Gangguan

perkembangan
remaja
(dari berbagai

Ratna Widiastuti, S.Psi.,M.A.,Psi.

sumber)
Ratna Widiastuti, S.Psi., M.A., Psi.

1
Intervensi gangguan perkembangan pd remaja
Prevensi sekunder:
identifikasi diri dan tritmen
utk masalah kesehatan yg
muncul atau perilaku yg
membahayakan kesehatan

Prevensi tertier:
manajemen dan
pengobatan
penyakit kronik
dan enyakit dg
Prevensi primer: konsekuensi
mencegah/mengurangi jangka panjang
perilaku berisiko (merokok,
seks bebas, malas-malasan)
MENGAPA REMAJA?
• ASSET NEGARA
• POLA HIDUP TIDAK SEHAT PADA
REMAJA AKAN BERDAMPAK PADA
MASA BERIKUTNYA  mengurangi
produktivitas, membebani biaya
negara
• PENGARUH: MEROKOK, OBESITAS,

Ratna Widiastuti, S.Psi.,M.A.,Psi.

MALAS BERGERAK / KURANG OR
• EFEK DR GAYA HIDUP TIDAK SEHAT
 PENYAKIT KRONIK (DIABETES,
JANTUNG, PARU, STROKE, TEKANAN
DARAH TINGGI, PENYAKIT SEKSUAL
MENULAR)  GANGGUAN
MENTAL ( ANXIETY, GANGGUAN
PSIKIATRIK, DEPRESI, BIPOLAR)

3
ANOREKSIA NERVOSA
• UMUR 16-24 TH
• 5% REMAJA
• KELG STATUS SOSIAL MENENGAH KE ATAS
• PREDISPOSISI :

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• FK BIOLOGIS & GENETIK  DISFUNGSI HIPOTALAMUS,
• INTRAPERSONAL  CEMAS, DEPRESI, INTROVERT,
PERFEKSIONIS, PERFEKSIONIS,
• KELUARGA  kaku, overprotekstif, penuh konflik, ibu tll
berperan & ayah tidak,
• SOSBUD  tuntuan budaya/TV, ekskul balet, penyakit kronik
diabetes melitus
4
MANIFESTASI
• MERASA DIRINYA GEMUK
• SUDAH KURUS PUN MASIH MERASA GEMUK
• KEPRIBADIAN: PENGKRITIK DIRI SENDIRI, PERFEKSIONIS,
CERDAS & POPULER DI SEKOLAH

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• APATIS, TIDAK MAMPU MENGEKSPRESIKAN KEBAHAGIAAN,
TERTEKAN, TIDAK BERGAIRAH, LEKAS MARAH, MALAS
BERGAUL
• DR KELG DG STRES KRONIS  BERCERAI ATAU BERPINDAH
TEMPAT

5
MANIFESTASI
• TINGKAH LAKU MAKAN 
MEMBATASI MAKANAN
BERKALORI TINGGI, DIBAGI-
BAGI DLM PORSI KECIL,
DIBUMBUI/DIBUBUHI SST
SHG TIDAK MENARIK,
CAMPURAN YG TIDAK WAJAR

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• MENGGAMBARKAN DIRINYA
20-80% LEBIH BESAR DR
UKURAN SSGHNYA
• MODEL DI MEDIA ADALAH YG
MENARIK YG KURUS,
SEMAKIN KURUS SEMAKIN
TINGGI STATUS SOSIAL

6
DIAGNOSIS
• MEMBIARKAN DIRI KELAPARAN
• TAKUT GEMUK; MENGHINDARI MAKAN
• GANGG FISIOLOGIS FS HORMON REPRODUKSI  TDK MENS
• DSM III:

