一位門診病人參與團體心理治療之療效因子與改變過程研究－以人際與心理動力取向團體心理治療爲例

An Analytic Study on the Change Process and Therapeutic Factors in Group Psychotherapy of an outpatient-Interpersonal and Psychodynamic Group Psychotherapy as an Example

10.7040/JGC.200608.0001

陳均姝(Chun-Shu Chen)；陳登義(Teng-Yi Chen)；施欣欣(Hsin-Hsin Shih)

療效因子 ； 團體心理治療 ； 改變過程 ； 人際取向團體心理治療 ； 心理動力取向團體心理治療 ； Therapeutic factors ； group psychotherapy ； change process ； interpersonal group psychotherapy ； psychodynamic group psychotherapy

輔導與諮商學報

28卷1期（2006 / 08 / 01）

1 - 27

繁體中文

本研究的目的在探討團體心理治療對個別成員的療效因子與改變過程。研究方法採用質性研究法，運用半結構的深度訪談、臨床觀察及文件資料分析方法，以一位長期參與（約兩年60次）人際與心理動力取向團體心理治療的門診病人爲研究對象，分析其主觀知覺之團體療效因子及其促成的影響與改變過程。研究結果顯示，該個案在參與團體治療中，知覺到團體中多樣療效因子的影響，這些因子又分別直接或間接促動四類改變過程內涵，該些改變過程內涵彼此間有相互牽動的關連，並隨著團體治療經驗的累積與加深，具有反覆循環性，其改變如螺旋狀般地不斷推進，尤其是後階段團體的改變更形明顯。本研究發現的療效因子有「自我瞭解」、「人際學習」、「家庭關係的體驗與瞭解」、「發展社交技巧」、「宣洩與自我揭露」、「傳達資訊」、「團體凝聚力」、「利他主義」、「普同感」、「存在性因素」、「灌輸希望」以及「行爲模仿與認同」。療效因子所促動的四類改變過程內涵爲：「催化改變與改變準備」、「經驗自我與覺察探索」、「洞察與自我整合」及「改變自我與行動」。依據個案之改變過程內涵的特色、深度及團體進展的時間性，本研究將個案在團體治療中的改變過程區分爲三個改變階段，分別爲：「現有困擾與憂鬱情緒的釐清與處理」、「衝突情緒及防衛機轉的釐清與處理」及「核心衝突的處理與修通」。本研究依據以上研究結果提出團體心理治療實務與研究方面的建議。

The purpose of this study is to explore the change process and therapeutic factors in group psychotherapy of specific member. Semi-structured interviews, clinical observation and document analysis methods were used to collect research data from an outpatient in (60 sessions in two years) the interpersonal and psychodynamic group psychotherapy. The qualitative research method was used to analyze the collected data. The result of the study shows that the outpatient perceives the influence of various therapeutic factors in group psychotherapy. These factors directly or indirectly activate four kinds of change process. These change processes are interrelated with each other. As the group experiences of that member were accumulated and intensified, the change process proceeds circularly and repeatedly. The change process moves forward constantly in a spiral form. The group process appears even more obvious in the latter stage of the group psychotherapy. The therapeutic factors from the outpatient's perception include self understanding, interpersonal learning, experience and understanding of family relationship, development of socializing techniques, catharsis and self disclose, imparting information, group cohesiveness, altruism, universality, existential factors, instillation of hope and imitative behavior and identity. Four kinds of change process activated by these therapeutic factors are: facilitating and preparing for change, experiencing the self and enhancing self-awareness and self-exploration, obtaining insight and achieving self-integration, and cultivating change in self and action. According to the characteristics, depth and change process of the outpatient in group psychotherapy, the change process in group psychotherapy can be divided into three change stages: to clarify and to deal with the problems and depression, to distinguish and to intervene with the inner conflicting emotions and defense mechanism, to work through the core conflicts. Suggestions on group works as well as future studies were discussed based on the results of this research.

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