リカバリー志向の作業療法による自己効力感の回復―～認知行動療法的手法を用いて～

Regaining a feeling of self-efficacy through recovery-oriented occupational therapy and cognitive-behavioral therapy techniques

要旨：本報告の目的は，統合失調症者に対するリカバリー志向の作業療法（以下，OT）とOTにおける認知行動療法（以下，CBT）的手法の有効性について検討することである．被害的な幻聴や注察感，作為体験により引きこもりの生活をしていた統合失調症患者に，リカバリー志向のOTを実践した．その過程で，CBT的手法を用いた面接を行った．結果，主体性の向上やセルフモニタリング機能の改善とともに，自己効力感が回復し，デイケアへの参加が可能となった．この経過から，リカバリー志向のOTとCBT的手法によって，OTがより実践的で有効なものになる可能性が示唆された．

　The purpose of this study was to consider the effectiveness of recovery-oriented occupational therapy (OT) and cognitive-behavioral therapy (CBT) in OT toward a person with schizophrenia. We practiced the recovery-oriented OT for the schizophrenic patient who was confined to his house because of auditory hallucinations, delusions of persecution and factitious behavior. OT interviews were conducted using CBT techniques. As a result, his self-efficacy was restored, and there were improvements of his self-monitoring function, treatment motivation, and identity. As a result, he could join the day care center programs. The results indicate that OT activities could be more practical and effective by combining recovery-oriented OT and the CBT technique.