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• TAKUT GEMUK BERLEBIHAN SHG TJD PENURUNAN BB
DRASTIS
• GANGGUAN PENAMPILAN TUBUH  TAKUT GEMUK SHG TDK
MAKAN
• PENURUNAN BB 25% DR BB SEMULA\MENOLAK
MEMPERTAHANKAN BB NORMAL
• TIDAK PENYAKIT FISIK LAIN YG MENGAKIBATKAN BB TRN
7
TATALAKSANA
• REHABILITASI NUTRISI  GASTROINTESTINAL (KALORI
3500/HARI) & EDEMA PERIFER (KURANGI GARAM), OBAT
ANTICEMAS
• PSIKOTERAPI  REGULASI EMOSI KRN CEMAS & TAKUT
• PEMELIHARAAN & TINDAK LANJUT  BERAT BADAN

Ratna Widiastuti, S.Psi.,M.A.,Psi.

NORMAL, TINGKAH LAKU MAKAN NORMAL, KEMATANGAN
SOS. EMOSI, MENS NORMAL, SEKOLAH/KERJA DG EFEKTIF,
HUBUNGAN MEMUASKAN, KEMAMPUAN DIRI CAKAP

8
BULIMIA NERVOSA
• EPISODE BINGE EATING
• MERANGSANG MUNTAH, GERAK BERLEBIHAN, PUASA
BERKEPANJANGAN, PENYALAHGUNAAN LAKSAN ATAU
DIURETIK
• TJD DI USIA 13-58

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• 3% DI MASYARAKAT
• SEMUA KELAS MASYARAKAT

9
ETIOLOGI
• ADIKSI MAKANAN & PERILAKU
• KELUARGA DISFUNGSI ATAU KEKERASA NFISIK & SEKSUAL
• SOSBUD  MEDIA MASSA
• KOGNITIF & TINGKAH LAKU  IRASIONAL BENTUK TUBUH,

Ratna Widiastuti, S.Psi.,M.A.,Psi.

BERAT BADAN, DIET, KEPERCAYAAN DIRI
• PSIKODINAMIKA  MENGENDALIKAN & MENGHINDARI RASA
TERTEKAN, IMPULSIF, CEMAS

10
MANIFESTASI
• BINGE EATING  3000-7000KAL
• PURGING  MEMUNTAHKAN DG MERANGSANG FARING,
LAKSAN, DIURETIK, ENEMA, GERAK BERLEBIHAN
• BODY IMAGE KELIRU

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• DEPRESI, RASA BERSALAH, MENYESAL YG MENDALAM

11
 GEJALA KLINIS
• PEMBENGKAKAN • MUDAH
TANGAN /KAKI PENDARAHAN
• LEMAH, LELAH • DIARE BERDARAH
• SAKIT KEPALA • PERUBAHAN KULIT

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• PERUT TERASA PENUH JARI,
• MUAL HIPERPIGMENTASI,
LUKA PARUT
• HAID TDK TERATUR
• PEMBESARAN
• KRAM OTOT KELENJAR LUDAH
• NYERI DADA & RASA • EROSI EMAIL GIGI
TERBAKAR
12
 PSIKOPATOLOGI
• ANOREKSIA NERVOSA • BULIMIA NERVOSA
• TAKUT GEMUK • SAMA
• MENGURANGI MAKAN • SAMA
• BINGE EATING & PURGING (TDK • SAMA (HRS ADA)
HRS ADA)

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• RAHASIA TINGKAH LAKU • SAMA
• TIDAK ADA KEINGINAN BERHENTI • INGIN ORLA
MENGHENTIKANNYA

13
TATALAKSANA
• MENURUNKAN POLA MAKAN BULIMIK
• HINDARI MAKANAN BINGE SPT ES KRIM
• OBAT ANTI DEPRESAN
• PSIKOTERAPI

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• OR RINGAN – SEDANG
• TERAPI KELOMPOK
• DIET RENDAH GARAM U/ YG MEMAKAI DIURETIK
• KONSUL DR GIGI UTK KERUSAKAN GIGI

