äžçäžã§é©çšå¯èœãªãå®èšŒæžã¿ã®äžå®ç®¡çãã¯ããã¯ãæ¢æ±ããŸããã¹ãã¬ã¹ã軜æžãã粟ç¥çãªå¹žçŠãæ¹åããã°ããŒãã«åãããäžçã§æåããããã®å®è·µçãªæŠç¥ãåŠã³ãŸãããã
å¿ããã¹ã¿ãŒããïŒã°ããŒãã«ãªäžçã®ããã®å¹æçãªäžå®ç®¡çãã¯ããã¯
仿¥ã®ããŒã¹ã®éããçžäºã«ç¹ãã£ãäžçã«ãããŠãäžå®ã¯ãããµããçµéšã§ããä»äºäžã®ãã¬ãã·ã£ãŒãå人çãªèª²é¡ããããã¯äžççãªåºæ¥äºã«èµ·å ãããã®ã§ãã£ãŠããäžå®ãçè§£ã管çããããšã¯ãå šäœçãªå¹žçŠãç¶æããããã«æ¥µããŠéèŠã§ãããã®å æ¬çãªã¬ã€ãã§ã¯ã倿§ãªæåãèæ¯ãè¶ããŠé©çšå¯èœãªå¹æçãªäžå®ç®¡çãã¯ããã¯ãæ¢æ±ããããªããèªèº«ã®ã¡ã³ã¿ã«ãã«ã¹ãã³ã³ãããŒã«ããæåããããã®åãäžããŸãã
äžå®ãçè§£ããïŒã°ããŒãã«ãªèŠç¹
äžå®ã¯ãå¿é ãç·åŒµãèœã¡çãã®ãªããšãã£ãææ ãç¹åŸŽãšãã人éã®èªç¶ãªææ ã§ãããéåžžã¯äžç¢ºå®ãªçµæã䌎ãåºæ¥äºãäœãã«ã€ããŠçããŸããææã®äžå®ã¯æ£åžžã§ãããæç¶çãŸãã¯é床ã®äžå®ã¯æ¥åžžç掻ã«å€§ããªåœ±é¿ãäžããå¯èœæ§ããããŸããäžå®ã¯æåã«ãã£ãŠçŸãæ¹ãç°ãªãããšãèªèããããšãéèŠã§ããããæåã§å žåçãªåå¿ãšèŠãªããããã®ããå¥ã®æåã§ã¯ç°ãªã£ãŠèŠããããããããŸããããããã£ãŠãèªåèªèº«ã®æåçæèã«ãããäžå®ã®ãã¥ã¢ã³ã¹ãçè§£ããããšãäžå¯æ¬ ã§ãã
äžå®ã®è¡šçŸã«ãããæåçå·®ç°ã®äŸïŒ
- æ±ã¢ãžã¢ïŒäžå®ã®èº«äœçç¶ïŒèº«äœçãªèšŽãïŒããææ çãªçç¶ãããå ±åãããããåŸåããããŸããå人ã¯å¿é ãææã®ææ ã衚çŸããããããè ¹çãé çãæãããšè¡šçŸãããããããŸããã
- è¥¿æŽæååïŒææ ã®çŽæ¥çãªè¡šçŸãäžè¬çã«åãå ¥ããããŠãããããå人ãäžå®ãªææ ãèšèã«ããå°éå®¶ã®å©ããæ±ããå¯èœæ§ãé«ããããããŸããã
- éå£äž»çŸ©æååïŒéå£ã®èª¿åãéèŠãããããä»è ã«è² æ ããããªãããã«ãšå人ãäžå®çç¶ãæå§ããããšããããŸãã
æåçèæ¯ã«é¢ããããäžå®ã®æ ¹åºã«ããççåŠçããã³å¿çåŠçã¡ã«ããºã ã¯äŒŒãŠããŸããäžå®ç®¡çãã¯ããã¯ã®ç®æšã¯ããããã®åå¿ã調æŽããèœã¡çããšã³ã³ãããŒã«ã®æèŠãä¿é²ããããšã§ãã
