諮商與心理治療歷程中的「同盟破裂與修復」：本土心理師的經驗訪談研究

本研究旨在探討本土心理師在諮商與心理治療歷程中與案主建立同盟、覺察同盟變化與破裂，以及修復同盟破裂的情形，並與西方文獻做跨文化的比較。本研究邀請國內五位諮商心理師與五位臨床心理師，研究方法採半結構式訪談，蒐集心理師們在助人實務工作上的經驗，並透過敘事分析的「類別－內容」模式進行資料的整理與分析。研究結果與發現如下：1、同盟是諮商與心理治療的基礎與根本；2、同盟的建立情形存在個案差異；3、同盟是動態的、非恆定的；4、同盟破裂的發生是不可避免的；5、焦點解決短期諮商雖較少出現同盟破裂，但亦有可能面臨的風險；6、同盟破裂必須透過適當的策略加以修復；7、同盟破裂的修復能力隨著實務經驗的累積而提升；8、同盟破裂是諮商與心理治療的考驗，但也可能帶來新的轉機；9、本研究發現與國外情形大致相符，然亦有相異之處：在本土諮商與心理治療歷程中，除了「面質型破裂」和「退縮型破裂」兩大類型之外，尚出現「過度討好與讚美」的類型表現，此可能與中西方的文化差異有關。根據上述研究結果與發現，本研究提出相關建議：1、心理師應將同盟建立視為治療初期的首要任務，且持續注意同盟的變化；2、心理師應預先做好準備，學習面對和接納同盟破裂；3、心理師應尊重案主的個別差異，以最適合的方式和步調進行治療；4、心理師應時時進行自我檢視與覺察，並學習自我照顧；5、在新手心理師的專業訓練上，應加強同盟概念及相關能力的培養。

關鍵字

諮商與心理治療歷程；同盟；同盟破裂；破裂修復

並列摘要

The purpose of this study was to explore the conditions that how local psychologists established alliance, detected the variations and ruptures of alliance, and repaired alliance ruptures in the counseling and psychotherapeutic process. Further, researcher took a cross-cultural comparison between this research outcome and Western literature. This study invited 5 internal counseling psychologists and 5 internal clinical psychologists. The research method took semi-structured interview to collect psychologists’ experiences in helping practical work. This study adopted categorical-content mode of narrative analysis to arrange and analyze the data. The results and findings were as follows: (1)Alliance was the foundation of counseling and psychotherapy. (2)There were individual differences in the establishment of alliance. (3)Alliance was dynamic, not constant. (4)Alliance ruptures were inevitable. (5)Although Solution-Focused Brief Counseling had less alliance ruptures, it still had some potential risks. (6)Alliance ruptures must be repaired through appropriate strategies. (7)The ability to repair alliance ruptures would promote according to the accumulation of practical experiences. (8)Alliance ruptures were tests to counseling and psychotherapy, but also might bring new turning points. (9)The findings of this study corresponded to foreign conditions approximately, but still had some differences. In local counseling and psychotherapeutic process, except for withdrawal ruptures and confrontation ruptures, there was still another type: overly ingratiation and praise. This might be relevant to the differences between Chinese and Western cultures. According to above-mentioned results and findings, this study proposed relevant suggestions: (1)Psychologists must regard the establishment of alliance as the first task in the initial stage and notice the variation of alliance continuously. (2)Psychologists must prepare for alliance ruptures and learn to confront and accept alliance ruptures. (3)Psychologists must respect individual differences and take the most appropriate way and pace. (4)Psychologists must keep self-examination and self-awareness and learn to take care of themselves. (5)In the professional training of beginners, it must strengthen the training of the concept of alliance and the relevant abilities.