TERAPIA COGNITIVO COMPORTAMENTAL PARA O MANEJO DAS OBSESSÕES SEXUAIS NO TRANSTORNO OBSESSIVO COMPULSIVO
UMA REVISÃO NARRATIVA
DOI:
https://doi.org/10.35919/rbsh.v35.1198Palavras-chave:
Terapia Cognitiva Comportamental, Transtorno obsessivo compulsivo (TOC), Obsessões sexuaisResumo
O transtorno obsessivo compulsivo (TOC) é um transtorno mental caracterizado pela presença de obsessões e compulsões. Algumas obsessões ou pensamentos intrusivos podem ter cunho sexual. O presente artigo tem por objetivo investigar as técnicas utilizadas pela Terapia Cognitivo Comportamental (TCC) para o tratamento das obsessões sexuais em pessoas com diagnóstico de TOC. Para tanto, foi realizada uma revisão narrativa por meio de consulta às bases PsycINFO, Pubmed e Socpus. Os resultados indicam que as principais técnicas da TCC utilizadas para o tratamento de obsessões sexuais são a psicoeducação, a reestruturação cognitiva, a exposição e prevenção de resposta, e as alternativas contextuais que salientam práticas de mindfulness e aceitação.
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Copyright (c) 2024 Fernanda Rafaela Cabral Bonato, Bruna Gund, Roberta Cristina Gobbi Baccarim, Nicolas de Oliveira Cardoso
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