ACT治療取向應用－以青少年拒學個案為例

A Case Study on the Application of Acceptance and Commitment Therapy in Adolescents with School Refusal

洪美鈴(Mei-Ling Hung)；曹國璽(Kuo-Hsi Tsao)

ACT ； 接納與承諾治療 ； 拒學

輔導季刊

53卷4期（2017 / 12 / 01）

61 - 73

繁體中文

近年來青少年拒學現象逐漸增加，深入探究拒學本質，是種帶著焦慮循環與糾結的問題，且會重複逃避行為，甚至嚴重時形成社交退縮。在這個焦慮循環的歷程中，接納與承諾治療（ACT）成為一種有效評估與處遇的取向。ACT被視為行為治療的第三波浪潮，嘗試修正傳統行為治療及認知行為治療的架構與作法，它認為人的心理問題主因在於「認知融合」和「經驗逃避」所導致的缺乏彈性，需藉由接納、脫鉤、建立超驗的自我、與當下連結、價值，以及承諾行動等方式，直接與間接建立心理彈性的過程。在筆者的實務經驗中，ACT的評估與處遇對於拒學青少年固著的認知思考及經驗逃避模式，確實能夠有效幫助個案跳脫原來的逃避退縮循環。故筆者進一步整理拒學行為模式，以ACT的主要架構作為治療地圖，幫助個案改變與焦慮的關係，朝向自己的學習價值前進。本文對ACT治療法的哲學背景、理論基礎與治療模型等進行整理式的說明，並以拒學案例作對照反思，透過ACT治療文獻中所提的幾種常見錯誤進一步討論運用ACT的注意事項，供作實務運用討論與參考。

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