兒少安置機構社工員對「難置兒」之處遇經驗探討

家外安置是兒少保護的最後一道防線，其中機構安置更是不得不的選擇。從實務中發現有些兒少因不當對待被迫離家進入機構照顧，但卻因特殊身心需求以及行為問題而在安置體系中面臨多次轉換安置，成為在機構中流浪的「難置兒」。為了更能瞭解安置體系中難置兒的現象，以及兒少安置機構社工員如何看待並提供服務，本研究邀請7位兒少安置機構社工員，從其服務經驗瞭解難置兒的樣貌、處遇方向、可能的困境與因應策略，並從實務與制度上提出建議。本研究發現如下：一、難置兒的樣貌：難置兒可區分成三種類型，分別是身體疾病或發展障礙的兒少、嚴重情緒與人際問題的兒少，以及具反社會性行為的兒少。這些難置兒所呈現的共同特徵如缺乏安全感更難建立關係，情緒反應明顯且強烈，低自我價值感與低學習動機。二、難置兒之處遇服務與策略：兒少安置機構社工員的處遇可分成一般兒少處遇，以及難置兒處遇。一般性處遇包含建立穩定的生活結構與規範、未來生涯規劃的討論，以及強化兒少與原生家庭的連結。在難置兒處遇上則包含提升兒少自我價值感、協助兒少學習表達情緒與行為，以及其他資源的協助。三、難置兒處遇困境與因應策略：處遇困境可分成社工員個人內在的影響、社工員與生輔員之間的合作與溝通、社工員與網絡之間的合作困境、組織管理限制以及安置體制的資源不足等。針對這些困境，社工員多採取自我調適、上課進修再學習、大量溝通交流，以及召開個案研討會。四、社工員對兒少安置體制的期許：社工員對兒少創傷的理解仍需訓練，重視照顧工作的困難，如制定合適照顧比、提供與照顧負荷相符之待遇與協助招募與培育照顧人才；此外，制定主責社工員合適的個案量，才能有足夠心力關注難置兒。在體制層面，因為現有安置型態不符其需求，安置兒少需分類、安置型態需更多元；教育體制上也需要更個別化銜接。據此，本研究針對研究發現進行討論，並針對社工員對難置兒處遇上，以及體制層面提出建議，以供未來實務與政策參考。

關鍵字

難置兒；安置機構；社工員

並列摘要

Out-of-home placement is the last resort of child protection, especially the residential care. In practice, some children were placed owing to the child maltreatment. However, because of the special needs and annoying behavior problems, the children were often rejected. Therefore, becoming “hard-to-placed child” not only has less choice, but also has to face more than one time replacement. The purpose of the study is to understand the phenomenon of hard-to-placed child, as well as how the residential social workers perceive and serve these children. The study used purposive sampling, interviewing 7 social workers, who work in the residential care and have the experiences with the hard-to-placed children. The findings were revealed as followed: 1.The image of hard-to-placed child: Hard-to-placed child can be categorized into three types. One is the physically and developmentally disabled children. Another is the children with severely emotional disturbance and have difficulties making connections with peers. The last one is the children with anti-social behavior problems. All of the three types have some characteristics in common. First, they both lack of security and hard to trust people. Second, their mood changed dramatically and easy to burst out negatively. Third, they often have low self-esteem and motivation of learning. 2.The treatment of hard-to-placed child: The treatment can be divided into normal treatment and the treatment toward hard-to-placed children. The former include providing the stable and formal live structure, discussing the future plans with children, and increasing the frequency of visits with family members. The latter include enhancing the children’s sense of self-worth, helping children to express themselves consciously, and using different resources to help children. 3.The difficulties of treatment and the strategy of coping: The difficulties include the negative influence to social workers, the communication problems between social worker and daily-life guidance personnel, the collaborate difficulties between social workers of residential care and government social workers, the rigid management of organization, and the inadequate resources of placement system. To solve the above problems, social workers take strategies like adjust, take more trainings, communicate more, and arrange formal case conference with government social workers. 4.The anticipation of social workers toward the placement system: social workers need more trainings of trauma-informed treatment, government should pay more attention on the work of care, which means to regulate appropriate care ratio, and provide adequate wage as well as recruit enough daily-life guidance personnel. In addition, government should formulate the limit of caseload, so that the government social workers have more time to pay close attention to hard-to-placed children. For the placement system, because the placement types exist currently don’t match the demands. Children placed should be categorized, and the types of placement should expand diversely. In education system, it is important to transit individually. Results are discussed according to the implications for treatment of hard-to-placed children. Recommendations for policy, practice, and future research are offered as well.