14
DEPRESI
• SEDIH
• GANGGUAN SOMATIK, MUDAH LELAH, KURANG ENERGI
• GANGGUAN PSIKOMOTOR, LAMBAT, KURANG ANTUSIAS,
RAGU2

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• MUDAH TERSINGGUNG
• GAGAL MENAIKKAN BERAT BADAN NORMAL
• WAKTU: SATU TAHUN
• GANGG AFEKSI
• IDE BUNUH DIRI
• MUDAH TERSINGGUNG
• IMSONIA 15
• SULIT BERKONSENTRASI
PENYEBAB
• PSIKODINAMIKA  PUTUS CINTA & INTROYEKSI
• KOGNITIF BEHAVIORAL: PANDANGAN NEGATIF TTG DIRI SENDIRI,
INTERPRETASI NEGATIF TTG HIDUPNYA, HARAPAN NEGATIF TTG
DIRINYA, RASA TAK BERHARGA, HELPLESS, HOPELESS
• LEARNED HELPLESSNESS MODEL

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• KETIDAKMAMPUAN ORTU MENCIPTAKAN HUBUNGAN YG BAIK
• BIOLOGIS  NOREPINEPRIN & SEROTONIN, GANGG HIPOTALAMUS,
HORMON PERTUMBUHAN, TIROID, NEURO IMUNOLOGIS, GENETIK
• PSIKOSOSIAL  MASALAH KELUARGA, KETRAMPILAN SOS
KURANG, CERAI, ORTU MISKIN, SAUDARA BANYAK, FUNGSI
KELUARGA BURUK
16
KLASIFIKASI
• AFEKTIF BIPOLAR (satu atau lebih episode energi peningkatan
kadar normal, kognisi , dan mood dengan atau tanpa satu atau lebih
episode depresi. Suasana hati meningkat secara klinis disebut
sebagai mania atau, jika ringan, hypomania . Episode ini biasanya
dipisahkan oleh periode "normal" suasana hati)

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• HIPOMANIA (lht atas)
• DISTIMIA (gangguan mood yang ditandai oleh depresi ringan)
• GANGG PENYESUAIAN ( gangguan sementara/awal ketika gambaran
klinis tidak jelas, namun reaksi thd keadaan lebih dari yang
diharapkan secara norma)
• SIKLOTIMIA, RINGAN SLM 1 TAHUN (Bentuk yang lebih ringan,
dimana periode kegembiraan dan depresi tidak terlalu berat,
berlangsung hanya beberapa hari dan kambuh dalam selang waktu
17
yang tidak beraturan. Pada akhirnya penyakit siklotimik
berkembang menjadi penyakit manik-depresif, tetapi tidak pernah
berkembang menjadi depresi maupun mania.)
TERAPI
• PSIKOTERAPI
KELUARGA
• OBAT ANTI
DEPRESAN

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• TERAPI CBT

18
SUICIDE/BUNUH DIRI
• USIA: 15-24 TH,
• POPULASI: 9%

Ratna Widiastuti, S.Psi.,M.A.,Psi.

19
FAKTOR RISIKO
• BIOLOGIS  SEROTONIN
• GANGGUAN MENTAL
ADHD, DEPRESI, IMSONIA
• PENYALAHGUNAAN ZAT
• MINORITAS, GAY,
LESBI,BISEKS
• MASALAH KELUARGA

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• MASALAH SOSIAL
 KDRT, MISKIN, SEXUAL
ABUSE
• MASALAH SEKOLAH 
TEKANAN PELAJARAN,
TEMAN SEBAYA
• CINTA
20
TERAPI
• CBT (COCNITIVE BEHAVIORAL THERAPY)
• PELATIHAN SOFT SKILL
• FARMAKOLOGI ANTIDEPRESAN

Ratna Widiastuti, S.Psi.,M.A.,Psi.

