看不見的傷痛：從災難事件探討國軍心輔人員面對替代性創傷的歷程與回應

Invisible Trauma: A Study of Military Counselors' Experience and Response to Vicarious Traumatization of Disasters

陳晏琮(Yan-Cong Chen) ； 丁華(Hua Ting)

《復興崗學報》 105期 (2014/12) Pp. 135-160

摘要

本研究主要在探討參與災難事件的國軍心輔人員，面對救災任務是否會產生「替代性創傷」，以及面對創傷所運用的因應方式。運用質性研究，透過半結構化深度訪談，共計訪談13位曾參與過重大災害救援的國軍心輔人員，了解其參與救災過程的經驗跟面對創傷的因應方式，研究發現主要有四點：一、心輔人員參與救災的過程的確會出現替代性創傷的現象：但不同於民間創傷助人者主要顯現在個人內在心理的負面轉變，國軍心輔人員的創傷徵候主要是因感官衝擊及任務壓力下在生、心理上的壓力反應及後續在日常生活上的行為及心態上的轉變。二、參與救災的任務內容是引發替代性創傷的關鍵因素：任務內容是否接觸罹難者大體是關鍵因素，有接觸大體經驗的心輔人員有較大的可能出現替代性創傷徵候。三、替代性創傷對國軍心輔人員的影響較不易顯現：透過在災區角色的單純化、在災區的期程較短以及接觸輔導的對象較為單純以及職務的論替等因素，國軍心輔人員的替代性創傷較民間創傷專業助人者較不易顯現。四、國軍心輔人員在替代性創傷的處遇與適應以個人自我調適為主：心輔人員能善用覺察、平衡與聯繫等處遇原則緩解壓力找回日常生活的平衡，惟亦凸顯組織對助人者在正式支持與專業督導上的不足。本研究最後亦針對救災三階段提出建議如下：一、救災前：強化教育訓練課程，完成救災人員管理資料庫，並編撰救災指導手冊，同時透過任務提示的方式，提供心輔人員所需資訊。二、救災中：運用覺察、平衡與聯繫，審視自我狀況，同時透過外部支持系統，適時提供所需資源與鼓勵。三、救災後：將心輔人員納入團體輔導或鼓勵與教育個人尋求適當紓壓方式。

關鍵字

替代性創傷 ； 心輔人員 ； 災難事件 ； 創傷 ； 壓力

並列摘要

This research aims to explore the possibility of ＂vicarious traumatization＂ for military counselors participating in disaster relief and solutions. This qualitative study observes the military counselors' experience of disaster relief and their response to traumatization through the application of semi-structured and in-depth interviews with thirteen counselors and reduces to four points as follows: 1. The process and stress sources of implementing disaster relief including introvert emotional feelings and extrovert visual shock, with the stress deriving from environments, work, family and so forth. 2. The effects on counselors: bad effects refer to changes in eating habits, tendencies of negative reflection on people, things and actions, while good effects refer to cherishing loved ones and self-development. 3. The responses to effects: self-improvement and psychological adjustment for internal system as family and peer support for external system. 4. Solutions to prevent vicarious traumatization: diminishing traumatic reactions by reinforcing mental health education regularly and completing recruitment and briefing beforehand. The research furthermore advances suggestions for the three phases of disaster relief: 1. Before operation: to improve training courses, complete personnel data management, compile operation manuals, and provide information for counselors when briefing. 2. During operation: to make use of perception, balancing, and contact, examine oneself, and provide timely resources and encouragement through the external supporting system. 3. After operation: to help counselors by group counselling, or to release pressure appropriately by individual.

並列關鍵字

vicarious traumatization ； counselors ； disasters ； traumatization ； stress