tailieunhanh - HANDBOOK OF PSYCHOLOGY - PART 5

Sự hiện diện kéo dài đau đầu bắt đầu gây một số tâm lý bệnh nhân theo thời gian, như vậy mà bệnh nhân trở nên • ốm và mệt mỏi cảm giác bị bệnh và suy nghĩ và cảm xúc tiêu cực phát sinh từ kinh nghiệm lặp đi lặp lại của đau đầu do đó có thể trở nên căng thẳng hơn nữa hoặc kích hoạt | 254 Headaches The prolonged presence of headache begins to exert a psychological toll on the patient over time such that the patient becomes sick and tired of feeling sick and negative thoughts and emotions arising from the repeated experience of headache thus can become further stressors or trigger factors in and of themselves referred to as headache-related distressZ serving at that point both to help maintain the disorder and to increase the severity and likelihood of future attacks. Pointing out the direct and indirect psychological in uences on headache may make it easier for the patient to understand and accept the role of psychological factors and can often facilitate referral for adjunctive psychological psychiatric care when needed to illustrate ask the patient which is worse onset of a headache when the patient is refreshed and rested or when work and family frustrations are at a peak . This model points out the various areas to address when interviewing headache patients. Implementation Appropriate treatment implementation assumes adequate expertise in the application of the interventions selected. Because this chapter is intended for nonmedical practitioners the following sections will address the application and implementation of nonpharmacological behavioral and cognitive behavioral interventions that have garnered empirical support to date. As previous sections have indicated appropriate medical evaluation cannot be overlooked and pharmacological therapy may be the treatment of choice or a necessary component. When pharmacotherapy is used ongoing medical assessment and collaboration with a quali ed medical provider is critical Blanchard Diamond 1996 . A common element among all therapies is patient education which begins at the onset and continues throughout treatment. Research by Packard 1987 reveals that information about headache is one of the top needs of patients when they come for treatment. Each of the following treatments begins .