TERAPI KOGNITIF PERILAKU PADA KASUS TRIKOTILOMANIA DAN GANGGUAN PENYESUAIAN DENGAN REAKSI DEPRESI BERKEPANJANGAN: SEBUAH LAPORAN KASUS

I Gusti Agung Ayu Widyarini; Natalia Widiasih Raharjanti; Anak Agung Ayu Agung Kusumawardhani

doi:10.51878/paedagogy.v5i2.5868

Authors

I Gusti Agung Ayu Widyarini Departemen Ilmu Kedokteran Jiwa/ Fakultas Kedokteran Universitas Udayana
Natalia Widiasih Raharjanti Departemen Ilmu Kedokteran Jiwa/ Fakultas Kedokteran Universitas Indonesia
Anak Agung Ayu Agung Kusumawardhani Departemen Ilmu Kedokteran Jiwa/ Fakultas Kedokteran Universitas Indonesia

DOI:

https://doi.org/10.51878/paedagogy.v5i2.5868

Keywords:

Cognitive Behavior Therapy, Habit Reversal Therapy, Graded Exposure, Trikotilomania, Gangguan Penyesuaian

Abstract

ABSTRACT

Trichotillomania and adjustment disorder with prolonged depressive reactions are comorbidities that cause significant distress and severe impairment in social, occupational, and other important areas of daily functioning. As an evidence-based psychotherapeutic intervention, Cognitive Behavior Therapy (CBT) has been shown to be effective in treating disorders rooted in cognitive distortions and maladaptive behaviors. This case report aims to illustrate in detail the therapeutic process and outcomes of a CBT intervention given to a female patient with this dual diagnosis. The main intervention stages involved structured CBT sessions that were specifically integrated with Habit Reversal Therapy (HRT) techniques to target hair pulling behavior, and graded exposure techniques to address social anxiety. Evaluation results during and after therapy showed significant clinical improvement in the patient. Key findings included a dramatic decrease in the frequency, duration, and amount of hair pulling, as well as a reduction in the level of tension when relating to others. This report concludes that a structured combination of CBT, HRT, and graded exposure is a comprehensive and effective intervention strategy in treating a complex case of trichotillomania with adjustment disorder.

ABSTRAK

Trikotilomania dan gangguan penyesuaian dengan reaksi depresi berkepanjangan merupakan komorbiditas yang menimbulkan penderitaan (distress) signifikan dan hendaya berat pada fungsi sosial, pekerjaan, serta area penting lainnya dalam kehidupan sehari-hari. Sebagai intervensi psikoterapi berbasis bukti, Terapi Perilaku Kognitif (Cognitive Behavior Therapy/CBT) terbukti efektif untuk mengatasi gangguan yang berakar pada distorsi kognitif dan perilaku maladaptif. Laporan kasus ini bertujuan untuk mengilustrasikan secara rinci proses dan luaran terapeutik dari intervensi CBT yang diberikan kepada seorang pasien perempuan dengan diagnosis ganda tersebut. Tahapan intervensi utama melibatkan sesi CBT terstruktur yang diintegrasikan secara khusus dengan teknik Habit Reversal Therapy (HRT) untuk menargetkan perilaku mencabut rambut, serta teknik graded exposure untuk mengatasi kecemasan sosial. Hasil evaluasi selama dan sesudah terapi menunjukkan perbaikan klinis yang signifikan pada pasien. Temuan utama meliputi penurunan drastis pada frekuensi, durasi, dan jumlah rambut yang dicabut, serta berkurangnya tingkat ketegangan saat berelasi dengan orang lain. Laporan ini menyimpulkan bahwa kombinasi terstruktur antara CBT, HRT, dan graded exposure merupakan strategi intervensi yang komprehensif dan efektif dalam menangani kasus kompleks trikotilomania dengan gangguan penyesuaian.

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