and the buildings were damaged.

     When Francis I became king of France in 1515, he brought in artists from many countries. One of the

artists was Leonardo da Vinci from Italy. Da Vinci's "Mona Lisa" is the best known painting in the museum

today.

     In 1793, the Louvre became a public museum, just as it is now. It is a place where art treasures have been

saved for everyone to enjoy.

1. How long has the Louvre been a museum?

A. For over 800 years.

B. Since 1350.

C. Since 1515.

D. For over 200 years.

2. Most of the works of art in the Louvre have been collected probably_____.

A. by the French people

B. by Francis I

C. by Leonardo Da Vinci

D. by people of the world

3. From the passage we can learn that _____.

A. the Louvre was once a church as well as a palace

B. Mona Lisa is kept in Italy

C. Da VinCi once stayed in France

D. the Louvre is only a place of interest to the French people

4. Why is it good for the works of art to be kept in public museums?

A. In public museums works of art will not be stolen.

B. In public museums works of art will not be damaged.

C. In public museums artists can study the works of art.

D. In public museums everyone can enjoy the works of art.

单项选择题