音樂意象團體對憂鬱傾向青少年治療效果之研究

The Effectiveness of Music and Imagery Group Counseling on Depressed Adolescents

張夢玲(Meng-Ling Chang)

指導教授 ： 蕭富聰

國立暨南國際大學/教育學院/輔導與諮商研究所/碩士(2015年)

摘要

本研究旨在探討「音樂意象團體」對憂鬱傾向青少年之立即性與持續性治療效果，以及團體中的意象經驗，採單組前、後與追蹤測之實驗設計，研究者為團體設計者及領導者，於2014年3月於中部某高中進行招募，經由輔導室轉介並施以憂鬱量表，共篩選出6位有憂鬱傾向的學生，於2014年5月至6月間進行六週「音樂意象團體」，每週一次，一次九十分鐘。

本研究採質量混合研究法，先以量化資料呈現成員憂鬱的改變程度，再以質性資料說明改變的面向。成員於團體前、後及結束後六週分別施以「流行病學研究中心憂鬱量表」，所得資料以無母數統計進行檢定。「視覺類比量表」實施於每次團體結束後，由成員自評放鬆程度，由0至10。另外在「音樂意象團體」介入之前，對成員的音樂、情緒以及色彩經驗施以問卷調查，團體之後並填寫團體的經驗及收穫，作為研究的質性資料。

團體方案依據「引導想像音樂治療」的理論及技術而訂定，流程依序為暖身討論、身體放鬆與引導、音樂聆聽、曼陀羅繪製及音樂意象討論。研究者以大自然音樂結合漸進式肌肉放鬆法，再以古典音樂引導成員進行想像，並將意象繪製成「曼陀羅」。由音樂體驗活動可知，成員皆有能力覺察音樂中的情緒，並且能依據「曼陀羅」作品中的意象進行討論。

研究結論如下：（一）經過六週的「音樂意象團體」，憂鬱量表結果顯示，成員的「人際問題」、「正向情感」獲得立即性的治療效果。（二）憂鬱量表結果顯示，成員整體憂鬱狀態未獲得立即性及持續性的治療效果。（三）「視覺類比量表」結果顯示，成員放鬆的平均指數為8.12，由質性資料顯示成員在團體中皆有深度放鬆的經驗，但是受到下列因素影響：身體狀況、課業壓力、生活壓力事件以及事件引起的心理焦慮。（四）音樂意象經驗結果：成員經由音樂的引導，引發意象，意象的產生除了與音樂有關，也與過往的生命經驗、帶領者的引導以及當時的情緒狀態有關。由成員的意象經驗能夠了解其內在需求、情緒狀態、人格特質、人際關係及生命的歷程及轉化。成員的內在需求皆與情感經驗有關，而作品中也出現一些共同的意象經驗，例如成員第五次及第六次的團體作品皆呈現正向的經驗，顯示憂鬱情緒正在轉化，而成員間的支持及陪伴是憂鬱情緒轉化的可能因素。（五）質性資料結果顯示成員有愉快及正向的團體經驗，對團體過程及領導者感到滿意，而正向的團體經驗是「人際問題」、「正向情感」獲得立即改善的可能因素。

最後研究者依據結論提出省思與建議，作為未來研究之參考。

關鍵字

音樂治療: 憂鬱傾向: 團體治療

並列摘要

The purpose of the study aims to investigate the effect of Music and Imagery Group counseling on adolescents with depression. The study uses a pre-post, 6-week follow-up test design. The researcher is the group leader and project designer as well. The group members including six students recruited from 232 first grader senior high students who received treatment for six weeks, 90 minutes a week.

The study is mixed with qualitative and quantitative research design. The quantatative data was analyzed first then the results of qualitative data were elaborated. CESD is conducted in the first week, the 6th and the 13th week. Visual Analogue Scale, a self-report scale, was conducted at the end of each session. Music and emotion experiences and color symbolism were collected before the group. Group members experiences were collected at the end of the sixth session.

The group project is based on the principles of the Guided Imagery and Music Therapy. The procedure would be warm-up stage, body relaxation and imagery guided stage, music-listening stage, mendala drawing stage and discussion stage. The data shows that members have the ability to investigate the emotion in music and discuss the meanings of mendala.

The major findings of the research are concluded as follows：
(1) The effects of treatment group on ”interpersonal problems” and ”positive affect” is immediate.
(2) The effects of treatment group on depression is not immediate and sustained.
(3) The average value of relaxation is 8.12. The quantitative data shows that members have deep relaxation experiences in group, however restricted with some factors.
(4) the results of music and imagery : Members were guided with music. The image emerges from
music itself and influenced by some factors, including past life experiences, imagery induction
and emotional condition. Music image reveals what members need and feel. Mendala show the
common graphic and color symbolism and positive image, which suggesting depression of
members is on change and reduced. Data shows that emotional support and company from
group members is the possible factor to reduce depression of members.
(5) The qualitative data shows that members are pleased with whole group process and group leader performance, which would be the possible factors of good results

. Finally, further suggestions for future study and workers in practice are provided.

Key words: music therapy, group counseling, adolescent, depression

並列關鍵字

music therapy ； depression ； group counseling

參考文獻

一、中文部分

王建楠、吳重達（2003）。兒童及青少年憂鬱症. 基層醫學, 18(7), 154-16。

王齡竟（2008）。家庭衝突及社會支持對青少年憂鬱情緒及偏差行為之 影響: 補償

抑或緩衝作用。臺灣大學社會工作學研究所學位論文。未出版。

方麗華、陳昭姿、陳純誠（1998）。憂鬱症的治療。台灣醫學, 2(4), 456-464。