{"id":1144,"date":"2013-01-30T22:24:47","date_gmt":"2013-01-30T20:24:47","guid":{"rendered":"http:\/\/www.hvtd.org\/?p=1144"},"modified":"2013-01-30T22:24:47","modified_gmt":"2013-01-30T20:24:47","slug":"ucus-korkusu-tedavi-yontemleri-bilissel-davranisci-terapi-ile-sanal-gerceklik-uygulamasinin-karsilastirilmasi","status":"publish","type":"post","link":"https:\/\/www.hvtd.org\/?p=1144","title":{"rendered":"U\u00c7U\u015e KORKUSU TEDAV\u0130 Y\u00d6NTEMLER\u0130: Bili\u015fsel Davran\u0131\u015f\u00e7\u0131 Terapi ile Sanal Ger\u00e7eklik Uygulamas\u0131n\u0131n Kar\u015f\u0131la\u015ft\u0131r\u0131lmas\u0131"},"content":{"rendered":"

\"ucuskorkusu\"<\/a>U\u00e7u\u015f korkusu, n\u00fcfusun %13.2\u2019sini etkileyen olduk\u00e7a yayg\u0131n bir fobidir. Ara\u015ft\u0131rmalar g\u00f6stermi\u015ftir ki, u\u00e7u\u015f korkusu da dahil olmak \u00fczere bir \u00e7ok \u00f6zg\u00fcl fobinin en etkili tedavi \u015fekli davran\u0131\u015f\u00e7\u0131 terapidir. Tedavi uygulamalar\u0131n\u0131n bir\u00e7o\u011fu, test u\u00e7u\u015flar\u0131 yoluyla maruz kalma (y\u00fczle\u015ftirme) y\u00f6ntemini ve u\u00e7u\u015fla ilgili temel bilgilendirmeyi i\u00e7ermektedir. Baz\u0131 programlar, y\u00fczle\u015ftirme tekni\u011fini u\u00e7u\u015f sim\u00fclat\u00f6rlerinde yapmaktad\u0131r.<\/p>\n

1. Bili\u015fsel Davran\u0131\u015f\u00e7\u0131 Terapi (BDT):<\/b> Etkinli\u011fi \u00e7e\u015fitli ara\u015ft\u0131rmalarla kan\u0131tlanm\u0131\u015ft\u0131r.<\/p>\n

2.<\/b> Sanal Ger\u00e7eklik Uygulamas\u0131 (Virtual Reality<\/b> Exposure –<\/b> VRE):<\/b> Bu teknikte, sanki ger\u00e7ek bir u\u00e7u\u015ftaym\u0131\u015f gibi, g\u00f6rsel ve di\u011fer alg\u0131lar\u0131 ger\u00e7ek gibi hissettiren bilgisayar donan\u0131mlar\u0131 ve aletlerin oldu\u011fu bir ortam yarat\u0131larak, ki\u015fi ger\u00e7ek kayg\u0131y\u0131 yaratan uyaranlarla de\u011fil, kopyalar\u0131yla y\u00fczle\u015ftirilirler. VRE y\u00f6ntemi sayesinde u\u00e7u\u015fun b\u00fct\u00fcn \u00f6\u011feleri terapistin ofisinde s\u0131n\u0131rs\u0131z bir \u015fekilde tekrarlanabilir ve farkl\u0131 hava ko\u015fullar\u0131 (\u00f6rn: f\u0131rt\u0131na) k\u0131sa s\u00fcrede yarat\u0131labilir.<\/p>\n

3. Bibliyoterapi (B\u0130B):<\/b> Okuma ve pratik yapma yoluyla kendi kendine yard\u0131m rehberi olarak \u00f6zg\u00fcl fobilerin tedavisinde (bir terapistin yard\u0131m\u0131 olmaks\u0131z\u0131n da) etkili oldu\u011fu ortaya konulmu\u015ftur.<\/p>\n

