2025-2026
PSYCHOLOGIE: TOEPASSING IN DE
REVALIDATIE
,TABLE OF CONTENTS
1 Introductie ....................................................................................................... 5
1.1 Introductie tot psychologie in de revalidatie ........................................................ 5
1.1.1 Wat is revalidatiepsychologie? ............................................................................................5
1.1.2 Waarom belangrijk in het revalidatieproces? .......................................................................5
1.1.3 Lichaam en geest: een biopsychosociaal model .................................................................6
1.1.4 Framework ..........................................................................................................................7
1.2 Doorverwijzing van patiënten met psychologie ................................................... 11
1.2.1 Wat kan je zelf doen? ........................................................................................................11
1.2.2 Doorverwijzen ...................................................................................................................11
1.2.3 Psycholoog, psychiater of psychotherapeut? ....................................................................12
1.2.4 Psycholoog of coach? .......................................................................................................12
1.2.5 Psycholoog of klinisch orthopedagoog? ............................................................................12
1.2.6 Praktisch doorverwijzen en terugbetaling ..........................................................................12
1.3 Introductie tot CBT ............................................................................................. 13
1.3.1 Historiek ...........................................................................................................................13
1.3.2 Theoretische basis ............................................................................................................14
1.3.3 Het 5-G schema – voorbeeld .............................................................................................15
1.3.4 Het ABC-schema – voorbeeld............................................................................................15
1.4 Wat is psychopathologie? .................................................................................. 16
1.4.1 Angst .................................................................................................................................16
1.4.2 Dwang ...............................................................................................................................24
1.4.3 Trauma en Stressgerelateerde aandoeningen ...................................................................28
1.4.4 Stemming..........................................................................................................................31
1.4.5 Persoonlijkheid en persoonlijksheidsstoornis ...................................................................34
1.4.6 Attention deficit hyperactivity disorder (ADHD) .................................................................37
1.4.7 Autisme spectrum stoornissen (ASS) ................................................................................39
1.4.8 Eetstoornissen ..................................................................................................................40
2 Rol van de kinesitherapeut binnen de palliatieve zorg .................................... 42
2.1 Inleiding ............................................................................................................. 42
2.2 Wat is Palliatieve Zorg (PZ)? ................................................................................ 42
2.2.1 Belangrijke aspecten .........................................................................................................42
2.2.2 palliatieve zorg VS curatieve zorg ......................................................................................43
2.2.3 Vroeg palliatieve zorg ........................................................................................................43
2.3 Doelen van PZ .................................................................................................... 44
2.3.1 PZ diensten .......................................................................................................................44
2.4 Mogelijke evidence-based interventies ............................................................... 45
2.4.1 Intervenie 1: oefentherapie ...............................................................................................45
2.4.2 Interventie 2: educatie.......................................................................................................46
2.4.3 Interventie 3: relaxatie .......................................................................................................46
2.4.4 Interventie 4: ademhalingsoefeningen...............................................................................47
2.4.5 Interventie 5: massage ......................................................................................................47
2.4.6 Interventie 6: TENS ............................................................................................................47
1
, 2.4.7 Keep in mind .....................................................................................................................48
2.4.8 Specifieke interventies ......................................................................................................48
2.5 Barrières & facilitatoren ..................................................................................... 48
2.5.1 Gedragsveranderingen ......................................................................................................48
2.5.2 Mogelijke barrières – patiënt..............................................................................................49
2.5.3 Mogelijke barrières – arts...................................................................................................49
2.5.4 Mogelijke barrières – kinesitherapeut ................................................................................50
2.5.5 Hoe kunnen we bovenstaande barrières aanpakken?........................................................50
2.6 Conclusie .......................................................................................................... 50
3 Kinesitherapie binnen GZZ ............................................................................. 51
3.1 Kinesitherapie.................................................................................................... 51
3.2 Ontwikkelings- en gezondheidsbenadering ......................................................... 52
3.2.1 Verbeteren fysieke fitheid..................................................................................................52
3.2.2 Preventie ...........................................................................................................................53
3.2.3 Testing en ontwikkelen motorische vaardigheid ................................................................54
3.2.4 Pijn-management..............................................................................................................54