21
PENYALAHGUNAAN ZAT
• akibat:
• Distress
• Hubungan dengan
orang lain terganggu

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• Gangguan
perkembangan
kognitif, emosi, sosial
• Kriminalitas
• Masalah kompetensi
disekolah 22
PENYALAHGUNAAN ZAT
• akibat:
• Gangguan psikiatrik
• Conduct disorder
• Depresi

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• ADHD
• Anxiety
• Kehamilan usia dini
• Penyakit seksual
• Sakit fisik (jantung,
saraf, seksual)
23
ADHD
• Tanda: tidak
perhatian, hiperaktif,
impulsif
• Terjadi pd 3-7% anak

Ratna Widiastuti, S.Psi.,M.A.,Psi.

dan masih berlanjut
hingga remaja (50-
80%)
• Social incompetence,
behavior
24
Treatments for ADHD
• Classroom-based interventions include educational strategies,
peer-directed strategies, and self-management strategies.
Treatments have addressed both social and academic
concerns associated with ADHD. Educational and instructional
interventions manipulate classroom organization and

Ratna Widiastuti, S.Psi.,M.A.,Psi.

instructional techniques that minimize the occurrence of
ADHD symptoms (Waschbusch & Hill, 2001). Examples of this
treatment strategy include the use of instructional materials
to increase stimulation to students with ADHD during
academic tasks to enhance attention and improve
performance (Zentall, 1993).
• peer tutoring appears to be an effective strategy for
addressing the academic and behavioral difficulties associated
with ADHD in general education classrooms 25
Treatments for ADHD
• Behavior management focused on increasing on-task
behaviors, task completion, compliance, impulse control, and
social skills. Behavior management aims for a reduction in
hyperactivity, off-task behavior, disruptive behavior, and
aggression. Refers to strategies that use reinforcement and

Ratna Widiastuti, S.Psi.,M.A.,Psi.

punishment to increase or decrease specific behaviors.
Positive reinforcement, punishment, and response cost
techniques are the most widely used of the behavior
therapies (Fiore, Becker, & Nero, 1993).
• Cognitive-behavioral therapy combines behavioral
techniques with cognitive strategies to directly address
problems of impulse control, problem solving, and self-
26
regulation. Produce desired changes in sustained attention,
impulse control, hyperactivity, and self-concept (Fiore, Becker,
& Nero, 1993).
Treatments for ADHD
• Self-management strategies have been employed with children who
have ADHD. This type of intervention focuses on teaching students
to systematically rate their own behavior according to the rating of
their teachers. Shapiro, DuPaul, and Bradley-Klug (1998)
conceptualize self-management interventions as existing on a
continuum. On one end, the teacher controls the intervention by
providing feedback regarding whether the student’s behaviors have

Ratna Widiastuti, S.Psi.,M.A.,Psi.

met the desired criteria and delivers appropriate consequences for
the behaviors. On the other end, the student is able to self-evaluate
his or her own behaviors against the criteria set for behavior and
performance. The student also self-administers consequences. The
goal of self-management interventions is to move the student
toward the self-management side of the continuum. Once students
are able to accurately measure their behavior against the standard
set by their teacher, the frequency of teacher feedback on student
judgments is gradually lessened until students are accurately judging
the quality of their behavior without the help of eternal
comparisons. 27
SKIZOFRENIA
• Schizophrenia is a mental
disorder involving a range
of cognitive and
emotional dysfunctions
that include perception,

Ratna Widiastuti, S.Psi.,M.A.,Psi.

inferential thinking,
language and
communication,
behavioral monitoring,
affect, fluency and
productivity of thought
and speech, hedonic
capacity, volition and
drive, and attention. 28
SKIZOFRENIA
• Criterion A: two or more of the following symptoms must be present
for a significant portion of time during a one-month period (if the
condition has been treated successfully, then the period may be
less).
• Delusions
• Hallucinations