å®èšŒæžã¿ã®äžå®ç®¡çãã¯ããã¯
以äžã®ãã¯ããã¯ã¯ãæ§ã ãªäººã ã«ãããŠäžå®ã管çããã®ã«å¹æçã§ããããšã瀺ãããŠããŸããåã ã®ããŒãºã«æé©ãªã¢ãããŒããæ±ºå®ããããã«ãå»çå°éå®¶ãã¡ã³ã¿ã«ãã«ã¹ã®å°éå®¶ã«çžè«ããããšãå¿ããªãã§ãã ããã
1. ãã€ã³ããã«ãã¹ãšçæ³
ãã€ã³ããã«ãã¹ãšã¯ã倿ãäžããã«çŸåšã®ç¬éã«æ³šæãéäžãããå®è·µã§ããçæ³ã¯ãåŒåžãé³ããã³ãã©ãªã©ã®åäžã®åç §ç¹ã«å¿ãéäžãããããã«èšç·Žããããšã§ããã€ã³ããã«ãã¹ãé€ããã¯ããã¯ã§ãããããã®å®è·µã¯ãèªåã®æèãææ ã«ããæ°ã¥ãã®ãå©ãããããã«æµãããããšãªã芳å¯ããããšãå¯èœã«ããŸãã
å®è·µæ¹æ³ïŒ
- ãã€ã³ããã«ãªåŒåžïŒéããªå ŽæãèŠã€ããå¿«é©ã«åº§ããåŒåžã«éäžããŸãã空æ°ãäœã«åºå ¥ãããæèŠã«æ°ã¥ããŸããããå¿ãïŒå¿ ç¶çã«ïŒããŸãã£ãããåªããæ³šæãåŒåžã«æ»ããŸãã
- ããã£ã¹ãã£ã³çæ³ïŒå¿«é©ã«æšªã«ãªããäœç³»çã«äœã®æ§ã ãªéšåã«æ³šæãåãã倿ããã«ããããæèŠã«æ°ã¥ããŸãã
- æ©è¡çæ³ïŒãã£ãããšæå³çã«æ©ããªãããè¶³ãå°é¢ã«è§ŠããæèŠã«æ³šæãæããŸãã
ã°ããŒãã«ãªé©å¿ïŒãã€ã³ããã«ãã¹ã®å®è·µã¯æ±æŽã®äŒçµ±ã«æ ¹ãããŠããŸãããäžä¿çãªçšéã«é©å¿ãããçŸåšã§ã¯äžçäžã§åºãå®è·µãããŠããŸããå€ãã®ã¢ããªããªã³ã©ã€ã³ãªãœãŒã¹ããæ§ã ãªèšèªã§ã¬ã€ãä»ãçæ³ãæäŸããŠããŸãã
2. èªç¥è¡åçæ³ïŒCBTïŒ
CBTã¯ãäžå®ã®åå ãšãªãåŠå®çãªæèãã¿ãŒã³ãè¡åãç¹å®ããå€åãããããšã«çŠç¹ãåœãŠãçæ³ã®äžçš®ã§ããæèãææ ãè¡åã®éã®é¢é£æ§ãçè§£ããããé©å¿çãªå¯ŸåŠæŠç¥ãéçºããã®ã«åœ¹ç«ã¡ãŸãã
CBTã®äž»èŠãªãã¯ããã¯ïŒ
- èªç¥åæ§ææ³ïŒåŠå®çãªæèãç¹å®ããããã«ææŠããŸããäŸãã°ãããã®ãã¬ãŒã³ããŒã·ã§ã³ã¯å€±æããã ããããšèããŠããå ŽåãCBTã¯ãã®èããè£ä»ãã蚌æ ãšåãã蚌æ ãæ€èšŒãããç§ã¯æºåãã§ããŠããããæåãå°œãããå®ç§ã§ãªããŠããäžçã®çµããã§ã¯ãªãããšãã£ãããããã©ã³ã¹ã®åããçŸå®çãªèãã«çœ®ãæããæå©ããããŸãã
