Применение психотерапевтического подхода «Терапия принятия и ответственности» у пациентов с первым психотическим эпизодом

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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