有关对地震后心理危机干预策略与方法的研究浅析中英文
对照
The study on the psychological crisis intervention strategies and methods after the earthquake in Chinese and English.
文主要对心理危机干预的内涵和发展历史、地震后灾民心理问题的主要表现、心理危机干预的策略与基本方法进行了初步探讨，为今后灾后心理紧急救助提供可行的方法支持。
This paper focuses on the psychological crisis intervention of the connotation and development history, after the earthquake victims of psychological problems, the main manifestations of psychological crisis intervention strategies and basic methods are discussed in the paper, for the future of post-disaster psychological aid provides a feasible method to support.
【关键词】地震心理危机干预策略方法
[ keyword ] earthquake psychological crisis intervention strategies
一、心理危机干预的内涵与发展概况
Overview of the connotation, psychological crisis intervention and development
1.心理危机干预内涵
1 psychological crisis intervention connotation
心理危机干预也被称为危机干预（crisis intervention），它是对处于危机之中、心理出现问题的个人及其家庭采取明确有效的心理干预措施，使其恢复信心，最终战胜危机的手段和过程。事实上心理危机干预是一种短程心理辅导（疏导）与心理治疗。心理危机干预适用于自然灾害、反恐行动、人质救援、暴力犯罪、战争等突发事件对人心理产生的强烈心理损害中，它可以起到缓解受害者心理压力、提供社会支持、重塑信心、帮助他们尽快适应环境的重要作用，它与物质支持同等重要，它彰显了政府和援助者以人为本的先进理念，这是社会进步的具体体现。
Psychological crisis intervention is also known as the crisis intervention ( crisis intervention ), it is in crisis, psychological personal and family problems to take clear the effective psychological intervention measures, make its restore confidence, means and process finally overcome the crisis. In fact, psychological crisis intervention is a short-range psychological counseling and psychotherapy ( counseling ). Psychological crisis intervention for strong psychological damage to natural disasters, terrorism, hostage rescue, violent crime, war and other emergencies of psychology, it can rise to alleviate psychological pressure, the victims provide important role of social support, confidence, as soon as possible to help them adapt to the environment, it is equally important with the material support, it reflects the advanced idea of government and donors to people-oriented, it is a concrete manifestation of social progress.
2.心理危机干预发展概况
Development of 2 psychological crisis intervention
心理危机干预实践最早出现在美国，当时二战刚刚结束，大批身心倍受摧残的军人需要心理专业人员的辅导，1946年，美国政府派遣200名实习心理医生，在老兵管理机构为退伍老兵提供情感治疗服务，他们卓有成效的工作得到了军方承认：1947年，参与心理危机干预的心理医生获得了长期的现役地位，并被作为一种制度在军队中确立下来。1978年，美军朴茨茅斯海军医院精神科组建了一个由临床心理学家、精神科专家、牧师、护士和卫生
员组成的特殊精神疾病快速干预小组，对一些重大的危机事件，如训练事故、自杀、自然灾害、爆炸等紧急突发事件进行处置，从此快速危机干预小组就成为军方危机应对机制的重要组成部分，在美军执行各种任务中发挥着重要的、不可替代的作用。
Psychological crisis intervention practice first appeared in the United States, at the time just after the war, a large number of physical and mental destroyed military psychological need professional guidance, in 1946, the United States government sent 200 student psychological doctor, provide emotional therapy services for veterans in the veterans administration agencies, they very fruitful work obtained the military admitted: 1947, participation psychology crisis intervention in psychological doctor to obtain long-term active status, and was established as a formal system in the army. In 1978, Department of psychiatry, U. S. naval hospital Portsmouth set up a special mental illness by clinical psychologists, psychiatrists, nurses and health minister, members of the rapid intervention team, a number of major crisis events, such as training accidents, Dutch act, natural disaster, explosion and other emergency incidents disposal, from the rapid intervention team it has become an important part of the military crisis response mechanism, plays an important, irreplaceable role in carrying out various missions in the u.s..