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• Disorganized speech, such as frequent derailment or incoherence
• Grossly disorganized or catatonic behavior
• Negative symptoms, such as affective flattening, alogia, or avolition
• If there are delusions, and they are bizarre; or if there are
hallucinations and they comprise a voice that keeps up a running
commentary on the person’s behavior or thoughts, or there are two
or more voices that are conversing with each other — then only
these sole symptoms are necessary and sufficient for diagnosis; a
second symptom is not required. The presence of this relatively
severe constellation of signs and symptoms is referred to as the 29
“active phase”.
SKIZOFRENIA
• Criterion B: a major area of function such as work,
interpersonal relations or self-care is severely impacted for a
significant portion of the time since the onset of the
disturbance.
• Criterion C: the disturbance persists continuously for at least

Ratna Widiastuti, S.Psi.,M.A.,Psi.

six months. These six months must include at least one month
of symptoms that meet criterion A. The period may also
exhibit prodromal or residual symptoms, during which the
signs of the disturbance may be manifested by only negative
symptoms. It is also possible that during the six-month period,
two or more symptoms listed in Criterion A present in an
attenuated form.
30
SKIZOFRENIA
• Criterion D: during the period of six months described under
Criterion C, there have been no major Depressive, Manic or
Mixed Episodes occurring concurrently with the symptoms of
Criterion A. Further, if at all any mood disorder episodes have
occurred during the six-month period, these episodes have

Ratna Widiastuti, S.Psi.,M.A.,Psi.

been of a duration that is much less than the period when the
Criterion A symptoms were active.
• Criterion E: the disturbance is not an outcome of the
physiological effects of a substance or a general medical
condition.
• Criterion F: in case there is a history of autistic disorder or any
other pervasive developmental disorder, then there must also
be the presence of prominent delusions or hallucinations, for
at least one month, in order for the individual to be diagnosed 31
for schizophrenia.
• The characteristic symptoms outlined in Criterion A may be
conceptualized as falling into two broad categories:
• Positive Symptoms: These symptoms appear to reflect an excess or
distortion of normal functions. Listed in Criterion A1 to A4, the
positive symptoms further comprise two distinct dimensions, each
related to its own underlying neural mechanism and clinical

Ratna Widiastuti, S.Psi.,M.A.,Psi.

correlates:
• Psychotic Dimension: The following two positive symptoms form
part of the psychotic dimension:
• Delusions: distortions in thought content
• Hallucinations: distortions in perception

32
• Disorganization Dimension: The following two positive symptoms
form part of the the disorganization dimension
• Disorganized speech: distortions in language and thought processes
• Grossly disorganized or catatonic behavior: deficiency in self-
monitoring of behavior
• Negative Symptoms: Listed in Criterion A5, negative symptoms

Ratna Widiastuti, S.Psi.,M.A.,Psi.

include restrictions in the range and intensity of emotions, and take
on the following forms:
• Affective flattening: restriction in emotional expressions
• Alogia: deficit in fluency of thought and productivity of thought and
speech
• Avolition: shortfall in initiating goal-directed behavior

33
Illness management skills
• patients can learn to prevent relapses. Patients can also use coping
skills to deal with persistent symptoms.
• IntRehabilitation. Rehabilitation emphasizes social and vocational
training to help people with schizophrenia function better in their
communities. Because schizophrenia usually develops in people
during the critical career-forming years of life (ages 18 to 35), and

Ratna Widiastuti, S.Psi.,M.A.,Psi.

because the disease makes normal thinking and functioning
difficult, most patients do not receive training in the skills needed
for a job.
• Rehabilitation programs can include job counseling and training,
money management counseling, help in learning to use public
transportation, and opportunities to practice communication skills.
34
Illness management skills
• Family education. People with schizophrenia are often discharged from
the hospital into the care of their families. So it is important that family
members know as much as possible about the disease. family members
can learn coping strategies and problem-solving skills. In this way the
family can help make sure their loved one sticks with treatment and stays
on his or her medication.
• Cognitive behavioral therapy that focuses on thinking and behavior. The