3.2.5 Ademhaling .......................................................................................................................55
3.3 Psychosociale benadering.................................................................................. 56
3.3.1 Aandacht voor de sociale basisvaardigheden ....................................................................56
3.3.2 Emotie-regulatie ...............................................................................................................56
3.3.3 Spanningsregulatie ...........................................................................................................57
3.3.4 Lichaamsbeeld .................................................................................................................61
3.3.5 Lichaamsbewustzijn .........................................................................................................61
3.3.6 Lichaamscontact ..............................................................................................................61
3.4 Vijf demensies ................................................................................................... 62
3.4.1 Psychomotorische dimensie .............................................................................................62
3.4.2 Cognitieve dimensie ..........................................................................................................62
3.4.3 Affectieve dimensie ...........................................................................................................63
3.4.4 Gedrags dimensie .............................................................................................................63
3.4.5 Symbolische dimensie ......................................................................................................63
4 Ontdek de kracht van ademhaling .................................................................. 63
4.1 Stress en ademhaling ......................................................................................... 64
4.1.1 Het diafragma ...................................................................................................................64
4.1.2 Ademhalingstechnieken....................................................................................................64
4.2 Hoe ademen? ..................................................................................................... 66
4.2.1 Bewustwording van de ademhaling ...................................................................................66
4.2.2 Ademen voor energie en immuniteit ..................................................................................66
4.2.3 Ademen om te ontstressen ...............................................................................................67
4.2.4 Box breathing ....................................................................................................................67
4.2.5 Ademen om tot het hier en nu komen ................................................................................67
4.2.6 Wat is de beste ademhalingsoefening? .............................................................................67
4.3 Hartcoherentie, Heart Rate Variability & Breathing Apps and tools ...................... 67
4.3.1 Bepaling van HRV ..............................................................................................................67
2
, 4.3.2 Hartcoherentie ..................................................................................................................68
4.3.3 HRV biofeedback ..............................................................................................................68
4.4 Kort: hyperventilatie........................................................................................... 68
4.4.1 Hyperventilatieklachten ....................................................................................................68
4.4.2 Hyperventilatie ontkracht ..................................................................................................70
4.5 Introductie van ademhalingstechnieken in de praktijk ........................................ 70
4.5.1 Algemeen introduceren van ademhalingstechnieken ........................................................70
4.5.2 Patiënt met depressie .......................................................................................................70
4.5.3 Oefenschema – begin........................................................................................................70
4.5.4 Valkuilen ...........................................................................................................................70
5 ACE-studies, trauma en het lichaam .............................................................. 70
5.1 ACES – Wat en Waarom? .................................................................................... 71
5.2 ACES – Hoe komt trauma “onder de huid”? ......................................................... 72
5.3 circuits en plasticiteit ........................................................................................ 73
5.4 Het lichaam als “sensor” ................................................................................... 74
5.5 Epigenetica & “biological embedding” (nuances) .................................................... 74
5.6 Klinische uitkomsten van psyche naar soma....................................................... 75
5.7 The body keeps the score ................................................................................... 76
6 Burn-out......................................................................................................... 78
6.1 Mythes ............................................................................................................... 78
6.2 Wat is burn-out?................................................................................................. 79
6.3 Burn-out bij zorgverleners .................................................................................. 79
6.4 Preventie van Burn-out bij kinesitherapeuten...................................................... 79
6.5 Preventie van burn-out bij kinesitherapeuten ...................................................... 79
6.6 Herkenning van burn-out symptomen bij zorgverleners ....................................... 79
6.7 Stress: van gevoel naar aandoening .................................................................... 80
6.7.1 Fysiologische effecten van burn-out ..................................................................................80
6.7.2 Psychosomatische klachten geassocieerd met burn-out ..................................................80
6.8 Impact van burn-out op patiËnten....................................................................... 81
6.9 Multidisciplinaire aanpak van burn-out bij patiËnten ........................................... 81
6.10 Hoe burn-out en lichamelijke klachten elkaar beïnvloeden .............................. 81
6.11 Samenvatting .................................................................................................. 82
7 Beweging en mentale gezondheid .................................................................. 82
7.1 Definities ........................................................................................................... 82
7.2 Epidemiologie .................................................................................................... 82
3
PSYCHOLOGIE: TOEPASSING IN DE