美国的心理危机干预机制对全世界的危机处置观念产生了重要影响。我国于上世纪90年代末开始关注心理危机干预，由于党和政府大力倡导以人为本、构建和谐社会的执政理念，心理危机干预成为各种灾后重建的重要内容，党和政府的大力支持为心理危机干预发展提供了自上而下的思想指导，为汶川大地震的心理危机干预提供了政策指导，我国心理危机干预面临着难得的发展机遇。
The important influence of psychological crisis intervention mechanism of the United States of America on the world's crisis management concept. Our country began to pay attention to the psychological crisis intervention in the 90's of the last century, since the ruling idea of the party and the government vigorously promote people-oriented, building a harmonious society, has become an important part of all kinds of post-disaster reconstruction of psychological crisis intervention, the party and the government's strong support provides top-down guidance for psychological crisis intervention, provides policy guidance as the psychological crisis intervention in Wenchuan earthquake, China's psychological crisis intervention is facing rare opportunities for development.
二、地震灾后心理问题的主要表现
The main findings of two, post-disaster psychological problems
震后心理危机干预必须清楚灾民灾后出现的一般心理问题。
Psychological crisis intervention must be clear after the general psychological problems after the disaster victims.
1.灾后一般心理问题
1 post-disaster psychological problems
从心理学角度看，面对突如其来的自然灾害，人们在心理上会产生各种应激反应：情绪波动大，紧张、恐惧、易冲动、自责、伤心、焦躁不安；出现睡眠障碍，如做噩梦或入睡困难；出现惊恐反应，对外界刺激（与地震相关的信息）的反应过于敏感，出现肌肉紧张、发抖、盗汗、恶心、尿急尿频、心慌胸闷等生理心理反应，属一般心理问题，这些不良反应可以随着时间流逝而自行恢复正常，如对对其加以心理危机干预，可以加快心理康复速度，提高心理康复质量。
From a psychological point of view, face come unexpectedly natural disasters, people will have a variety of stress response in Psychology: mood swings, tension, fear, easy impulse, remorse,
sadness, anxiety; sleep disorders, such as nightmares or difficulty falling asleep; panic reaction, to external stimuli ( relevant seismic information ). The reaction is too sensitive, reactive psychophysiological muscle tension, trembling, sweating, nausea, urgency-frequency, palpitation and chest tightness, which is the general psychological problems, these adverse reactions can be with the passage of time to return to normal, as by psychological crisis intervention on the psychological rehabilitation, can accelerate the speed, improve the psychological quality of rehabilitation.
2.灾后严重心理问题
2 after the disaster of serious psychological problems
灾后严重心理问题是指因受到强烈刺激而导致的各种身心症状，如持续时间较长，则属于较严重的心理疾病，需要专业的心理治疗。这些症状包括目光呆滞、情感淡漠，有幻觉产生，思维与动作迟缓，有抑郁、孤独、狂躁、焦虑、易激动、产生语言障碍、甚至出现濒死感等，极端者可出现失聪、失明、失语、失忆、精神分裂等精神疾病。在灾后严重心理问题中比较典型和常见的心理疾病是创伤后应激障碍（Post—traumatic stress disorder，PTSD）。创伤后应激障碍是人在遭受强烈的、灾难性事件后，在其后数月至半年出现心理障碍，主要的心理反应是在受害人心理上反复出现创伤性情景、过度警觉、噩梦、出现惊跳反应，并感到强烈恐惧、抑郁、焦虑、有强烈的无助与厌恶感，严重者甚至会轻生、犯罪等，这种心理障碍总是与人遭受的灾难相生相伴。现代心理学研究发现：50%的人一生中有可能暴露于创伤事件中，但只有7.8%的人会产生这种疾病，且女性患病率高于男性。我国学者从1995—1999年对地震诱发的创伤后应激障碍进行研究后发现：唐山大地震孤儿的发病率为23%；灾后急性应激障碍的发病率为6%，灾后三个月的创伤后应激障碍的发病率快速上升到19%，三个月后则下降到7%，由此看来，对灾后应激障碍干预的关键期是灾后的三个月。三、灾后心理危机干预的策略与方法
After the disaster of serious psychological problem refers to various psychosomatic symptoms caused by strong stimulation, such as longer duration, is a serious mental illness, need of professional psychological treatment. These symptoms include glassy-eyed, apathy, are hallucinations, thinking and slow, depression, mania, anxiety, loneliness, easy excited, language barriers, even feeling of impending death, extreme person can appear deaf, blind, aphasia, amnesia, schizophrenia and mental illness. In the aftermath of serious psychological problems of relatively typical and common mental illness is post-traumatic stress disorder ( Post - traumatic stress disorder, PTSD ). Post-traumatic stress disorder is a catastrophic event in strong, after, after six months appear mental