- æé²çæ³ïŒå®å šã§ç®¡çãããç°å¢ã§ãæããŠããç¶æ³ã察象ã«åŸã ã«èº«ãããããŸããããã«ãããäžå®ã¯ãããæ²»ãŸããæããŠããçµæã¯äºæ³ããã»ã©æªããªãããšãåŠã¶ã®ã«åœ¹ç«ã¡ãŸãã
- è¡å掻æ§åïŒåã³ãéææãããããæŽ»åã«åŸäºããŸããããã¯æ°åãæ¹åããäžå®æã軜æžããã®ã«åœ¹ç«ã¡ãŸãã
ã°ããŒãã«ãªã¢ã¯ã»ã·ããªãã£ïŒCBTã¯åºãå®è·µãããç ç©¶ãããŠããçæ³ã§ããäžçäžã®å€ãã®ã»ã©ãã¹ããCBTã®èšç·ŽãåããŠããããªã³ã©ã€ã³ãªãœãŒã¹ãã»ã«ããã«ãææãå©çšå¯èœã§ããããããã¡ã³ã¿ã«ãã«ã¹ãµãŒãã¹ãžã®ã¢ã¯ã»ã¹ã¯ãå Žæã瀟äŒçµæžçå°äœã«ãã£ãŠå€§ããç°ãªãå ŽåããããŸããé éæ²»çã¯ãé éå°ããµãŒãã¹ã®è¡ãå±ããŠããªãå°åã®äººã ã«å¯ŸããŠããŸããŸãCBTãžã®ã¢ã¯ã»ã¹ãæäŸããŠããŸãã
3. ãªã©ã¯ãŒãŒã·ã§ã³æ³
ãªã©ã¯ãŒãŒã·ã§ã³æ³ã¯ãå¿ææ°ã®å¢å ãçèã®ç·åŒµãéãåŒåžãªã©ãäžå®ã«äŒŽãçççãªè奮ã軜æžããã®ã«åœ¹ç«ã¡ãŸãã
广çãªãªã©ã¯ãŒãŒã·ã§ã³æ³ïŒ
- æ·±åŒåžæ³ïŒãã£ãããšããæ·±ãåŒåžã¯ããªã©ã¯ãŒãŒã·ã§ã³ãä¿é²ããå¯äº€æç¥çµç³»ã掻æ§åãããããšãã§ããŸãã4-7-8ãã¯ããã¯ã詊ããŠã¿ãŠãã ããïŒ4ç§éæ¯ãåžã蟌ã¿ã7ç§éæ¯ãæ¢ãã8ç§éãããŠæ¯ãåãåºããŸãã
- 挞é²ççåŒç·©æ³ïŒPMRïŒïŒäœã®æ§ã ãªçè矀ãç·åŒµããããç·©ãããããããšã§ãçèã®ç·åŒµãããæèããããããªã©ãã¯ã¹ãããæ¹æ³ãåŠã¶ã®ã«åœ¹ç«ã¡ãŸãã
- èªåŸèšç·Žæ³ïŒèªå·±æç€ºãçšããŠæè¶³ã«æž©ãããéãã®æèŠãçã¿åºãããªã©ã¯ãŒãŒã·ã§ã³ã«å°ããã¯ããã¯ã§ãã
æåçãªé¢é£æ§ïŒãªã©ã¯ãŒãŒã·ã§ã³æ³ã¯äžè¬çã«æåãè¶ããŠé©çšå¯èœã§ããããããå人ã«é¿ãç¹å®ã®ãã¯ããã¯ã¯ç°ãªãå ŽåããããŸããäŸãã°ãã¬ã€ãä»ãã®ã€ã¡ãŒãžã³ã°ãèŠèŠåã奜ã人ãããã°ãæ·±åŒåžæ³ããã广çã ãšæãã人ãããŸãã
4. éåãšèº«äœæŽ»å