Bu ara\u015ft\u0131rmaya kat\u0131lanlar 3 gruba ayr\u0131lm\u0131\u015flard\u0131r:<\/p>\n

1) VRE (Sanal ger\u00e7eklik uygulanan grup) – 1 saatlik seanslar (4 haftada 1 )<\/p>\n

2) BDT ( Bili\u015fsel davran\u0131\u015f\u00e7\u0131 tedavi grubu) – 1 saatlik 2-4 haftal\u0131k seanslar<\/p>\n

3) B\u0130B uygulanan grup – 5 hafta<\/p>\n

B\u00fct\u00fcn deneklerden u\u00e7u\u015f korkusu ile ilgili bir kitap okumalar\u0131 (Yard\u0131m! U\u00e7mal\u0131y\u0131m) istenmi\u015ftir. BIB grubundakiler sonraki 5 hafta boyunca ba\u015fka bir tedavi almam\u0131\u015flard\u0131r.<\/p>\n

Tedavi:<\/b><\/p>\n

VRE uygulamas\u0131 Amsterdam \u00dcniversitesi Klinik Psikoloji b\u00f6l\u00fcm\u00fcnde karanl\u0131k bir laboratuarda uygulanm\u0131\u015ft\u0131r. Sanal u\u00e7u\u015f ortam\u0131 bilgisayar arac\u0131l\u0131\u011f\u0131 ile olu\u015fturulmu\u015ftur. U\u00e7u\u015f korkusu i\u00e7in bir havaalan\u0131 (Amsterdam) ve bir u\u00e7ak i\u00e7i ortam\u0131 olmak \u00fczere 2 adet sanal ortam yarat\u0131lm\u0131\u015ft\u0131r. \u0130lk b\u00f6l\u00fcmde hastalar\u0131n havaalan\u0131 i\u00e7erisinde y\u00fcr\u00fcd\u00fckleri ortam canland\u0131r\u0131lm\u0131\u015ft\u0131r. Bu b\u00f6l\u00fcmde alana, hastalar\u0131n tutunabilece\u011fi y\u00fcr\u00fcyen bir parmakl\u0131k konulmu\u015ftur. \u0130kinci k\u0131s\u0131mda ise hastalar kalk\u0131\u015f, t\u00fcrbulans ve ini\u015f s\u0131ras\u0131ndaki titre\u015fimleri veren u\u00e7ak koltu\u011funa oturtulmu\u015flard\u0131r. Y\u00fckseklik korkusu i\u00e7in de a\u015famal\u0131 olarak uygulanan 3 sanal ortam yarat\u0131lm\u0131\u015ft\u0131r: a) A\u00e7\u0131k bir alanda 6 katl\u0131 bir yang\u0131n \u00e7\u0131k\u0131\u015f\u0131; b) Bir binan\u0131n tepesinde bir teras bah\u00e7esi; c) 8 katl\u0131 sanal bir in\u015faat alan\u0131.<\/p>\n

Kapal\u0131 alan korkusunun\u00a0 (Klostrofobi) tedavisi i\u00e7in de 3 farkl\u0131 sanal ortam olu\u015fturulmu\u015ftur:<\/p>\n

a) Biri b\u00fcy\u00fck, biri k\u00fc\u00e7\u00fck 2 asans\u00f6r; b) Gittik\u00e7e daralan bir koridor; c) 1 metrekarelik k\u00fc\u00e7\u00fck bir oda.<\/p>\n