disorders, psychological reaction is mainly in the psychological traumatic situations, and hypervigilance, nightmare, startle response, and feel a strong fear, depression, anxiety, helplessness and have strong disgust feeling, and even suicide, crime, this kind of psychological obstacle is always accompanied with people suffering from. Modern psychology study found that: 50% the lifetime risk of exposure to traumatic events, but only 7.8% people will have the disease, and the prevalence of female is higher than male. Chinese scholars found that from 1995 to 1999 on the earthquake induced post-traumatic stress disorder research: Tangshan earthquake orphan disease rate was 23%; the incidence after acute stress disorder rate was 6%, after three months of onset PTSD rate rises to 19%, three months after the down to 7%, from this point of view, the key period of stress disorder intervention is three months after the disaster after disaster. The strategies and methods in three, post-disaster psychological crisis intervention 创伤后应激障碍的早期心理干预对缓解病情十分重要，他们如能得到良好的社会支持，尤其是家庭的支持，可以大大减少发病率。目前国内外较好的干预方案是心理治疗合并药物
治疗，其中以心理治疗为主。采取的主要方法有催眠、心理动力疗法、认知疗法、系统脱敏法等。
Early psychological intervention on post-traumatic stress disorder are very important to alleviate the condition, if they could get good social support, especially family support, can greatly reduce the incidence of. The intervention scheme better home and abroad is the psychological treatment combined with drug treatment, mainly psychological treatment. The main methods include hypnosis, psychodynamic therapy, cognitive therapy, systematic desensitization.
对于创伤后应激障碍的心理干预，主要有三个原则：一是尽早尽快实施心理危机干预；二是心理治疗与药物治疗相结合，但以心理治疗为主；三是充分发挥灾民自身心理康复潜能，通过心理辅导，让他们具备自我心理调节能力与技巧。当前，国外比较成功的心理治疗方法有三种：
Psychological intervention on post-traumatic stress disorder, there are three main principles: first, as soon as possible the implementation of psychological crisis intervention; two is the psychological treatment in combination with medication, but mainly psychological treatment; three is to give full play to their potential victims of psychological rehabilitation, through psychological counseling, let them have the self psychological adjustment ability and skills. At present, there are three kinds of psychological treatment method of foreign successful:
1.早期心理危机干预
1 early psychological crisis intervention
早期心理危机干预的目标是帮助处在危机中的人摆脱因地震灾害引发的暂时的认知、情绪和行为的扭曲，主要方法是在创伤初期（1个月内）为灾民提供最大的社会与心理支持，如全社会的广泛理解与援助、提供有效的应对策略和迅速适应环境的方法、帮助他们提高心理危机应对技能，使其能及时宣泄和表达不良情绪，尽快摆脱悲伤，使心理恢复平衡。Early psychological crisis intervention aims to help people in crisis caused by the earthquake from the temporary cognitive, emotional and behavioral distortions, the main method is in the initial trauma ( 1 months ) to provide social and psychological support to the victims as the largest, extensive understanding and assistance, the whole society should provide effective strategy and rapid methods to adapt to the environment, to help them to improve their psychological crisis coping skills, so that it can timely release and expression of negative emotions, get rid of sadness as soon as possible, so that the psychological balance.
2.认知行为辅导
2 cognitive behavioral counseling
这是当前治疗创伤后应激障碍最有效的心理技术，心理危机干预者通过行为矫正技术改变患者扭曲的认知观念。这种心理技术又包括暴露治疗、焦虑管理训练和认知治疗。
This is the current treatment of posttraumatic stress disorder is the most effective psychological techniques, psychological crisis intervention through the behavior correction technology change the cognitive concept with distorted. This kind of psychological techniques including exposure therapy, anxiety management training and cognitive therapy.
