Bowen自我分化諮商團體於共依附特質傾向青少年之成效與療效因素初探

Effects and Therapeutic Factors of a Counseling Group Based on Bowen's Concept of Differentiation for Adolescents with Codependency in Taiwan

10.3966/172851862017120050004

劉瓊珊(Chiung-Shan Liu)；張世華(Shih-Hua Chang)

共依附 ； 自我分化 ； 青少年 ； 諮商團體 ； Bowen理論 ； Adolescents ； Bowen theory ； codependency ； counseling group ； differentiation of self

中華輔導與諮商學報

50期（2017 / 12 / 01）

89 - 121

繁體中文

本研究旨在探討Bowen自我分化諮商團體於共依附特質傾向且有感情困擾之青少年的成效與療效因素，採混合研究之嵌入式設計，主要以質性研究探討本團體對成員的幫助和療效因素；輔以量化研究評估成員於團體結束及結束三個月後，其在自我分化、人際親密能力，以及自我概念的變化。本研究參與者為六位北部某專科五專生（均為女性），平均年齡16歲。本研究質性資料主題分析結果發現，團體對成員的幫助，包括：（1）自我的成長與朝向分化；（2）親密與自主的平衡；（3）學習關係困擾的解決方法等三個主題；本團體的療效因素則包括：（1）家庭與人際互動經驗的覺察；（2）對他人經驗的體會與共鳴；（3）團體提供溫暖信任與回饋的環境；（4）幫助成員解決問題等四個主題。本研究量化資料以Wilcoxon配對符號等級檢定結果顯示，團體成員之自我分化、人際親密能力與社會自我概念於團體結束後有顯著的提升，且其人際親密能力與社會自我概念，於團體結束三個月後仍有顯著的提升。最後，本研究綜合討論質性與量化研究結果與發現，並對未來相關研究與諮商實務工作提出若干建議。

Evolving from the treatment of families of alcoholics, the construct of codependency has been expanded and mainly refers to excessively other-oriented caretaking traits and behaviors that are derived from a stressful or dysfunctional family environment. Current research findings and clinical observations have consistently shown codependency traits and related symptoms including low self-esteem, relationship difficulties, and psychological maladjustment among adolescents and college students in both Western countries and Taiwan. However, there is limited work examining and assessing the effectiveness of treatment model based on a theoretical framework for codependency. Chang (2012, 2016) has proposed and provided empirical support for a Bowen-based model of codependency for adolescents and college students in Taiwan. Particularly, differentiation of self was found to be negatively related to codependency traits and was a significant mediator of the relationship between family-of-origin dysfunction and codependency traits. Consistent with previous research, codependency traits were found to be significantly associated with low self-esteem, relationship anxiety and avoidance, as well as psychological adjustment problems including somatic symptoms, anxiety, depression, and social dysfunction. The purpose of this study was to develop a group counseling model based on Bowen's concept of differentiation of self and explore the effects and therapeutic factors of the counseling group for adolescents with codependency in Taiwan. With a mixed method embedded design, the core qualitative method was used to understand participants' perceptions of the helpfulness and therapeutic factors of the counseling group. The supplemental quantitative method was used to examine their changes in measures of differentiation of self, interpersonal competence, and self-concept at the end of the group and a three-month follow up. The group model consisted of eight two-hour sessions for a total of sixteen hours for eight successive weeks. The group goals were to increase members' differentiation of self, to help them understand the impact of their family-of-origin experiences on intimate relationships, as well as to enhance their ability to recognize and take care of their own needs. Participants were six female students in a five-year junior college in Taipei, and their ages ranged from 15 to 18 with a mean age of 16 years. They had an average score higher than 3 on the Chinese version of the Spann-Fischer Codependency Scale, and experienced codependent relationships or had problems in the current or past intimate relationships. With semi-structured interviews and a phenomenological approach, qualitative data were coded and analyzed using thematic analysis. Participants' perceptions of the ways in which the group was helpful included: (1) development and differentiation of self, (2) balance of intimacy and autonomy, (3) learning solutions for relationship problems. The therapeutic factors of the group included: (1) awareness of the experiences in family and interpersonal interaction, (2) understanding and resonating with others' experiences, (3) a warm environment of trust and feedback exchange in the group, (4) helping members solve problems. Results of Wilcoxon Matched-Pairs Signed-Ranks tests indicated that participants' levels of differentiation of self, interpersonal competence, and social self-concept improved significantly at the end of the group. Also, their interpersonal competence and social self-concept continued to improve at a three-month follow up. The findings of the study provide preliminarily empirical support for the effectiveness of the Bowen- based treatment group for adolescents with codependency in Taiwan. Counselors and therapists are encouraged to use the group counseling model and extend the group sessions or time for adolescents and college students who struggle with codependent relationships. The implications of the findings for group counseling for codependency as well as suggestions for future research are discussed.

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