宿çãªèº«äœæŽ»åã¯ãäžå®ã管çããããã®åŒ·åãªããŒã«ã§ããéåã¯æ°åã髿ããã广ã®ãããšã³ãã«ãã£ã³ãæŸåºãããŸããçèã®ç·åŒµãåãããç¡ç ãæ¹åããã®ã«ã圹ç«ã¡ããããã¯ããããäžå®ã®äžå ãšãªãåŸãŸãã
æšå¥šäºé ïŒ
- é±ã®ã»ãšãã©ã®æ¥ã«ãããŠãå°ãªããšã30åã®äžåŒ·åºŠã®éåãç®æããŸãããã
- ãŠã©ãŒãã³ã°ãã©ã³ãã³ã°ãæ°Žæ³³ããã³ã¹ããšã¬ãªã©ã楜ãããæŽ»åãéžã³ãŸãããã
- 10åéã®æ£æ©ã®ãããªçæéã®æŽ»åã§ãããå€åãããããããšããããŸãã
ã°ããŒãã«ãªèæ ®äºé ïŒèº«äœæŽ»åã®ããã®å®å šã§ã¢ã¯ã»ã¹ããããã¹ããŒã¹ãžã®ã¢ã¯ã»ã¹ã¯ãå Žæã«ãã£ãŠç°ãªãå ŽåããããŸããéåæŽ»åãéžã¶éã«ã¯ãæ°åãã€ã³ãã©ãæåçãªèŠç¯ãªã©ã®èŠå ãèæ ®ããŠãã ããã
5. 瀟äŒçæ¯æŽ
ä»è ãšç¹ããã匷åãªç€ŸäŒçæ¯æŽãããã¯ãŒã¯ãç¯ãããšã¯ãäžå®ã管çããäžã§æ¥µããŠéèŠã§ããä¿¡é Œã§ããå人ãå®¶æããŸãã¯ãµããŒãã°ã«ãŒããšè©±ãããšã¯ãææ çãªæ¯æŽãæäŸããå€ç«æãæžãããç°ãªãèŠç¹ãæäŸããããšãã§ããŸãã
瀟äŒçæ¯æŽã®æ§ç¯ïŒ
- å人ãå®¶æã«å®æçã«é£çµ¡ãåããŸãããã
- äžå®ãæ±ãã人ã ã®ããã®ãµããŒãã°ã«ãŒãã«åå ããŸãããã
- å°å瀟äŒã§ãã©ã³ãã£ã¢æŽ»åãããŸãããã
- 楜ãããç€ŸäŒæŽ»åã«åå ããŸãããã
æåçãªé æ ®ïŒç€ŸäŒçæ¯æŽã·ã¹ãã ã®å©çšå¯èœæ§ãšå容床ã¯ãæåã«ãã£ãŠç°ãªããŸããäžéšã®æåã§ã¯å®¶æãå°å瀟äŒã®ã¡ã³ããŒããã®å©ããæ±ããããšã奜ãŸããŸãããä»ã®æåã§ã¯å°éå®¶ã®å©ããããäžè¬çã§ãã瀟äŒçæ¯æŽãæ±ããéã«ã¯ãæåçãªèŠç¯ã奜ã¿ãå°éããããšãéèŠã§ãã
6. çæŽ»ç¿æ £ã®èª¿æŽ
ããžãã£ããªçæŽ»ç¿æ £ã®å€æŽã¯ãäžå®ã¬ãã«ã«å€§ããªåœ±é¿ãäžããå¯èœæ§ããããŸãã
äž»èŠãªçæŽ»ç¿æ £ã®èª¿æŽïŒ
- å¥åº·çãªé£äºïŒæç©ãéèãå šç²ç©ç©ãè±å¯ãªãã©ã³ã¹ã®åããé£äºã¯ãæ°åãæ¹åããäžå®ã軜æžããããšãã§ããŸããå å·¥é£åãçã飲ã¿ç©ãéå°ãªã«ãã§ã€ã³ãã¢ã«ã³ãŒã«ã¯å¶éããŸãããã