Tedavi s\u0131ras\u0131nda hastalardan kayg\u0131lar\u0131n\u0131 d\u00fczenli olarak 0-10 aras\u0131nda derecelendirmeleri ve tedavi s\u0131ras\u0131nda kendilerine kayg\u0131 yaratan durumlar\u0131 a\u015famal\u0131 olarak anlatmalar\u0131 istenmi\u015ftir. Her a\u015famadaki kayg\u0131 sonland\u0131\u011f\u0131nda hastalar bir sonraki a\u015famaya ge\u00e7meleri i\u00e7in cesaretlendirilmi\u015flerdir. (\u00f6rn: u\u00e7a\u011f\u0131n \u00f6nce bir basama\u011f\u0131na \u00e7\u0131k\u0131p, kayg\u0131 sonland\u0131\u011f\u0131nda ikinci basama\u011fa ge\u00e7mek gibi.) Bu s\u00fcre\u00e7te sadece maruz b\u0131rakma (y\u00fczle\u015ftirme) kullan\u0131lm\u0131\u015f, herhangi bir kognitif m\u00fcdahale ya da gev\u015feme tekni\u011fi verilmemi\u015ftir. Hastalara ev \u00f6devi de verilmemi\u015f veya evde kendi kendilerine pratik yapmalar\u0131 istenmemi\u015ftir. Bireysel seanslar ise kognitif terapi ve relaksasyonu (gev\u015feme) da kapsam\u0131\u015ft\u0131r. Bu teknikler\u00a0 4 seans kadar bir s\u00fcre devam etmi\u015f ve ayn\u0131 zamanda terapistin ofisindeki u\u00e7ak koltu\u011funda otururken de uygulanm\u0131\u015ft\u0131r. Kognitif teknikler ki\u015finin ger\u00e7ek d\u0131\u015f\u0131 inan\u00e7lar\u0131n\u0131 ortadan kald\u0131rmak i\u00e7in kullan\u0131lm\u0131\u015ft\u0131r. BIB grubundakilere u\u00e7u\u015f korkusu i\u00e7in, \u201cu\u00e7u\u015f, u\u00e7aklar, gev\u015feme, kognitif ve davran\u0131\u015f\u00e7\u0131 ba\u015fa \u00e7\u0131kma stratejileri ve kendi kendine yard\u0131m\u0131\u201d i\u00e7eren kitap verilmi\u015f ve 5 hafta i\u00e7inde VRE veya BDT ile tedavi ba\u015flamadan \u00f6nce okumalar\u0131 istenmi\u015ftir. B\u00fct\u00fcn gruptaki kat\u0131l\u0131mc\u0131lar VRE veya BDT’yi tamamlad\u0131ktan sonra son olarak, psikoe\u011fitim, u\u00e7aklar hakk\u0131nda e\u011fitim, pilot u\u00e7u\u015f g\u00fcvenli\u011fi, kognitif terapi, 2 sim\u00fclasyon u\u00e7u\u015funu ve bir ger\u00e7ek u\u00e7u\u015fu kapsayan 2-d grup e\u011fitimi alm\u0131\u015flard\u0131r.<\/p>\n

