安置機構照顧者與兒少發展依附關係之經驗探討

A Study on the Development of Attachment Relationship Between Residential Caregivers and Children

林蕙平(Lin Hui-Ping)

指導教授 ： 沈慶盈

國立臺灣師範大學/國際與社會科學學院/社會工作學研究所/碩士(2016年)

https://doi.org/10.6345/NTNU202205016

摘要

本研究旨在了解中長期兒童及少年安置機構中，照顧者與受安置兒少發展依附關係的經驗。研究者採取深度訪談法，訪談中部地區一所兒童及少年安置機構的六位資深照顧者。研究發現為：
一、依附關係發展歷程可略分為關係初期、關係磨合期、調整修復與重建期、關係穩定期與關係告別，歷程非單向線性而是呈現多線、來回發展，階段停留時間亦有個別差異。
二、依附關係發展的磨合因素包括1.安置機構體制限制；2.照顧者個人困境，如價值磨合與角色期待實踐；3.孩子的依附樣貌包括安全感與控制、情緒議題、焦慮/矛盾依附、信任議題、負向內在模式與自尊。以上三者會互相交互作用彼此影響。
三、依附關係的重建架構分為照顧者個人實踐和機構支持兩部分，由下而上則可分為三層。第一層以照顧者的自我覺察、調適為金字塔的基礎，機構則協助照顧者自我探索和整理。第二層重建孩子的安全信任關係是最重要的核心，照顧者的實踐原則包括：1.接納、好奇、同理的態度；2.反覆保證與溝通；3.用口語和肢體行為表達愛；4.對孩子的早期經驗保持敏感度且能適時協助整理；5.問題與人分開；6.建構歸屬感的儀式；7.非暴力的管教；8.運用替代策略緩解分離焦慮。而機構方面則和孩子發展多元依附關係，並支援照顧者。最上層的認知調整和行為管理原則包括1.以關心為基礎；2.溝通澄清；3.理性管教；4.增加孩子對環境的可預測性，避免二度創傷。機構則藉由多元角色合作減輕照顧者管教負擔。
研究建議：照顧者持續進行自我覺察和調適，並對依附關係發展的過程保持理解和耐心；兒少安置機構提升照顧者對依附創傷與重建的知能，提供良好的督導品質和同儕支持，建構完善的安置團隊合作模式與氣氛，減少照顧者工作負荷並給予合理休假，以提升安置照顧的品質。

關鍵字

安置機構 ； 照顧者 ； 依附關係

並列摘要

The purpose of this study is to understand the development of attachment relationships between caregivers and children who have been rehoused in medium- to long-term child and youth placement agencies. The researcher conducted in-depth interviews with six senior caregivers in a residential home for children and youth in central Taiwan. The findings of this study are as follows:
1.The development process of attachment relationships can be approximately divided into the following stages: initial, friction, adjust–repair–rebuild, stable, and closing stages. Rather than being monolinear, the process is multilinear with alternating progression and regression periods. The amount of time spent at each stage varies according to the individuals involved in the relationship.
2.Sources of friction in the development of attachment relationships include the given factors: (a) the institutional constraints of the placement agencies; (b) individual difficulties of caregivers, such as friction between values and role expectations; (c) the children’s attachment style, including their sense of safety and control, emotional issues, anxious or avoidant attachment, trust issues, internal negative patterns, and self-esteem. The three factors listed above interact with and have an influence on each other.
3.The framework for rebuilding attachment relationships constitutes two parts, including the individual practices of caregivers and institutional support. Bottom-up can be divided into three layers. The first-layer, Caregivers’ self-awareness and adjustment form the base of the pyramid while the agencies assist caregivers in their self-exploration and organization. The second-layer, rebuilding the children’s sense of safety and trust in relationships, addresses the core issue. The principles that caregivers implement include: (a) acceptance, curiosity, and empathy; (b) repetitive assurance and communication; (c) expressing love with verbal and physical behaviors; (d) remaining sensitive to children’s early life experiences and assisting them in dealing with the aftermath of those experiences, when appropriate; (e) maintaining a separation between the individual and the problem; (f) conducting ceremonies to foster a sense of belonging; (g) adopting nonviolent disciplinary measures; and (h) implementing substitutional strategies for easing separation anxiety. As for the agencies, they should foster multiple attachment relationships with the children and provide assistance to caregivers. At the highest level, principles for cognitive adjustment and behavioral management include: (a) building a foundation based on caring; (b) having a clear communication; (c) carrying out reasonable discipline measures; and (d) increasing children’s environmental predictability to avoid secondary trauma. To lighten caregivers’ disciplinary burden, institutions can promote cooperation between multiple people in disciplinary roles.
The suggestions based on this study are as follows: caregivers should continue to expand their self-awareness and make adjustments as they remain patient and understanding toward the development process of attachment relationships; children placement agencies should assist in developing caregivers’ knowledge of attachment trauma and rebuilding, providing qualified supervision and peer support. In addition, the agencies should also establish a comprehensive placement team cooperation model and atmosphere in order to lighten the caregivers’ burden and provide them with reasonable vacation leave thereby enhancing the quality of placement services ultimately.

並列關鍵字

Residential Institution ； Caregiver ； Attachment Relationship

參考文獻

陳金定、劉焜輝（2003）。青少年依附行為與情緒調適能力之因果模式初探。教育心理學報，35（1），39-57。

陳毓文（2008）。國內接受機構安置少年憂鬱情緒之探究：問題陳顯與解釋因素。中華心理衛生學刊，21（1），75-101。

黃淑滿、周麗端、蔡明芬（2008）。依附與其相關因素之後設分析－台灣近二十年文獻的研究。教育心理學報，40（1），39-62。

中文部分

中華民國統計資訊網（2015）。兒童及少年福利機構及服務概況。2015年4月1日，取自http://statdb.dgbas.gov.tw/pxweb/Dialog/..%5CDialog%5Cvarval.asp？ma=SW0116A1A&ti=%A8%E0%B5%A3%A4%CE%A4%D6%A6~%BA%D6%A7Q%BE%F7%BAc%A4%CE%AAA%B0%C8%B7%A7%AAp-%A6~&path=../PXfile/SocialWelfare/&lang=9&strList=L