電話諮商的協助歷程：戒菸個案的觀點

本研究旨在探討個案在戒菸電話諮商中所出現戒菸前的心理衝突及面對與處理戒菸不同階段的體驗與歷程，藉由個案回溯諮商歷程中改變的契機，作為將來建立戒菸電話諮商中個案的改變模式。研究者採取質性研究中的文件分析法與深度訪談法進行資料收集與分析，藉此進行兩者相互資料比對，俾便以更為客觀的角度探討吸菸者在戒菸電話諮商中的歷程。透過三角校正工作進行分析、歸類與概念化，期使研究結果更具可信度。研究結果發現十六名參與研究訪談的個案過去經歷數次戒菸失敗經驗，故一開始對於戒菸電話諮商抱著姑且一試的心態，在諮商員提供真誠、支持、關懷的態度中，個案才逐漸正視戒菸電話諮商，同時開始體驗戒菸歷程中出現種種生理不適應與心理掙扎，期間更面臨復發挑戰，甚至興起隱瞞諮商員的念頭，但在諮商員無條件的關懷與接納下坦承接受復發的困境，並重新設定戒菸目標，藉由短期諮商尋找個案正向資源，並且搭配認知與行為上的調整逐漸戒菸成功。本研究建議戒菸個案除了在戒菸行為上可以搭配多種戒菸方法，心理上也可以透過自我內在語言改變戒除心理依賴，並且提前做好自我認同角色的改變。諮商工作者也可以嘗試運用家庭系統觀詮釋個案戒菸歷程，並在初期仔細評估個案的期待以作為後續諮商計畫的參考。

關鍵字

戒菸；戒菸電話；質性研究；電話諮商；協助歷程

並列摘要

The purpose of the present study was to understand the junior high school dropout-at-risk students' dropout intention and related factors. The present study randomly surveyed 327 junior high school dropout-at-risk students. There were eight instruments applied in this study: ”academic performance” scale, ”school relationship” scale, ”others way” scale, ”dropout intention” scale, ”external commitment” scale, ”joining out-school deviant peer group” scale, ”academic self-esteem” scale and ”behavior” scale. The data were analyzed with a number of descriptive statistic methods, Person correlation t-test and structured equation model. The results of this study were listed as follows. 1. The junior high school dropout-at-risk students had lower performance than the general junior high school students on the academic performance and academic self-esteem, rather than on deviant behaviors. 2. There was no significant difference in the school relationship between the junior high school dropout-at-risk students and the general junior high school students. 3. The academic performance and deviant behaviors of junior high school dropout-at-risk students were highly related to the school relationship. 4. The deviant behavior of junior high school dropout-at-risk students was highly related to joining out-school deviant peer group. 5. The academic performance, the school relationship, the deviant behaviors, and other behaviors of the junior high school dropout-at-risk students were highly related to the academic self-esteem. 6. The deviant behavior, joining out-school deviant peer group of the junior high school dropout-at-risk students were highly related to the external commitments. 7. The other behaviors and the external commitments of the junior high school dropout-at-risk students were highly related to the dropout intention. 8. The junior high school dropout-at-risk students' dropout intention and its related factors model were supported. According to the results, a number of specific suggestions for clinical workers and future researches were provided.