精神分裂症個案之復原歷程及治療師治療經驗之探討

A case study for recovery process of schizophrenia and psychotherapy experience of the counselor

蘇玫君(Mei-Chun Su)

指導教授 ： 彭慧玲

共同指導教授 ： 蕭文

國立暨南國際大學/教育學院/輔導與諮商研究所/碩士(2011年)

https://doi.org/10.6837/NCNU.2011.00139

摘要

本研究旨在探討精神分裂症個案接受心理治療之復原歷程與治療師的心理治療經驗。本研究以單一個案的心理治療逐字稿為文本，並以質性研究的方式進行資料分析，主要研究結果發現如下。
一、精神分裂症個案接受心理治療之復原歷程部份
（一）個案的復原歷程在心理治療的協助下，出現「被充分同理支持的會談經驗」、「病識感提升的頓悟經驗」與「控制疾病的成功經驗」，每一次的經驗都是轉戾點，讓個案在復原歷程有更進一步的成長與超越。
（二）心理治療協助個案完成「情緒經驗的整合」、「過去生命經驗的統整」、「對疾病與治療的掌控」、「對現實困境的接納」與「對未來生活的面對」五項復原歷程的任務，每一次任務的完成，皆是對個案賦權，協助個案繼續往復原的路上前進。
（三）個案在心理治療的歷程中，呈現「混亂」、「疑惑」、「理解」、「發病」、「因應」、「再發病」與「成長」總共七個復原階段，整體過程趨向成長而非線的狀態。
二、心理師的心理治療經驗部份
（一）心理治療對應個案復原歷程不同階段的狀態，可區分為「關係建立」、「疾病處理與因應」與「關係結束」三大階段，每個階段治療師皆營造支持與同理的環境，並運用不同的治療方式提供個案協助。
（二）在個案的復原歷程中，治療師使用「評估」、「個人中心治療」、「認知行為治療」、「後現代取向治療」與「危機介入」共五大取向的治療模式，過程中並且以社區諮商的觀點切入，隨時評估個案環境系統的問題與需求。
研究者根據上述研究結果加以討論，並據此對諮商與心理治療專業人員及未來研究者提供建議。

關鍵字

精神分裂症個案 ； 復原歷程 ； 心理治療

並列摘要

This study explored the recovery process of the schizophrenia client who had received psychotherapy, and the psychotherapy experience of the counselor. In this study, we use psychotherapy verbatim of a client as the transcript, and conducted data analysis by the means of qualitative research, the main findings are shown as follows:
一、The recovery processes of the schizophrenia client receiving psychotherapy:
（一）Under the assistance of psychotherapy, "talk experience supported by sufficient empathy", "epiphany experience of improved insight" and "successful experience of disease control" were turned up in the recovery process of the client. Each experience is the turning point that made the client to have further growth and beyond in the recovery process.
(二) The client was assisted by psychotherapy to accomplish five tasks of the recovery process: "Integration of emotional experiences," "integration of past life experience", "control of disease and treatment", "acceptance of reality plight" and "face to future life". The completion of each task empowered the client, and helped the client to continuously forward to rehabilitation.
(三) In the course of psychotherapy, the client had showed "alienation", "confusion", "realization", "relapse", "adaptation", "relapse again", "growth", a total of seven recovery phases, the overall process trend to grow up rather than liner.
二、The psychotherapy experience of the counselor:
(一) The statuses of psychotherapy, that corresponding to different stages in the recovery process of the client, can be divided into three major phases: "Relationship building", "disease treatment and coping", and "relationship ending". The counselor was to create a supportive and empathic environment and use different treatment to provide assistance for the client at each stage.
(二) Five orientation of the treatment model: "Assessment", "person-centered psychotherapy" "cognitive-behavior therapy", "post-modern orientation of therapy", and "crisis intervention" were used by the counselor during the recovery process of the client. The viewpoint of community counseling was used in the process, and assesses problems and needs of the environmental system of the client at any time.
Finally, the researcher discusses and provides recommendations for counseling and psychotherapy professionals and future researchers according as these findings.

並列關鍵字

schizophrenia client ； recovery process ； psychotherapy

參考文獻

一、中文部份

范燕燕（2000）：精神病患者生活經驗與主體性之研究。國立陽明大學衛生福利研究所碩士論文，未出版，台北市。

丁雪茵、鄭伯壎、任金剛（1996）：質性研究中研究者的角色與主觀性。本土心理學研究，6，354－376。

丁雁琪（1992）：高學歷精神分裂症患者主觀經驗研究。東吳大學社會學研究所碩士論文，未出版，台北市。

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