1. Hugræn atferlismeðferð með börnum og unglingum
Guðrún Oddsdóttir, sálfræðingur
Sjálandsskóla nóvemnber 2009

2. HAM Hugræn atferlismeðferð
“Það eru ekki atburðir sem valda heldur það sem menn halda”
Epictetos 1. öld eftir Krist
Hugsun okkar og túlkanir stjórna því hvernig okkur líður
HAM sprettur upp úr atferlismeðferð og hugfræðirannsóknum. Upphafsmenn Albert Ellis og Aaron T. Beck um 1960.
It was during the period 1950 to 1970 that CBT became widely utilized, with researchers in the United States, the United Kingdom and South Africa who were inspired by the behaviorist learning theory of Ivan Pavlov, John B. Watson and Clark L. Hull.[5] In Britain, this work was mostly focused on the neurotic disorders through the work of Joseph Wolpe, who applied the findings of animal experiments to his method of systematic desensitization,[16] the precursor to today's fear reduction techniques.[5] British psychologist Hans Eysenck, inspired by the writings of Karl Popper, criticized psychoanalysis in arguing that "if you get rid of the symptoms, you get rid of the neurosis",[17] and presented behavior therapy as a constructive alternative.[5][18] In the United States, psychologists were applying the radical behaviorism of B. F. Skinner to clinical use. Much of this work was concentrated towards severe, chronic psychiatric disorders, such as psychotic behavior.[5][19] and autism[5][20]
Albert Ellis (1913–2007) was a pioneer in the development of CBT.
Although the early behavioral approaches were successful in many of the neurotic disorders, it had little success in treating depression.[5] Behaviorism was also losing in popularity due to the so-called "cognitive revolution". The therapeutic approaches of Albert Ellis and Aaron T. Beck gained popularity among behavior therapists, despite the earlier behaviorist rejection of "mentalistic" concepts like thoughts and cognitions. Both these systems included behavioral elements and interventions and primarily concentrated on problems in the present. Albert Ellis's system, originated in the early 1950s, was first called rational therapy, and can arguably be called one of the first forms of cognitive behavioral therapy. It was partly founded as a reaction against popular psychotherapeutic theories at the time, mainly psychoanalysis.[21] Aaron T. Beck, inspired by Albert Ellis, developed cognitive therapy, in the 1960s.[22] Cognitive therapy rapidly became a favorite intervention to study in psychotherapy research in academic settings. In initial studies, it was often contrasted with behavioral treatments to see which was most effective. During the 1980s and 1990s, cognitive and behavioral techniques was merged into cognitive behavioral therapy. Pivotal in this merging was the successful developments of treatments of panic disorder by David M. Clark in the UK and David H. Barlow in the US.[5]

3. Hugræn atferlismeðferð
Ná fram breytingum í hugsun, hegðun og tilfinningum fólks með fjölbreyttum, kerfisbundnum aðferðum.
Áhersla á þau einkenni (hugsanir, hegðun, tilfinningar) sem eru til staðar í dag.
Stutt inngrip.
Byggir á samvinnu meðferðaraðila og skjólstæðings.
Miklar rannsóknir og góðar niðurstöður. Til raunprófaðir meðferðarpakkar fyrir þunglyndi, kvíðaraskanir, átraskanir, verki, persónuleikaraskanir, fíknir, lágt sjálfsmat, reiði o.sfrv....
Núna er HAM yfirlýst meðerðarstefna við geðrænum kvillum víðast hvar í Evrópu og USA, meðal annars HÍ og LSH.
Cognitive behavioral therapy (or cognitive behavioral therapies or CBT) is a psychotherapeutic approach that aims to solve problems concerning dysfunctional emotions, behaviors and cognitions through a goal-oriented, systematic procedure. The title is used in diverse ways to designate behavior therapy, cognitive therapy, and to refer to therapy based upon a combination of basic behavioral and cognitive research.[1]
There is empirical evidence that CBT is effective for the treatment of a variety of problems, including mood, anxiety, personality, eating, substance abuse, and psychotic disorders.[2][3] Treatment is often manualized, with specific technique-driven brief, direct, and time-limited treatments for specific psychological disorders. CBT is used in individual therapy as well as group settings, and the techniques are often adapted for self-help applications. Some clinicians and researchers are more cognitive oriented (e.g. cognitive restructuring), while others are more behaviorally oriented (in vivo exposure therapy). Other interventions combine both (e.g. imaginal exposure therapy).[4]
CBT was primarily developed through a merging of behavior therapy with cognitive therapy. While rooted in rather different theories, these two traditions found common ground in focusing on the "here and now", and on alleviating symptoms.[5] Many CBT treatment programs for specific disorders have been evaluated for efficacy and effectiveness; the health-care trend of evidence-based treatment, where specific treatments for symptom-based diagnoses are recommended, has favored CBT over other approaches such as psychodynamic treatments.[6] In the United Kingdom, the National Institute for Health and Clinical Excellence recommends CBT as the treatment of choice for a number of mental health difficulties, including post-traumatic stress disorder, OCD, bulimia nervosa and clinical depression, and for the neurological condition chronic fatigue syndrome/myalgic encephalomyelitis.[7]

4. Atburður
Hugsun
Hegðun
Líðan

5. HUGRÆN atferlismeðferð bera kennsl á hugsanir og hugsanaskekkjur
HUGRÆN atferlismeðferð bera kennsl á hugsanir og hugsanaskekkjur og geta skipt út skekktum og ógagnlegum hugsunum
Við erum alltaf að hugsa, hver kveikja setur af stað ósjálfráðar hugsanir og túlkanir sem aftur leiða til tilfinninga og hegðunar.
Fólk tekur oftast eftir aðstæðum og hvernig því líður, en sjaldnast eftir þeim hugsunum sem gefa aðstæðunum einhverja merkingu (túlkun)
Til að breyta óhjálplegum hugsunum þarf fyrst að læra að finna þær...
Þegar þú hefur áttað þig á því hvaða aðstæður, hugsanir, skekkjur og kveikjur hafa áhrif á tilfinningar þínar ertu tilbúin á næsta stig; að breyta hugsunum þínum.
Markmiðið er að geta fundið raunsærri eða hjálplegri hugsun sem dregur úr tilfinningalegum viðbrögðum.
Hafa eitthvert val um hvernig maður bregst við aðstæðum.

6. Hugræn ATFERLISmeðferð
Minnka forðun og flóttahegðun
Auka virkni og ánægjulegar athafnir
styrkja viðeigandi hegðun, t.d. nám, hugrekki, meðferðarheldni, ákveðni, sjálfstæði...
þjálfa t.d. vandamálalausn, félagsfærni, reiðistjórnun og markmiðssetningu

7. HAM með börnum og unglingum
Börn frá um það bil 7 ára aldri geta nýtt sér HAM.
Átta sig á hugsunum sínum, geta rætt þær
Geta velt upp mismunandi skýringum á atburðum
Skilja á milli ólíkra tilfinninga
Geta skilið tengsl milli hugsana, tilfinninga og atburða
Eftir því sem börn eiga erfiðara með ofangreint eða eru yngri er fókus meðferðar meira á atferli og umhverfi/foreldrum
Oft mjög stutt íhlutun og áhersla á ákveðin vandamál og þróun bjargráða við þeim.

8. Á morgun...
Einelti
Kvíði
Þunglyndi
Áfallastreituröskun