成年自殺倖存者的生態因素與生態諮商策略

論文名稱：成年自殺倖存者的生態因素與生態諮商策略校院系：國立暨南國際大學教育學院輔導與諮商研究所頁數：233 畢業時間：101年12月學位別：教育學博士研究生：張曉佩指導教授：蕭文論文摘要本研究主要目的在於探討成年自殺倖存者的自殺因素與生態諮商策略。研究對象包括四位曾經出現自殺行為但獲得協助得以延續生命，並曾接受心理衛生服務的成年自殺倖存者，以及五位曾與成年自殺倖存者進行實務工作的心衛生專業工作者。研究者採用敘說探究做為研究方法，並以半結構性深度訪談法喚起研究參與者的生命經驗以蒐集資料。研究發現包括：1.引發成年自殺倖存者自殺行為的因素涵蓋生態系統各層面；2.各系統因素不斷交互作用，且影響力是與時俱進的；3.自殺行為反映系統失衡下的社會性苦難；4.深度治療關係是引發成年自殺倖存者後續改變的前置性因素；5.專業工作者應以實用有效性的立場在系統中運用多元策略；6.專業工作者需擔負起倡導與促進系統改變的角色；7.預防與治療在自殺防治工作中同樣重要以及8.專業工作者需透過訓練、督導與支持團隊進行自我照顧。最後依據結果進行討論並提出建議以供未來研究與實務工作者參考。

關鍵字

成年自殺倖存者；生態諮商

並列摘要

Title of Dissertation: Understanding and counseling with adult suicidal survivors: An ecological approach Name of Institute: Graduate Institute of Guidance and Counseling, College of Education, National Chi Nan University Pages: 233 Graduation Time: December, 2012 Degree Conferred: Ph. D. Student Name: Hsiao-Pei Chang Advisor Name: Wen Hsiao Abstract The purpose of this research was to explore the ecological system factors and key ecological counseling strategies that facilitated overcoming suicidal behaviors in adult suicidal survivors. Narrative inquiry was used to develop an understanding of what was happened in adult suicidal survivors’ life contexts and what was helpful in counseling. Four adult suicidal survivors and five mental health professionals participated in this study. Individual interviews were conducted by the researcher and guided by open-ended questions. The interviews were audio-recorded and transcribed entirely. Two independent coders were applied to identify descriptive themes from the transcribed interviews, to compare and to integrate into a final list of coding categories. The findings indicated three characteristics of suicidal factors. First, suicidal factors were ecological not individualistic. Second, there were interaction between factors and their influences were continual. Third, suicide was a kind of social sufferings reflected the imbalanced of systems. The effective strategies and suggestions were: (1) building in-depth therapeutic relationships, (2) using intervening strategies in multiple contexts based on the concept of pragmatic utility, (3) doing advocacy actions to facilitate the change of system, (4) doing more efforts of prevention in daily life and (5) developing self-care plan including training, continuing education, supervision and support team to promote working effectiveness. The clinical implications of the findings were discussed.

並列關鍵字

adult suicidal survivors ； ecological counseling

參考文獻

Borges, G., Benjet, C., Medina-Mora, M. E., Orozco, R., & Nock, M. (2008). Suicide ideation, plan, and attempt in the Mexican adolescent mental health survey. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 41-52. doi:10.1097/chi.0b013e31815896ad

參考文獻