減害計畫中愛滋帶原之海洛因成癮者團體心理治療：團體個案報告

Psychoeducative Group Therapy in HIV Sero-positive Heroin Addicts of the Harm Reduction Program: A Group Case Report

李俊宏(Chun-Hung Lee) ； 唐心北(Hsin-Pei Tang) ； 張達人(Ta-Jen Chang)

《中華團體心理治療》 13卷3期 (2007/09) Pp. 5-19

https://doi.org/10.30060/CGP.200709.0002

摘要

愛滋帶原之海洛因成癮者為現今公共衛生體系帶來巨大的衝擊，特別是在愛滋傳播與後遺症部份。然而，目前並無針對此類成癮者社會心理處遇在共用針具、高危險行為以及海洛因戒癮效果之本土研究。本篇論文針對參與團體治療之愛滋帶原海洛因成癮者探討在成癮渴求皮、成癮行為、對高危險行為與情境認知上的改變。十位參與團體的成員皆為愛滋病毒陽性之帶原者，且於參與團體前已進行美沙冬替代療法一個月以上，開始參與每過一次之心理教育團體。所有成員皆符合DSM-IV-TR之海洛因依賴準則，且皆由地檢署安排參與此項計畫。我們藉由施測問卷與探討整個團體歷程的質性資料來評估固體結果。研究結果整理於本篇論文中，經由團體，成員學習到對海洛因成癮的正確態度，海洛因成癮渴求度與美沙冬劑量皆隨固體次數而下降，對海洛因戒除的準備程度亦隨之增強。重要的團體療效因子包括普同性、建議、人際學習、宣洩、家庭重現、灌注希望與團體凝眾力。團體歷程與動力改變皆被評估並於本論文探討。依據此團體經驗，心理教育團體治療能為愛滋帶原之海洛因成癮者帶來莫大助益。

關鍵字

海洛因成癮 ； 愛滋帶原 ； 美沙冬替代療法 ； 團體心理治療

並列摘要

HIV sero-positive heroin addicts may bring lots of challenges to our public health services in recent days, especially in AIDS transmission and further consequences. However, there' s no marked local study focus on the effect of psychosocial interventions to the sharing drug paraphernalia, high risk behavior、s and heroin abstinence rate in these patients. This report explored HIV sero-positive heroin addicts who received a psychoeducative group therapy whether got greater improvements in craving, addictive believes, cognition about high risk behaviors/situations. Ten individuals who had been HIV-seropositive and had been receiving standard methadone maintenance treatment for at least 1 months prior to inclusion in the study were entered in a weekly psychoeducative group therapy. All members met the DSM-IV-TR criteria of heroin dependence and all are assigned to harm reduction program by the Public Prosecutors Office. We evaluated the effect of this group by testing questionnaires and investigating the qualitative data in whole group process. The results of group therapy were summarized in this paper. Through group activities, these members learned accurate attitudes toward heroin addiction and made strong belief to abstinence. The intensity of heroin craving and methadone dosage decreased. And the readiness for heroin abstinence was enhanced. The important therapeutic factors were universality, suggestion, interpersonal learning, catharsis, family re-enactment, instillation of hope and cohesiveness of group. The process and dynamic changes throughout this group were been evaluated and mentioned below. Our findings suggested that psychoeducative group therapy can made a lot of benefits for HIV sero-positive heroin addicts.

並列關鍵字

Heroin ； HIV ； Methadone ； Group therapy