- ååãªç¡ç ïŒæ¯æ©7ã8æéã®è³ªã®é«ãç¡ç ãç®æããŸããããèŠåæ£ããç¡ç ã¹ã±ãžã¥ãŒã«ã確ç«ãããªã©ãã¯ã¹ã§ããå°±å¯åã®ç¿æ £ãäœããŸãããã
- ã«ãã§ã€ã³ãšã¢ã«ã³ãŒã«ã®å¶éïŒãããã®ç©è³ªã¯äžå®çç¶ãæªåãããå¯èœæ§ããããŸãã
- ã¹ãã¬ã¹ç®¡çïŒç掻ã®äžã®ã¹ãã¬ã¹æºãç¹å®ãã管çããŸããããã«ã¯ãå¢çç·ãèšå®ããããã¿ã¹ã¯ãå§ä»»ããããæé管çè¡ãå®è·µãããããããšãå«ãŸããå ŽåããããŸãã
ã°ããŒãã«ãªé©å¿ïŒé£äºã®ã¬ã€ãã©ã€ã³ãç¡ç ãã¿ãŒã³ã¯æåã«ãã£ãŠç°ãªãå ŽåããããŸããçæŽ»ç¿æ £ã«é¢ããæšå¥šäºé ãããèªèº«ã®æåçèæ¯ãå人ã®ããŒãºã«åãããŠèª¿æŽããŸãããã
7. èªç¶ãšã®è§Šãåã
èªç¶ã®äžã§æéãéããããšã¯ãã¹ãã¬ã¹ãäžå®ã軜æžããããšã瀺ãããŠããŸããç ç©¶ã«ãããšãç·å°ãžã®é²åºã¯ã³ã«ããŸãŒã«ã¬ãã«ãäžããæ°åãæ¹åããèªç¥æ©èœãé«ããããšãããã£ãŠããŸãã
çæŽ»ã«èªç¶ãåãå ¥ããæ¹æ³ïŒ
- å ¬åãæ£®ãæ£æ©ããŸãããã
- ã¬ãŒããã³ã°ãããããå±å€ã§æéãéããããããŸãããã
- å®¶ããªãã£ã¹ã«æ€ç©ã眮ããŸãããã
- èªç¶ã®åçãèŠãŸãããã
ã¢ã¯ã»ã·ããªãã£ïŒç·å°ãžã®ã¢ã¯ã»ã¹ã¯å Žæã«ãã£ãŠç°ãªãå ŽåããããŸããèªç¶ã®äžã§éããæéããããã§ãã£ãŠãæçã§ããèªç¶ç°å¢ãžã®ã¢ã¯ã»ã¹ãéãããŠããå Žåã¯ãèŠ³èæ€ç©ãèªç¶ããã¥ã¡ã³ã¿ãªãŒãªã©ã®å±å ã§ã®ä»£æ¿æ¡ãæ€èšããŠãã ããã
å°éå®¶ã®å©ããæ±ããã¹ãæ
ã»ã«ããã«ãã®ãã¯ããã¯ã¯è»œåºŠããäžç床ã®äžå®ã管çããã®ã«å¹æçã§ãããæ¬¡ã®ãããªå Žåã¯å°éå®¶ã®å©ããæ±ããããšãéèŠã§ãïŒ
- äžå®ãæ¥åžžç掻ã«å€§ããªåœ±é¿ãäžããŠããã
- ãããã¯çºäœãçµéšããŠããã
- èªå·ãä»å®³ã®èããããã
- ã»ã«ããã«ãã®ãã¯ããã¯ã§ã¯ååãªç·©åãåŸãããªãã
ã¡ã³ã¿ã«ãã«ã¹ã®å°éå®¶ã¯ãåã ã®ããŒãºã«åãããå æ¬çãªè©äŸ¡ã蚺æãæ²»çèšç»ãæäŸã§ããŸããæ²»çã®éžæè¢ã«ã¯ãã»ã©ããŒãæè¬ããŸãã¯ãã®äž¡æ¹ã®çµã¿åãããå«ãŸããå ŽåããããŸãã
