— 心理社會完整性 · MEDIUM · MCQ —
一位患有強迫症（OCD）的 30 歲個案每天花數小時洗手。對此個案最合適的目標為何？
A 30-year-old client with obsessive-compulsive disorder (OCD) spends hours washing hands. What is the most appropriate goal for this client?
- AEliminate the ritualistic hand washing completely in 24 hours在24小時內完全消除儀式性洗手
- BPunish the client for each hand-washing event因每次洗手事件懲罰病人
- CPrevent the client from washing hands at all防止病人洗手
- DGradually reduce the time spent on hand washing rituals✓ 正解逐漸減少花在洗手儀式上的時間
— Explanation · 中文詳解 —
強迫症治療需循序漸進。直接禁止（A、C）會導致嚴重焦慮，甚至引發恐慌。懲罰（B）完全不具治療性。漸進式減量（Exposure and Response Prevention, ERP）能讓個案在可控範圍內減輕焦慮，並獲得成就感。
Treatment of OCD requires a gradual approach. Outright prohibition (A and C) leads to severe anxiety and may even precipitate panic. Punishment (B) has no therapeutic value. Gradual reduction (Exposure and Response Prevention, ERP) allows the patient to reduce anxiety within a manageable range and experience a sense of accomplishment.
✦ 台美臨床差異
台美皆推行行為治療，但台灣基層門診中，此類個案常配合藥物治療以降低焦慮，較少專注於純行為治療。