REVALIDATIE
,TABLE OF CONTENTS
1 Introductie ....................................................................................................... 5
1.1 Introductie tot psychologie in de revalidatie ........................................................ 5
1.1.1 Wat is revalidatiepsychologie? ............................................................................................5
1.1.2 Waarom belangrijk in het revalidatieproces? .......................................................................5
1.1.3 Lichaam en geest: een biopsychosociaal model .................................................................6
1.1.4 Framework ..........................................................................................................................7
1.2 Doorverwijzing van patiënten met psychologie ................................................... 11
1.2.1 Wat kan je zelf doen? ........................................................................................................11
1.2.2 Doorverwijzen ...................................................................................................................11
1.2.3 Psycholoog, psychiater of psychotherapeut? ....................................................................12
1.2.4 Psycholoog of coach? .......................................................................................................12
1.2.5 Psycholoog of klinisch orthopedagoog? ............................................................................12
1.2.6 Praktisch doorverwijzen en terugbetaling ..........................................................................12
1.3 Introductie tot CBT ............................................................................................. 13
1.3.1 Historiek ...........................................................................................................................13
1.3.2 Theoretische basis ............................................................................................................14
1.3.3 Het 5-G schema – voorbeeld .............................................................................................15
1.3.4 Het ABC-schema – voorbeeld............................................................................................15
1.4 Wat is psychopathologie? .................................................................................. 16
1.4.1 Angst .................................................................................................................................16
1.4.2 Dwang ...............................................................................................................................24
1.4.3 Trauma en Stressgerelateerde aandoeningen ...................................................................28
1.4.4 Stemming..........................................................................................................................31
1.4.5 Persoonlijkheid en persoonlijksheidsstoornis ...................................................................34
1.4.6 Attention deficit hyperactivity disorder (ADHD) .................................................................37
1.4.7 Autisme spectrum stoornissen (ASS) ................................................................................39
1.4.8 Eetstoornissen ..................................................................................................................40
2 Rol van de kinesitherapeut binnen de palliatieve zorg .................................... 42
2.1 Inleiding ............................................................................................................. 42
2.2 Wat is Palliatieve Zorg (PZ)? ................................................................................ 42
2.2.1 Belangrijke aspecten .........................................................................................................42
2.2.2 palliatieve zorg VS curatieve zorg ......................................................................................43
2.2.3 Vroeg palliatieve zorg ........................................................................................................43
2.3 Doelen van PZ .................................................................................................... 44
2.3.1 PZ diensten .......................................................................................................................44
2.4 Mogelijke evidence-based interventies ............................................................... 45
2.4.1 Intervenie 1: oefentherapie ...............................................................................................45
2.4.2 Interventie 2: educatie.......................................................................................................46
2.4.3 Interventie 3: relaxatie .......................................................................................................46
2.4.4 Interventie 4: ademhalingsoefeningen...............................................................................47
2.4.5 Interventie 5: massage ......................................................................................................47
2.4.6 Interventie 6: TENS ............................................................................................................47
1
, 2.4.7 Keep in mind .....................................................................................................................48
2.4.8 Specifieke interventies ......................................................................................................48
2.5 Barrières & facilitatoren ..................................................................................... 48
2.5.1 Gedragsveranderingen ......................................................................................................48
2.5.2 Mogelijke barrières – patiënt..............................................................................................49
2.5.3 Mogelijke barrières – arts...................................................................................................49
2.5.4 Mogelijke barrières – kinesitherapeut ................................................................................50
2.5.5 Hoe kunnen we bovenstaande barrières aanpakken?........................................................50
2.6 Conclusie .......................................................................................................... 50
3 Kinesitherapie binnen GZZ ............................................................................. 51
3.1 Kinesitherapie.................................................................................................... 51
3.2 Ontwikkelings- en gezondheidsbenadering ......................................................... 52
3.2.1 Verbeteren fysieke fitheid..................................................................................................52
3.2.2 Preventie ...........................................................................................................................53
3.2.3 Testing en ontwikkelen motorische vaardigheid ................................................................54
3.2.4 Pijn-management..............................................................................................................54
3.2.5 Ademhaling .......................................................................................................................55
