個別認知行為治療對於焦慮疾患兒童之療效和改善母親親職壓力的效果評估

The Efficacy of Individual Cognitive-Behavioral Therapy for Children with Anxiety Disorders and Parenting Stress in Mothers

黃梓瑜(Tzu-Yu Huang)

指導教授 ： 林宜美

共同指導教授 ： 顏正芳(Cheng-Fang Yen)

高雄醫學大學/人文社會科學院/心理學系碩士班/碩士(2013年)

https://doi.org/10.6832/KMU.2013.00070

摘要

焦慮疾患是兒童最常見的心理疾病之一，不僅影響目前與未來廣泛的心理社會層面，亦增加家長履行親職角色的壓力，因此本研究目的為檢測個別認知行為治療對於台灣焦慮疾患兒童之焦慮症狀及母親親職壓力的效果。本研究採用參考自國外兒童焦慮治療方案Coping Cat Program的個別認知行為治療手冊，共進行十六週共十七個節次，成效評估的測驗工具包含兒童自陳的台灣版多向度兒童青少年焦慮量表(Multidimensional Anxiety Scale for Child-Taiwan version, MASC-T)、六至十八歲兒童行為檢核表家長版(Child Behavior Checklist for Age 6-18, CBCL)以及由母親填答的親職壓力量表(Parenting Stress Index, PSI)。受試者為精神科醫師轉介的六至十二歲共47名符合任一焦慮疾患核心診斷準則的兒童，接受治療的實驗組共21名，控制組26名，兩組先進行前測，並於十六週後進行後測。以單變量共變數分析控制兩組前測分數，評估兩組前、後測差異分數是否達顯著差異，結果顯示，實驗組經治療介入後，兒童自陳焦慮症狀與母親觀察之兒童內化行為問題的改善程度均較控制組顯著，特別以社會焦慮的改善最顯著，但兩組母親感受到來自於家長與兒童領域的親職壓力之改善程度並無顯著差異。

關鍵字

認知行為治療 ； 兒童焦慮 ； 親職壓力

並列摘要

The aims of this intervention study were to examine the effects of individual cognitive-behavioral therapy (CBT) based on the modified Coping Cat Program on improving anxiety symptoms and behavioral problems in Taiwanese children with anxiety disorders and parenting stress perceived by their mothers. A total of 21 children with anxiety disorders in the treatment group completed the 17-session individual CBT based on the modified Coping Cat Program, and 26 children in the control group received the treatment as usual intervention. The Taiwanese version of the MASC (MASC-T), the Child Behavior Checklist for Ages 6-18 (CBCL/6-18) and the Chinese version of the Parenting Stress Index (C-PSI) were applied to assess the severities of anxiety symptoms, behavioral problems and parenting stress, respectively. The effects of CBT on improving anxiety symptoms, behavioral problems and parenting stress were examined by using analysis of covariance (ANCOVA) to control for the effect of pretreatment scores. The results indicated that compared with the control group, the experimental group had more significant improvement on the self-reported anxiety symptoms, especially on social anxiety. Meanwhile, the mothers of the experimental group reported more significant improvement on the internalizing behavioral problems and anxiety problem. However, no significant difference in the levels of parenting stress on the C-PSI was found between the experimental and control groups.

並列關鍵字

cognitive-behavioral treatment ； childhood anxiety ； parenting stress

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