自殺危機系統合作制度之探究—以國立暨南國際大學為例

本研究目的在於探討國立暨南國際大學危機處理流程之演進與轉變,透過探討此制度以了解危機處理流程在實務中之運作,並了解在此流程之中系統間之合作是如何進行。研究者採用個案研究之「時序分析法」呈現研究結果,並借用「質性研究」之編碼方式,以求研究結果呈現之邏輯性及完整性。本研究以立意取樣為取樣原則,透過曾任學校諮商中心主任之老師推薦符合本研究目的之研究參與者,透過電子郵件邀請,共招募七位研究參與者。研究者以半結構是深度訪談進行資料搜集,分別進行一~二次之訪談,以了解「暨大危機處理流程的演進與轉變」與「系統合作對於危機處理流程之影響」。研究結果顯示: 一、心理師出勤制度為校園危機處理流程中系統合作之縮影雖然育部已明文頒布危機處理流程標準作業流程,然而該流程卻會因各校之地理環境、校內文化而有所調整。暨大獨有之心理師出勤制度即因應校內之特殊背景產生,暨大心理師出勤制度係指:1.心理師到場協助自殺危機個案處理;2.心理師 24 小時待機執勤。該制度顯現了系統之間,例如校安中心、諮商中心、導師、家長等系統間相互合作的情形。二、對保密原則的僵化詮釋容易使危機處理受到阻礙保密原則為諮商心理師所重視之倫理之一,然而對於保密原則之僵化理解將使得系統合作遭遇困難,尤其是自殺危機個案之處遇,更需要系統之間相互配合以及資訊交流,因此若能適時調整對保密原則之理解,例如在系統間交換個案之訊息,僅透露數、議題等能知悉個案情形,但又能保護個案隱私之資訊,則能使系統合作趨於順利。三、在系統合作中對「個案利益」持開放態度與討論空間將能對個案提供更全面之照護對個案利益之詮釋不僅是個案之心理師之權力,當個案處在系統合作情形之下,個案之利益更需要以開放思維探討,透過系統之間相互討論個案情形以及處置作為,方能為個案帶來更全面之照護。四、系統化的對危機個案進行處遇更能完善處理個案之危機狀況引起自殺行為一連串複雜之歷程,並非由單一事件、單一人所引起,同理,要進行自殺危機處遇,也絕非單一單位、單一專業人士之工作,對於自殺危機個案更需要透過系統化之相互合作,在個案可能出現的每一個角落皆能像個案伸出援手,使個案之危機狀況得到更完善之處理。

關鍵字

自殺；危機處理流程；系統合作

並列摘要

The purpose of this research is to explore the evolution and transformation of crisis management processes at the National Chi Nan International University. Through this system, we will understand how crisis management processes work in practice and understand how cooperation between systems works in this process. Researchers use the "chronological analysis method" of case studies to present research results, and use the coding method of "qualitative research" to seek the logic and completeness of the presentation of research results. In this study, sampling was based on the principle of intentional sampling. Teachers who were former directors of school counseling centers recommended research participants who met the purpose of the study, and invited a total of seven research participants via email invitation. Researchers conducted semi-structured in-depth interviews to collect data, and conducted one or two interviews to understand the "evolution and transformation of the crisis management process" and "the impact of system cooperation on the crisis management process." The results of research show: I. Psychologist attendance system is the epitome of systematic cooperation in the campus crisis management process: Although the Ministry of Education has clearly issued a standard operating procedure for crisis management procedures, the procedure will be adjusted due to the geographical environment and school culture of each school. NCNU ’s unique psychologist attendance system is created in response to the special background of the school. NCNU psychologist's attendance system refers to: 1. psychologists are present to assist in the handling of suicide crisis cases; 2. psychologists are on standby 24 hours a day. The system shows the cooperation between systems, such as School Security Centers, Counseling Centers, Department, and Parents. II. The rigid interpretation of the principle of confidentiality can easily hinder crisis management: The principle of confidentiality is one of the ethics valued by counseling psychologists. However, a rigid understanding of the principle of confidentiality will make system cooperation difficult, especially in the case of suicide crisis. It also requires cooperation and information exchange between the systems. The ability to adjust the understanding of the principle of confidentiality in a timely manner, such as exchanging case information between systems, revealing only numbers, issues, and other information that can understand the circumstances of the case, but also protect the privacy of the case, can make system cooperation smooth. III. Openness to the case benefit '' and discussion space in system cooperation will provide more comprehensive care for the case The interpretation of individual interest is not only the power of the psychologist of the individual case. When the individual case is under the condition of systematic cooperation,the interests of the individual case need to be discussed with an open mind, and the individual case can be considered as a case through the mutual discussion of the individual case situation and disposal actions. Brings more comprehensive care. IV. Systematic handling of crisis cases can better handle the crisis situation of the case: A series of complicated processes that cause suicide are not caused by a single incident or a single person. Similarly, to deal with suicide crisis, it is definitely not the work of a single unit or a single professional. For suicide crisis cases, it is necessary to use a systematic approach. By cooperating with each other, we can reach out like a case in every corner where a case may occur, so that the crisis situation of the case can be handled more completely.