預防復發模式融合動機與正念應用於非鴉片類藥癮愛滋團體減少藥物性愛之個案報告

The Case Report of Relapse Prevention Integrated With Motivation and Mindfulness-Based Intervention in the Non-Opioid Group for Reducing Chemsex Among Gay Men With HIV

10.6550/ACP.202112_15(1_2).0003

陳伯愷(Po-Kai Chen)；江佳璇(Chia-Hsuan Chiang)；翁銘鴻(Min-Hung Weng)；盧永欽(Yung-Chin Lu)；廖御圻(Yu-Chi Liao)；李俊宏(Chun-Hung Lee)；郭乃文(Nai-Wen Guo)

愛滋 ； 藥物性愛 ； 同志 ； 預防復發 ； 正念 ； AIDS ； chemosex ； gay ； relapse prevention ； mindfulness

臨床心理學刊

15卷1/2期（2021 / 12 / 01）

32 - 48

繁體中文

目的：南部某療養院自2018年起執行非鴉片類醫療戒治計畫，並以正念預防復發為架構開設團體心理治療。但根據臨床實務經驗發現，前來接受治療的非鴉片類藥癮愛滋同志族群，在學歷、認知及職業功能皆有別於一般非鴉片類毒品使用者，且使用毒品的初始動機和持續因素亦不相同。故而必要將此族群獨立出來，另行開設非鴉片類藥癮愛滋團體（藥愛團體）心理治療。方法：團體納入同時符合性傾向為同性、HIV陽性，以及曾使用非鴉片類毒品藥物進行性愛者，共計9人，平均年齡38.8 ± 6.3歲，教育年數15.0 ± 1.8年，全量表智商109.7 ± 9.0。進行為期八週，每週一小時的團體，內容融合動機式晤談、預防復發、討論藥物性愛、愛滋適應、安全性觀念衛教，以及正念技巧。前後測使用中文版止觀覺察注意量表（Chinese Translation of Mindful Attention Awareness Scale, CMAAS）、巴氏衝動量表（Barratt Impulsiveness Scale, BIS-11），以及世界衛生組織生活品質問卷（World Health Organization Quality of Life Scale Brief Version, WHOQOL-BREF）─台灣簡明版。結果：共7人完成團體，一年追蹤尿液檢驗為陰性，而2位退出者均撤銷緩起訴處分。結論：CMAAS和BIS-11得分的變化可能顯示成員在團體治療後可增進自我覺察，故自陳報告的注意力和衝動性得分在後測中看起來更接近現實。本研究的限制在於樣本量小，且未提供控制組。然而，藥愛團體的完成率為77.8%。未來的研究應關注神經生理與心理、情緒等變項之療效。

Objectives: A psychiatric center in the south Taiwan has implemented a non-opioid medical treatment plan since 2018 and set up group psychotherapy based on a mindfulness-based relapse prevention model. However, there was a difference in gay, diagnosed with HIV+ patients, and had sex with drugs from general addictive patients, including education level, cognitive ability, occupation, motivation, and continuing factors. Therefore, it is necessary to establish the non-opioid addiction AIDS gay group (called the drug love group) in Taiwan. Methods: There were nine patients in the drug love group, with a mean age of 38.8 ± 6.3 years, mean education was 15.0 ± 1.8 years, and a full-scale IQ of 109.7 ± 9.0. The course and duration of the group is one hour a week for eight consecutive weeks. The group combined motivational interviewing, relapse prevention, discussion of drugs with sex, the adaption of AIDS, safety sex, psychoeducation, and mindfulness exercises. The study used the Chinese Translation of Mindful Attention Awareness Scale (CMAAS), the Barratt Impulsiveness Scale (BIS-11), and the Taiwan version of World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF) in pre-and-post tests. Results: Seven patients completed the group. They all showed negative findings in the urine test during the one-year follow-up. However, the other two patients were both revocations of deferred prosecution. Conclusions: The change of scores in CMAAS and BIS-11 showed that patients might increase self-awareness after group therapy. The scores of self-report attention and impulsivity might look closer to the reality in the post-test. This study's limitations are the small sample size and not a controlled study. However, this drug love group's completion rate was 77.8%. Future studies should focus on factors of neurophysiological and neuropsychological, and emotion factors.

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