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“离家”的痛苦——一例学生抑郁咨询案例

Between Loyalty and Autonomy: A Case Study of Family-Driven Psychological Counseling in University Students

Theory and Practice of Psychological Counseling / 2025,7(3): 82-90 / 2025-03-14 388 223

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• Authors: 郭霞      李思蕾     
• Information:

  兰州大学，兰州

• Keywords: College students; Family; Psychotherapy 大学生；家庭；心理咨询
• Abstract: This case study presents a college student experiencing severe depression and social anxiety due to intergenerational family conflicts, particularly parental expectations of perfection in pursuing medicine. Through a 12-session integrative intervention combining CBT and attachment theory, the client achieved three key outcomes: (1) Disrupting irrational beliefs of “perfection as necessity” and redefining self-worth through intrinsic growth; (2) Developing practical emotion regulation strategies (e.g., diaphragmatic breathing, reality testing) to manage acute anxiety; and (3) Transforming family dynamics from unidirectional compliance to reciprocal communication, resulting in a PHQ-9 score reduction from 21 to 9 (clinical remission). The case underscores the importance of culturally sensitive, family-inclusive approaches in university mental health services to foster students’ autonomy amid generational tensions. 本案例报告聚焦于一名因家庭代际文化冲突引发严重抑郁情绪与社交焦虑的大学生来访者。其核心困扰源于父母对其“学医就必须完美”的严苛期待，导致其长期压抑真实自我需求，形成“情感依附型生存模式”。通过十二次咨询，咨询师协助来访者完成以下关键转变：（1）瓦解“非完美即失败”的非理性信念，重构“自我价值源于内在成长”的认知体系；（2）建立情绪调节工具箱（如呼吸训练、现实检验技术），有效缓解急性焦虑发作；（3）重塑家庭互动模式，从单向服从转向双向沟通。最终实现抑郁量表（PHQ-9）得分从21分降至临床缓解标准的9分。本案例揭示了高校心理服务需突破个体治疗局限，通过文化敏感性干预与家庭系统协作，帮助学生在代际冲突中构建主体性人格，为同类问题提供跨学科整合的实践参考。
• DOI: https://doi.org/10.35534/tppc.0703010
• Cite: 郭霞，李思蕾．“离家”的痛苦——一例学生抑郁咨询案例［J］．心理咨询理论与实践，2025，7（3）：82-90.