3.3 Psychosociale benadering.................................................................................. 56
3.3.1 Aandacht voor de sociale basisvaardigheden ....................................................................56
3.3.2 Emotie-regulatie ...............................................................................................................56
3.3.3 Spanningsregulatie ...........................................................................................................57
3.3.4 Lichaamsbeeld .................................................................................................................61
3.3.5 Lichaamsbewustzijn .........................................................................................................61
3.3.6 Lichaamscontact ..............................................................................................................61
3.4 Vijf demensies ................................................................................................... 62
3.4.1 Psychomotorische dimensie .............................................................................................62
3.4.2 Cognitieve dimensie ..........................................................................................................62
3.4.3 Affectieve dimensie ...........................................................................................................63
3.4.4 Gedrags dimensie .............................................................................................................63
3.4.5 Symbolische dimensie ......................................................................................................63
4 Ontdek de kracht van ademhaling .................................................................. 63
4.1 Stress en ademhaling ......................................................................................... 64
4.1.1 Het diafragma ...................................................................................................................64
4.1.2 Ademhalingstechnieken....................................................................................................64
4.2 Hoe ademen? ..................................................................................................... 66
4.2.1 Bewustwording van de ademhaling ...................................................................................66
4.2.2 Ademen voor energie en immuniteit ..................................................................................66
4.2.3 Ademen om te ontstressen ...............................................................................................67
4.2.4 Box breathing ....................................................................................................................67
4.2.5 Ademen om tot het hier en nu komen ................................................................................67
4.2.6 Wat is de beste ademhalingsoefening? .............................................................................67
4.3 Hartcoherentie, Heart Rate Variability & Breathing Apps and tools ...................... 67
4.3.1 Bepaling van HRV ..............................................................................................................67
2
, 4.3.2 Hartcoherentie ..................................................................................................................68
4.3.3 HRV biofeedback ..............................................................................................................68
4.4 Kort: hyperventilatie........................................................................................... 68
4.4.1 Hyperventilatieklachten ....................................................................................................68
4.4.2 Hyperventilatie ontkracht ..................................................................................................70
4.5 Introductie van ademhalingstechnieken in de praktijk ........................................ 70
4.5.1 Algemeen introduceren van ademhalingstechnieken ........................................................70
4.5.2 Patiënt met depressie .......................................................................................................70
4.5.3 Oefenschema – begin........................................................................................................70
4.5.4 Valkuilen ...........................................................................................................................70
5 ACE-studies, trauma en het lichaam .............................................................. 70
5.1 ACES – Wat en Waarom? .................................................................................... 71
5.2 ACES – Hoe komt trauma “onder de huid”? ......................................................... 72
5.3 circuits en plasticiteit ........................................................................................ 73
5.4 Het lichaam als “sensor” ................................................................................... 74
5.5 Epigenetica & “biological embedding” (nuances) .................................................... 74
5.6 Klinische uitkomsten van psyche naar soma....................................................... 75
5.7 The body keeps the score ................................................................................... 76
6 Burn-out......................................................................................................... 78
6.1 Mythes ............................................................................................................... 78
6.2 Wat is burn-out?................................................................................................. 79
6.3 Burn-out bij zorgverleners .................................................................................. 79
6.4 Preventie van Burn-out bij kinesitherapeuten...................................................... 79
6.5 Preventie van burn-out bij kinesitherapeuten ...................................................... 79
6.6 Herkenning van burn-out symptomen bij zorgverleners ....................................... 79
6.7 Stress: van gevoel naar aandoening .................................................................... 80
6.7.1 Fysiologische effecten van burn-out ..................................................................................80
6.7.2 Psychosomatische klachten geassocieerd met burn-out ..................................................80
6.8 Impact van burn-out op patiËnten....................................................................... 81
6.9 Multidisciplinaire aanpak van burn-out bij patiËnten ........................................... 81
6.10 Hoe burn-out en lichamelijke klachten elkaar beïnvloeden .............................. 81
6.11 Samenvatting .................................................................................................. 82
7 Beweging en mentale gezondheid .................................................................. 82
7.1 Definities ........................................................................................................... 82
7.2 Epidemiologie .................................................................................................... 82
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