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A Guide in the Process of Cognitive Behavioral Therapy in Obsessive Compulsive Disorder: Formulation

Nergis LAPSEKİLİ, Mehmet AK.

Abstract
A Guide in the Process of Cognitive Behavioral Therapy in Obsessive Compulsive Disorder: Formulation Introduction: The implementation of effective treatment depends on thorough understanding of disorder and its presentation. Treatment strategies must depend on the individual formulation of the patient. In this paper an Obsessive Compulsive Disorder(OCD) patient treated with Cognitive Behavioral Therapy (CBT) methods is presented. It is discussed that in the therapy, formulation is an ongoing dynamic process and necessarily required for the effectiveness of therapy. Case: Y.B. was 32 years old, single male patient graduated from university. He applied because of his obsessions and compulsions. He was diagnosed OCD after the psychiatric evaluation according to Diagnostic and Statistical Manual of
Mental Disorders-IV(DSM-IV). In treatment following strategies were applied: 1) Cognitive restructuring of the thoughtaction-fusion, anxiety intolerance, overestimated threat appraisals, 2) exposure and response prevention techniques aimed to test if catastrophic expectations would occur.
Discussion: When planning CBT for the treatment of OCD, the first and most important step is a good formulation created with the data obtained from a good evaluation process. Treatment planning in our case was planned on using cognitive restructing techniques for thought-action-fusion, anxiety intolerance and overestimated threat appraisals but the formulation was completed in the course of treatment when the patient could talk about his early experiences. As a result, the formulation is a roadmap that should be taken into consideration at every stage of therapy. Its presence is essential to reach the correct destination and it is a dynamic process needed to be updated according to the information from the patient.

Key words: Obsessive Compulsive Disorder, Formulation



Obsesif Kompulsif Bozuklukta Bilişsel Davranışçı Terapi Sürecinde Yol Gösterici: Formülasyon

Ozet
Giriş: Obsesif Kompulsif Bozukluğun(OKB) bilişsel davranışçı tedavisinde(BDT), etkin tedavinin uygulanması bozukluğun ve bunun her bireydeki yansımasının tam olarak anlaşılmasına bağlıdır. Tedavi stratejileri, hastaya ait formülasyona dayandırılmalıdır. Bu yazıda bilişsel terapi yöntemleriyle tedavi edilmiş bir OKB hastası sunulmaktadır. Terapi sürecinde formülasyonun devam eden dinamik bir işlem olduğu ve tedavinin etkinliği için varlığının zorunluluğu ele alınmıştır. Olgu: Y.B. 32 yaşında, bekar, üniversite mezunu, erkek hasta. Obsesyon ve kompulsiyonlar nedeniyle başvurusu oldu. Değerlendirme sonucunda DSM-IV kriterlerine göre OKB tanısı kondu. Tedavide: 1) Tehlikeyi abartılı algılama, düşünce eylem kaynaşması ve sıkıntıya tahammül edemeyeceği ile ilgili olarak, Bilişsel Yeniden Yapılandırma, 2) Katastrofik
beklentilerin gerçekleşip gerçekleşmeyeceği ile ilgili maruz bırakma ve tepki önleme tekniği uygulanmıştır.
Tartışma: OKB tedavisinde BDT planlanırken ilk ve en önemli basamak iyi bir değerlendirme sürecinde elde edilenbilgilerle formülasyonu iyi yapmaktır. Vakamızda tedavi planlaması; Tehlikeyi abartılı algılama, düşünce eylem kaynaşması ve sıkıntıya tahammül edememe değerlendirmeleri üzerine bilişsel yeniden yapılandırma teknikleri kullanılarak planlanmış olup, tedavi süresince erken yaşantıları getirebildiğinde ancak formülasyon tamamlanmıştır. Sonuç olarak; formülasyon terapi sürecinin her aşamasında terapistin gözünün önünde olması gereken bir yol haritasıdır. Doğru hedefe ulaşabilmek için varlığı olmazsa olmaz olup hastadan gelecek bilgilere göre güncellenmesi gereken dinamik bir süreçtir.

Anahtar Kelimeler: Obsesif Kompulsif Bozukluk, Formülasyon


 
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How to Cite this Article
Pubmed Style

LAPSEKILI N, AK M. [A Guide in the Process of Cognitive Behavioral Therapy in Obsessive Compulsive Disorder: Formulation]. JCBPR. 2012; 1(1): 21-27. Turkish.


Web Style

LAPSEKILI N, AK M. [A Guide in the Process of Cognitive Behavioral Therapy in Obsessive Compulsive Disorder: Formulation]. http://www.jcbpr.org/?mno=18848 [Access: August 16, 2018]. Turkish.


AMA (American Medical Association) Style

LAPSEKILI N, AK M. [A Guide in the Process of Cognitive Behavioral Therapy in Obsessive Compulsive Disorder: Formulation]. JCBPR. 2012; 1(1): 21-27. Turkish.



Vancouver/ICMJE Style

LAPSEKILI N, AK M. [A Guide in the Process of Cognitive Behavioral Therapy in Obsessive Compulsive Disorder: Formulation]. JCBPR. (2012), [cited August 16, 2018]; 1(1): 21-27. Turkish.



Harvard Style

LAPSEKILI, N. & AK, M. (2012) [A Guide in the Process of Cognitive Behavioral Therapy in Obsessive Compulsive Disorder: Formulation]. JCBPR, 1 (1), 21-27. Turkish.



Turabian Style

LAPSEKILI, Nergis, and Mehmet AK. 2012. [A Guide in the Process of Cognitive Behavioral Therapy in Obsessive Compulsive Disorder: Formulation]. Journal of Cognitive-Behavioral Psychotherapy and Research, 1 (1), 21-27. Turkish.



Chicago Style

LAPSEKILI, Nergis, and Mehmet AK. "[A Guide in the Process of Cognitive Behavioral Therapy in Obsessive Compulsive Disorder: Formulation]." Journal of Cognitive-Behavioral Psychotherapy and Research 1 (2012), 21-27. Turkish.



MLA (The Modern Language Association) Style

LAPSEKILI, Nergis, and Mehmet AK. "[A Guide in the Process of Cognitive Behavioral Therapy in Obsessive Compulsive Disorder: Formulation]." Journal of Cognitive-Behavioral Psychotherapy and Research 1.1 (2012), 21-27. Print.Turkish.



APA (American Psychological Association) Style

LAPSEKILI, N. & AK, M. (2012) [A Guide in the Process of Cognitive Behavioral Therapy in Obsessive Compulsive Disorder: Formulation]. Journal of Cognitive-Behavioral Psychotherapy and Research, 1 (1), 21-27. Turkish.