暴露治疗是患者面对使其恐惧的情景，然后危机干预者通过放松法使患者逐渐适应这种情景，放松的有效方法有渐进性肌肉放松法、想象性放松法和深呼吸放松法。情景可以是想象的、模拟的或半真实的。该方法主要包括五个步骤：收集患者个人资料、呼吸调节训练、想象暴露、视觉暴露和心理教育。
Exposure therapy in patients with face fear in the scene, then the crisis intervention by relaxation method to make patients gradually adapt to this situation, effective way to relax is progressive
muscle relaxation, the imagination of relaxation and deep breathing relaxation method. Scenarios can be imagined, simulated or real. The method includes five steps : the collection of personal data, adjust the breath of patients with training, imagine exposure, visual exposure and psychological education.
焦虑管理训练是通过为患者提供应付焦虑的技巧，如放松训练、积极的自我陈述、生物反馈技术和社会技能训练等方法，帮助患者提高应对能力，增加应付资源，增强战胜危机的信心，使他们从被动的无助状态转化到积极的应对状态。
Anxiety management training is to provide technique for patients with anxiety, such as relaxation training, positive self statements, biofeedback and social skills training methods, to help patients to improve the ability to deal with, cope with the increase of resources, enhance the confidence to overcome the crisis, they transformed from helplessness passive to active coping state.
认知治疗是危机干预者让患者认识自己扭曲的认知，通过与不合理的认知辩论来重建新的正确的认知，通过对灾民认知方式的改变到达改善不良情绪、减少症状、恢复社会功能的目的。
Cognitive therapy is a crisis intervention let patients know their distorted cognition, the cognitive debate and unreasonable to reconstruct a new correct cognition, the cognitive style on victims of change to improve bad mood, reduce symptoms, recovery of social function objective.
3.开展心理疏导
3 psychological counseling
对于心理创伤程度较轻的人，应通过心理辅导与心理教育，让灾民逐渐掌握自我心理疏导的基本方法与策略，对自身及亲人不良情绪进行及时宣泄；各级政府应动员相关人员开展有意义的社会活动，转移灾民注意力，帮助他们平稳度过危机期。
For the psychological trauma to a lesser extent, through psychological counseling and psychological education, let people gradually mastered the basic methods and Strategies of psychological counseling, timely release of self and family emotion; governments at all levels should mobilize the relevant personnel to carry out meaningful social activities, transfer of victims attention, to help them tide over the crisis period.
在这项工作中心理危机干预者应注意以下几点：第一，提供充足时间和合适场合鼓励他们宣泄心中的悲痛和压抑；让其充分休息，保持足够体力；第二，危机干预者耐心倾听他们的诉说，用支持和理解的态度鼓励他们；第三，帮助他们利用社会资源，从好朋友、幸存的亲人、所爱的人那里得到安慰与支持；第四，帮助他们制订切实可行的重建目标，使灾民灾后有心理动因，不至于陷入自暴自弃的消极境地中；第五，组织有共同心理问题的人相互交流心理体验，讨论应对策略；第六，说明使用镇定剂、安眠药、酒精、烟草等物品的副作用和消极效应，鼓励他们与人交往，积极参加有意义。
In this work the psychological crisis intervention should note the following points: first, to provide sufficient time and the right place to encourage them to express their grief and depression; let them rest, to maintain adequate physical strength; second, crisis intervention, patience to listen to them, with the support and understanding attitude to encourage them; third, help them to use social resources, comfort and support from friends, surviving relatives, loved ones; fourth, to help them develop practical reconstruction, so that the victims have psychological causes of disaster, so as not to fall into pessimism negative situations; fifth, the organization has the common psychological problems of people communicate with each other psychological experience, discuss coping strategies; sixth, side effects that use of tranquilizers, sleeping pills, alcohol, tobacco and other goods and the negative effect, encourage them to interact with people, and actively
participate in meaningful.