Ratna Widiastuti, S.Psi.,M.A.,Psi.

therapist teaches people with schizophrenia how to test the reality of
their thoughts and perceptions, how to "not listen" to their voices, and
how to manage their symptoms overall. CBT can help reduce the severity
of symptoms and reduce the risk of relapse.
• Self-help groups. With members support and comfort each other which
can help everyone feel less isolated, with families to work together to
advocate for research and more hospital and community treatment
programs, to draw public attention to the discrimination many people
with mental illnesses face.
35
Gangguan lain pada remaja
• kecemasan / anxiety  stres/distres
• Learning disorder  disleksia, diskalkulia,
disgrafia, clumsy/ motor disorganized disorder
• Bipolar

Ratna Widiastuti, S.Psi.,M.A.,Psi.

36
Treatments for ADHD
• Classroom-based interventions YAITU DENGAN strategi
pendidikan (di kelas), kelompok sebaya (tutoring), dan
manajemen diri.

Ratna Widiastuti, S.Psi.,M.A.,Psi.

37
Treatments for ADHD
• Manajemen perilaku memfokuskan pada penugasan,
perilaku yang dituju, mengendalikan impuls, ketrampilan
sosial. Tujuan dari manajemen perilaku untuk mengurangi
hiperaktivitas, perilaku btidak mengikuti perintah,

Ratna Widiastuti, S.Psi.,M.A.,Psi.

menganggu, dan agresi. Teknik yg banyak digunakan adalah
hadiah, hukuman, token ekonomy (Fiore, Becker, & Nero,
1993).
• Cognitive-behavioral therapy mengkombinasikan strategi
kognitif untuk mengendalikan impuls, pemecahan masalah,
dan regulasi diri agar impuls terkendali, hiperaktivitas
menurun, dan konsep diri positif (Fiore, Becker, & Nero,
38
1993).
SKIZOFRENIA
• Schizophrenia adalah
gangguan mental yg
melibatkan disfungsi
kognitif dan emosional
termasuk persepsi,

Ratna Widiastuti, S.Psi.,M.A.,Psi.

berpikir, bahasa dan
komunikasi, perilaku,
perasaan, produksi dan
ketepatan pikiran dan
perkataan, kapasitas
hedonik, perhatian,
dorongan. 39
SKIZOFRENIA
• Criterion A:dua atau lebih simtom yg harus muncul selama jangka
waktu tertentu dalam satu bulan (jika kondisi langsung ditangani
mungkin kurang dari sebulan)
• Delusi

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• Halusinasi
• Perkataan tidak beraturan, misal ngawur atau tidak koheren
• Perilaku katatonik atau tidak terorganisir
• Simptom negativisme seperti emosi tumpul/datar, alogia, atau
avolition
• Delusi yg aneh, misal suara yg ada di kepala atau pikiran, atau suara
orang ngobrol, simtom ini penting dan memdadi utk diagnosis
sebgagai tandai fase aktif. 40
SKIZOFRENIA
• Criterion B: area fungsi diri mayor seperti di ttempat
kerja, hubungan interpersonal, atau rawatan diri
terganggu dengan sangat sejak munculnya gangguan.
• Criterion C: angguan berlangsung terus menerus

Ratna Widiastuti, S.Psi.,M.A.,Psi.

sedikitnya selama 6 bulan, termsuk selama sebulan
memenuhi kriteria A. Periode ini juga ada simtom
residual yg termanifes mungkin hanya simtom
negativitas. Selama jangka waktu 6 bulan ini dau atau
lebih simtom di kriteria A muncul.

