個案報告：神經心理治療於高心理危機職災勞工之介入成效探討

目的：職災勞工常面臨強大且持續的心理危機與壓力，這將直接對其大腦結構與功能造成破壞，進而增添重返職場的困難度。本文透過案例分享來呈現神經心理治療對處於高心理危機之職災勞工的介入成效。方法：個案為34歲男性，工作時從機台跌落導致腰椎骨折，因其頻繁出現身心症狀，嚴重干擾工作強化訓練之進行，故轉介予臨床心理師。臨床心理師透過搭配目標管理訓練和心理危機介入的神經心理治療模式來進行介入，全程分為基礎建立與情境應用兩個階段，每個階段的介入策略與內容皆是依照個案的心理危機程度、心理健康狀態和生態需求來進行規劃。個案於轉介點、階段轉換點、結案點均接受心理健康狀態評估。結果：根據晤談資料、臨床觀察、量表評估分數與量表反應之質性分析，個案在結案時的心理危機程度已大幅下降，且睡眠困難、易苦惱和動怒等狀況都已有改善，也開始能夠專注思考未來的生活規劃與發展，同時對自己終將能成功重返就業市場充滿信心。結論：本案例結果顯示，即便已受傷超過一年，大腦神經迴路與功能都已因長時間處在持續性壓力下而遭到嚴重破壞，依照個別生態條件與需求而規劃的神經心理治療仍可有效促使個案逐步重拾自主選擇與決定人生發展的能力和責任。

關鍵字

神經心理治療；目標管理訓練模式；心理危機介入；職災勞工

並列摘要

Objective: Injured workers often face severe psychological crises and intense pressures, which will directly damage their brain structure and function, and further increase the difficulty of returning to work. Neuropsychotherapy is an internationally recognized modality of brain-based therapy. This report aimed to show the effect of applying neuropsychotherapy for an injured worker in a severe psychological crisis. Method: The client is a 34-year-old male who fell from a machine at work and caused a lumbar spine fracture. He was referred to the clinical psychologist since his psychosomatic symptoms seriously interfered with the work-hardening training. The clinical psychologist applied a neuropsychotherapy that combined goal management training and psychological crisis intervention. The neuropsychotherapy included two stages: foundation establishment stage and situational application stage. The primary goal of the neuropsychotherapy is to reduce the client's psychological crisis, and the secondary goal is to enhance his autonomy. The intervention strategies and contents were arranged according to the client's psychological crisis, mental health status, and ecological needs. The client received mental health assessment when he was referred to the clinical psychologist, when the intervention is going to progress to the second stage, and when he finished the neuropsychotherapy. Results: According to the interview data, clinical observations, and assessment responses and results, the client had a significantly minor psychological crisis after receiving the neuropsychotherapy. His sleep problems, distress, and irritability have improved. Besides, the client began to focus on his career planning. He also regained the confidence that he would successfully return to the job market someday. Conclusion: Even being injured for over one year, and the neural circuits and brain functions damaged severely because of prolonged exposure to continuous stress, a neuropsychotherapy that was arranged according to the client's mental function and ecological needs can still reduce the psychological crisis effectively and can assist him to regain the ability and responsibility to develop the career plan independently.

並列關鍵字

neuropsychotherapy ； goal management training ； psychological crisis intervention ； injured worker

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個案報告：神經心理治療於高心理危機職災勞工之介入成效探討

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