Sonu\u00e7lar ve Tart\u0131\u015fma:<\/b><\/p>\n

Ara\u015ft\u0131rmaya, demografik ve anamnezik \u00f6l\u00e7\u00fcmlerinde (ya\u015f, cinsiyet da\u011f\u0131l\u0131m\u0131, son u\u00e7u\u015ftan sonra ge\u00e7en s\u00fcre, fobi s\u00fcresi ve kayg\u0131 skorlar\u0131) farkl\u0131l\u0131k olmayan 86 ki\u015fi al\u0131nm\u0131\u015ft\u0131r. Sonu\u00e7lar, tek ba\u015f\u0131na hi\u00e7bir tedavi y\u00f6nteminin istenilen etkiyi sa\u011flamad\u0131\u011f\u0131n\u0131 g\u00f6stermi\u015ftir. B\u0130B, di\u011fer \u00f6zg\u00fcl fobilerde iyi sonu\u00e7 vermekle birlikte u\u00e7u\u015f korkusunda etkili bir tedavi y\u00f6ntemi olarak bulunmam\u0131\u015ft\u0131r. B\u0130B, VRE ve BDT de tek ba\u015f\u0131na istenilen etkiyi g\u00f6stermemi\u015ftir. Etkiler beklenilenden az olarak \u00f6l\u00e7\u00fclm\u00fc\u015ft\u00fcr. Bunun sebebi, sanal ortamda ya\u015fanan kayg\u0131 s\u00f6nmesinin ger\u00e7ek hayatta kontrol edilememesi nedeniyle olabilir. \u00d6rne\u011fin, hastalar akrofobi i\u00e7in tedavi edilselerdi bunun etkisini g\u00fcnl\u00fck ya\u015famda deneyimleyebilirlerdi (\u00f6rn: merdiven \u00e7\u0131kma, al\u0131\u015fveri\u015f merkezine gitme vb.) Ancak u\u00e7u\u015f korkusunun genellenmi\u015f etkisi, kendini sadece ger\u00e7ek u\u00e7ak i\u00e7inde u\u00e7arken belli etmektedir. VRE s\u0131ras\u0131nda korku s\u00f6nmesi ya\u015fayan hastalar, bunun ger\u00e7ek u\u00e7u\u015fta olup olmayaca\u011f\u0131na dair \u015f\u00fcphe duymu\u015f olabilirler ve bu da beklenilen etkiyi d\u00fc\u015f\u00fcrm\u00fc\u015f olabilir.<\/p>\n

Bu \u00e7al\u0131\u015fma, u\u00e7u\u015f korkusu tedavisinin di\u011fer \u00f6zg\u00fcl fobilerin tedavisinden daha kompleks oldu\u011funu ve bir\u00e7ok tekni\u011fin bir arada kullan\u0131lmas\u0131 gerekti\u011fini g\u00f6stermi\u015ftir.<\/p>\n

\u00c7eviri<\/b>:<\/b> Psk. Sevin\u00e7 K\u0131r\u0131mer<\/p>\n

Kaynak<\/b>:<\/b> Krijn M, Emmelkamp PMG, \u00d3lafsson RP, et al. Fear of Flying Treatment Methods: Virtual Reality Exposure vs. Cognitive Behavioral Therapy. Aviat Space Environ Med 2007; 78:121-128.<\/p>\n","protected":false},"excerpt":{"rendered":"

U\u00e7u\u015f korkusu, n\u00fcfusun %13.2\u2019sini etkileyen olduk\u00e7a yayg\u0131n bir fobidir. Ara\u015ft\u0131rmalar g\u00f6stermi\u015ftir ki, u\u00e7u\u015f korkusu da dahil olmak \u00fczere bir \u00e7ok \u00f6zg\u00fcl fobinin en etkili tedavi \u015fekli davran\u0131\u015f\u00e7\u0131 terapidir. Tedavi uygulamalar\u0131n\u0131n bir\u00e7o\u011fu, test u\u00e7u\u015flar\u0131 yoluyla maruz kalma (y\u00fczle\u015ftirme) y\u00f6ntemini ve u\u00e7u\u015fla ilgili temel bilgilendirmeyi i\u00e7ermektedir. Baz\u0131 programlar, y\u00fczle\u015ftirme tekni\u011fini u\u00e7u\u015f sim\u00fclat\u00f6rlerinde yapmaktad\u0131r. 1. Bili\u015fsel Davran\u0131\u015f\u00e7\u0131 Terapi (BDT): Etkinli\u011fi \u00e7e\u015fitli ara\u015ft\u0131rmalarla kan\u0131tlanm\u0131\u015ft\u0131r. […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_eb_attr":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[6],"tags":[],"class_list":["post-1144","post","type-post","status-publish","format-standard","hentry","category-bulten"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts\/1144","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1144"}],"version-history":[{"count":2,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts\/1144\/revisions"}],"predecessor-version":[{"id":1147,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts\/1144\/revisions\/1147"}],"wp:attachment":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1144"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1144"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1144"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}