41
SKIZOFRENIA
• Criterion D: selama 6 bulan dimasukkan dalam kriteria C,
tidak ada major Depressive, Manic atau bercampur dengan
simtom kriteria A. Jika semua gangguan mood terjadi selama
periode 6 bulan, waktunya lebih sedikit daripada masa /fase

Ratna Widiastuti, S.Psi.,M.A.,Psi.

aktif di kriteria A.
• Criterion E: gangguan bukan merupakan efek atau hasil dari
efek fisiologis zat atau kondisi medik.
• Criterion F: dalam kasus autisme atau gangguan
perkembangan menetap (pervasive developmental
disorder), arus ada delusi, halusinasi sedikitnya 1 bulan.
42
Karateristik simtom Criterion
A• terbagi dalam 2 kategori:
• Positive Symptoms: muncul merefleksikan fungsi normal yg
berlebihan atau terdistorsi, yaitu:
• Psychotic Dimension: simtom positif dalam bentuk dimensi
psikotik adalah:

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• Delusi: isi pikiran yg terdistorsi
• Halusinasi: distorsi persepsi
• Disorganization Dimension: dua bentuk simtom positif
dimensi disorganisasi adalah
• Perkataan tak terorganisir: distorsi proses pikiran dan
bahasa
43
• Tak terorgasnisir motorik kasar tidak terorganisir atau
perilaku katatonik: kurang monitoring diri perilaku
Negative Symptoms
• Daftar Criterion A5, termasuk
keterbatasan dalam jarak dan
intensitas emosi & mengikuti
bentuk di bawah:
• Perasaan tumpul:

Ratna Widiastuti, S.Psi.,M.A.,Psi.

keterbatasan ekspresi emosi
• Alogia: kurang lancarnya
pikiran dan produksi pikiran
serta perkataan
• Avolition: kurang aktif dalam
perilaku yg mempunyai tujuan
tertentu
44
 Ketrampilan manajemen
gangguan
• Pasien dapat belajar untuk mencegah munculnya kekambuhan,
dan mempunyai ketrampilan mengatasi (coping skills) untuk
menghadapi simtom menetap.
• Rehabilitation. Rehabilitasi menekankan pada pelatihan sosial

Ratna Widiastuti, S.Psi.,M.A.,Psi.

dan vokasional utk membantu pasien skizofren beerfungsi
lebih baik dalam komunitasnya. Karena skizofrenia muncul
pada usia karir (18 – 35 tahun), dan penyakit membuat cara
berpikir serta fungsi diri mengalami kesulitan jadi harus
mendapat pelatihan utk mendapat pekerjaan.
• Termasuk program rehabilitasi adalah konseling pekerjaan dan
pelatihan pekerjaan, konseling manajemen keuangan, belajar 45
menggunakan fasilitas umum, mempelajari ketrampilan
berkomunikasi.
Ketrampilan menejemen
• Family education. Pasien seringkali sesudah keluar dari institusi
perawatan harus dirawat keluarga sehingga keluarga harus tahu
berbagai hal yang berkaitan dengan skizofren, membantu
mempelajari coping yang baru, cara mengatasi masalah, dan

Ratna Widiastuti, S.Psi.,M.A.,Psi.

meyakinkan pasien utk melanjutkan pengobatannya.
• Cognitive behavioral therapy yaitu memfokuskan pada pikiran dan
perilaku, mengajarkan bagaimana menlakukan tes apakah pikiran
dan persepsi mereka benar/yg sesungguhnya dan bagaimana
mengelolanya. CBT dapar membantu mengurangi keparahan
simtom dan mengurangi kekambuhan.
• Self-help groups. Dengan dukungan dan kenyamanan anggota satu
sama lain akan mengurangi rasa terasing pasien. Keluarga juga 46
dapat bekerja bersama dalam program tritmen, untuk meminta
masyarakat lebih peduli dengan diskriminasi yg dialamai pasien.
Gangguan lain
• Gangguan mood :
depresi, Bipolar,
kecemasan / anxiety
 stres/distres

Ratna Widiastuti, S.Psi.,M.A.,Psi.

• Psikopatologi,
antisosial
• Learning disorder 
disleksia, diskalkulia,
disgrafia, clumsy/
motor disorganized
disorder 47