台灣大專院校助人工作者之自殺與自傷危機處遇經驗調查

The Survey of Professional Helpers’ Experiences in crisis Intervention of Suicide and Self-harm in Taiwan’s Universities and Colleges

黃敏懿(Min Yi Huang)

指導教授 ： 蕭富聰

國立暨南國際大學/教育學院/諮商心理與人力資源發展學系 輔導與諮商碩士班/碩士(2017年)

摘要

本研究旨在調查台灣大專院校助人工作者在自殺與自傷危機處遇的實務經驗。研究工具為研究者自編之「助人工作者危機處遇實務經驗問卷」，進行網路調查後，取得有效樣本共99份。所得資料以描述性統計、變異數分析、交叉表等統計方式整理。
　　本研究結果發現：（1）大專院校在自殺卅自傷危機處遇時，單位內、校園社區間、與校外合作現況：1.多重角色增加工作難度，2.工作者自評能取得良好的系統合作，3.導師為校內合作要角、就醫為主要轉介目標、個案會議成員組成意見分歧、轉介就醫目的與合作程度。（2）大專院校助人工作者對自殺卅自傷危機處遇介入流程現況與操作偏好：1.通報前先在單位內進行評估，2.部分流程排序矛盾，3.合作目標依照不同介入角色而有所差異。(3)大專院校助人工作者對自殺卅自傷危機處遇的評估之現況偏好：1.過半數工作者傾向操作標準化評估，且年資和介入角色有偏好差異，2.測驗工具以憂鬱/自殺與能立即解測為主，3.非標準化評估中，立即性因子最敏感，社會性因子最不敏感，4.工作者對評估結果有信心且同時參照標準與非標準評估。（4）大專院校助人工作者對自殺卅自傷個案態度偏好：1.工作者有意願持續與危機個案系統進行後續工作，2.工作者同意要平衡危機個案與其環境之間的需求張力，是有挑戰的，3.工作者支持在諮商室外與自殺卅自傷個案互動有正面影響，4.約一成的工作者會蒐集危機處遇回饋。（5）大專院校助人工作者對自殺卅自傷危機處遇的準備度與自我照顧現況：1.危機處遇對工作者有若干負面影響，且年資一到兩年最顯著，2.工作者自評個人相關議題探索足夠，又年資越高者對自殺卅自傷專業信心越高，3.工作者自評現階段以『跨單位合作的品質』為危機處遇中，最迫切亟需改善的項目。
　　最後，根據研究結果進行討論，並進一步提出實務與研究建議，以供助人工作者在進行自殺卅自傷危機處遇時，有更貼近文化與時空脈絡的資料作為參考。

關鍵字

自殺 ； 危機處遇 ； 系統合作 ； 自殺評估

並列摘要

The purpose of the study is to investigate the experiences in crisis Intervention of Suicide and Self-harm in Taiwan’s Universities and Colleges of Professional Helpers.　Research Instrument used in the study is The Inter-Net Questionaire of Professional Helpers’ Experiences on crisis Intervention. 99 responses are received. The data are analyzed by descriptive statistics, ANOVA as well as Chi-square.
　　The results of this study are as following:
(1) Current status of the cooperation among the Counseling Cente, the unit of University or Colleges, and out of off campuses are as belowed description: 1. Multiple roles increase the difficulties of intervention work. 2.The self-evaluation of the helpers indicates that they get good cooperation in crisis intervetion. 3. Homeroom teachers play a very important role in crisis cooperation; the main goal in referral is to hosptialized the clients; the crisis conference attains no consensus; the school helpers cooperate well with hospital helpers.
(2) The helpers’ SOP in Crisis intervetion are as following: 1. Internal-assessment is done before announced. 2. It shows some contradictoris in crisis intervetion SOP. 3.Some discrepancies appears whetn different roles have different goals while cooperation in crisis intervetion.
(3) The Preferences of the helpers in crisis assessment: 1. More than half of the helpers use Standardized test to do the assessment. The working seniority and the roles of the helpers make differences in crisis assessments. 2. Depression or suicide scales are mainly chosen as a standardized-test tool by the helpers. 3.The elpers are more sensitive in Suicide’s immediately risk predictors, but tend to neglect the social risk factors. 4. The helpers have confidance in their own crisis assessment and they also consult with standard and non-standard assessment.
(4) The attitudes owns by the helpers toward clients: 1. The helpers are willing to continually work with the clients in systems. 2. The helpers believe that it is difficult to get balanced between the needs of suicidal clients’ and the systematic requestments. 3. The helpers belive that it has possitive affects to interact with the suicidal clients outside of the counseling room will be helpful. 4. Only 10% of the helpers would get the feedback from crisis clients.
(5) The helpers preparation and self-care in suicidal crisis intervetion : 1. It has negative impacts on the helpers, especially to those who have 1~2 years seniority of working. 2. The helpers believe that the more self-exploration they have in persoanal issues as well as the more working senerioty they have, the more professional confidance they will have in suicidal and self-hurting interventions. 3.Helpers suggest the most urgent need for crisis intervention is to improve “cooperation quality”.
　　At last, according to the above-mentioned results, some discussions and suggestions for suicidal crisis intervention and cooperation are proposed.

並列關鍵字

suicide ； crisis intervention ； cooperation ； suicide assessment

參考文獻

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一、中文部分