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Yıl:2018; Cilt: 3; Sayı: 2>> Özet
Türkiye Klinikleri Psikoloji Özel Dergisi; 2018;3(2):13-21
Kronik Ağrı Sendromlarında Motivasyonel Müdahale Yöntemleri
ÖS Berk
İstanbul Üniversitesi, İstanbul
Pek çok fiziksel ve ruhsal hastalığa ya da belirtiye eşlik eden kronik ağrı, tanımı ve nitelikleri itibari ile biyopsikososyal bir yaşantı olup tedavilerinin multidisipliner bir ekip içinde Ağrı Başetme Merkezlerinde yürütülmesi giderek yaygınlaşan bir altın standart haline gelmiştir. Öte yandan kronik ağrı yönetiminde tedavi modalitelerinin etkinliğine dair tutarsız sonuçlar elde edilmekte, aynı durum mutidisipliner sistem içinde merkezi konumda olan psikolojik yöntemlerden Bilişsel Davranışçı Terapiler için de gözlenmektedir. Bu tartışmalar farklı yöntem arayışlarını da beraberinde getirmiş olup kronik ağrı tedavilerinde motivasyonel yöntemler, ilk adımları yaklaşık 20 yıl öncesine dayanan bir geçmişle, psikolojik müdahaleler içinde yerini almaya başlamıştır. Bu kısa derleme çalışmasında ilk olarak kronik ağrı sendromlarına yönelik bilişsel-davranışçı terapilerin temel özellikleri özetlenecek, ardından bu tedavilere uyumu artırmayı amaçlayan motivasyonel müdahalelerin hedeflerinden, yöntemlerinden ve etkinliklerinden yani bu müdahalelerin başarı düzeylerinden bahsedilecektir. Son olarak kronik ağrının doğası ile kronik ağrı vakalarının ihtiyaçları doğrultusunda motivasyonel yöntemlerde ne tür revizyonlara gidilebileceğine dair öneriler ele alınacaktır.
Motivational Intervention Strategies for Chronic Pain Syndromes
Chronic pain (CP) is a biopsychosocial experience which accompanies numerous physical/mental health problems. Due to its multidimensional nature, it is well acknowledged that multidisciplinary treatment interventions in Pain Management Centers are a gold standard. However, the treatment outcome studies yield moderate efficiency and inconsistent results, which is also true for Cognitive Behavioral Therapies (CBT), the most widely employed psychological approach. This has led researchers/clinicians seek for novel treatment modalities. Thus, motivational interventions (MI) for CP syndromes have called increased attention since last two decades. Within this brief review the major aspects of CBT for chronic pain will shortly be summarized. Then, the main goals, strategies and practices of MI that aim to increase adherence to multidisiciplinary treatments will be reviewed. Finally, as a function of the nature of CP and the needs of individuals with CP, what major revisions are called for and can be employed will be addressed.

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