ã°ããŒãã«åãããäžçã§äžå®ãä¹ãåã
ã°ããŒãã«åã¯ãã¡ã³ã¿ã«ãã«ã¹ã«ãšã£ãŠæ©äŒãšèª²é¡ã®äž¡æ¹ããããããŸããããã¯æåãè¶ããŠäººã ãã€ãªããæ°ãããªãœãŒã¹ãèŠç¹ãžã®ã¢ã¯ã»ã¹ãæäŸã§ããäžæ¹ã§ã次ã®ãããªèŠå ã«ããã¹ãã¬ã¹ãäžå®ã®å¢å€§ã«å¯äžããããšããããŸãïŒ
- ç«¶äºã®æ¿åïŒã°ããŒãã«ãªåŽååžå Žã¯éåžžã«ç«¶äºãæ¿ããããã¬ãã·ã£ãŒãšäžå®ã®å¢å€§ã«ã€ãªããå¯èœæ§ããããŸãã
- æåãžã®é©å¿ïŒæ°ããæåãç°å¢ã«é©å¿ããããšã¯ãã¹ãã¬ã¹ãå€ããäžå®ãåŒãèµ·ããå¯èœæ§ããããŸãã
- æ å ±éå€ïŒäžçäžããã®ãã¥ãŒã¹ãæ å ±ãžã®çµ¶ãéãªãã¢ã¯ã»ã¹ã¯ãå§åçã§ãããäžå®æã®äžå ãšãªãããšããããŸãã
- 瀟äŒçå€ç«ïŒã°ããŒãã«åã¯æã«ãå€ç«æãèªãã®æåçã«ãŒãããã®æçµ¶æã«ã€ãªããããšããããŸãã
ãããã®èª²é¡ãä¹ãåãããã«ã¯ãã¬ãžãªãšã³ã¹ïŒå埩åïŒãé€ãã匷ã瀟äŒçã€ãªãããç¶æããã»ã«ãã±ã¢ãåªå ããããšãéèŠã§ããæåçã³ãã¥ããã£ããã®æ¯æŽãæ±ããåæ§ã®çµéšãå ±æããä»ã®äººã ãšã€ãªãããŸãããã
çµè«
äžå®ã¯ä»æ¥ã®ã°ããŒãã«åããäžçã§ã¯ãããµããçµéšã§ããã管çå¯èœã§ããæåã«ããäžå®ã®ãã¥ã¢ã³ã¹ãçè§£ãããã®ã¬ã€ãã§è°è«ããããã¯ããã¯ãå®è·µããããšã§ãããªãã¯èªåã®ã¡ã³ã¿ã«ãã«ã¹ãã³ã³ãããŒã«ããæåããããšãã§ããŸããå°éå®¶ã®å©ããæ±ããããšã¯åŒ·ãã®èšŒã§ãããã¡ã³ã¿ã«ãŠã§ã«ããŒã€ã³ã°ãžã®ããªãã®æ ããµããŒãããããã®ãªãœãŒã¹ãå©çšå¯èœã§ããããšãå¿ããªãã§ãã ããããã€ã³ããã«ãã¹ãã»ã©ããŒããªã©ã¯ãŒãŒã·ã§ã³æ³ãéåã瀟äŒçæ¯æŽãçæŽ»ç¿æ £ã®èª¿æŽãåãå ¥ãããäžå®ç®¡çãžã®å šäœçãªã¢ãããŒããåãå ¥ããŸããããããªãã®ã¡ã³ã¿ã«ãã«ã¹ãåªå ããçžäºã«ç¹ãã£ãäžçã®èª²é¡ãšæ©äŒãä¹ãåãããã®å埩åã®ããèãæ¹ãé€ã£ãŠãã ãããèªåã«ãšã£ãŠäœãæã广çããèŠã€ããããã«æéããããå šäœçãªå¹žçŠããµããŒãããå人çãªäžå®ç®¡çèšç»ãäœæããŠãã ãããããªãã®ã¡ã³ã¿ã«ãã«ã¹ã¯éèŠã§ãã