憂鬱症動力取向人際關係團體心理治療之氣氛變化及療效因素

Changes of Group Climate and Therapeutic Factors in Dynamically Interpersonal Groups for the Depressive Patients

鐘明勳(Ming-Shun Chung) ； 郭建成(Chine-Cheng Kuo) ； 杜家興(Juia-Hsin Tsu) ； 吳秀琴(Hsiu-Chin Wu) ； 林姵瑩(Peing-Ein Lin) ； 柯華寧(Hua-Ning Ko) ； 張達人(Ta-Jen Chang)

《中華團體心理治療》 14卷4期 (2008/12) Pp. 5-23

https://doi.org/10.30060/CGP.200812.0002

摘要

目的：本研究之目的在瞭解憂鬱症個案，在施以動力性人際關係團體心理治療過程中國體氣氛及固體療效因素之變化。
方法：本研究針對門診憂鬱症個案，實施為期十六次動力性人際關係團體心理治療。將10期團體早期、中期及晚期所收集之資料以成對樣本T檢定、趨勢分析進行分析。
結果：本研究結果顯示動力性人際關係團體早期投入性低、衝突性適中和逃避性高，團體中期投入性升高、衝突性適中和逃避性降低，團體晚期投入性仍可持續、衝突性降低但逃避性高。團體早期比較重要的療效因素為存在性、情緒宣洩及希望灌注；團體中期為普同性、情緒宣洩及存在性，團體晚期為內注性人際學習、自我瞭解及希望灌注。固體中期比早期升高者僅有仿同性，而內注性人際學習、自我瞭解及指導建議等三個療效因素在團體晚期皆較早期及中期升高。
結論：治療者在帶領動力性人際關係團體時，在團體早期應以支持的態度，鼓勵成員面對困境表達情緒，再以造橋的技巧聯結成員的互動，當團體凝聚力足夠時，則集中在討論當下成員人際關係之困難，面對彼此的差異及衝突，再經由治療者的詮釋移情指出其重複出現之現象，發揮內注性人際學習及自瞭解的療效，最後在帶著希望離開團體。

關鍵字

動力性人際關係團體 ； 憂鬱症 ； 團體氣氛 ； 療效因素

並列摘要

Objects: The purpose of this research was to find the change of the group climate and the therapeutic factors in the dynamically interpersonal group psychotherapy for the depressive outpatient.
Methods: Each psychotherapeutic group was run with 16 sessions at the outpatient setting. The data collected from 10 groups by questionnaires during the different stage of the group are analyzed statistically by paired-T test and trend analysis.
Results: The avoidance of group climate was high; the conflict was moderate and the engagement was low in early stage. But the avoidance reduced, the engagement elated and the conflict persisted without change in middle stage. The conflict decreased, the avoidance increased and the engagement persisted in the late stage. The most important therapeutic factors were existence, catharsis and instillation of hope in early stage; universality, catharsis and existence in middle stage; interpersonal learning, self-understanding and insti11ation of hope in late stage.
Conclusions: Leaders should encourage the members to face the difficulties and express their emotion through supportive attitude and bridging skills to facilitating interaction in early stage. When the group becomes cohesive, we can focus on immediate interpersonal difficulties and the individual difference. The effects of interpersonal learning and self-understanding are developed by the transference interpretation of leaders. Finally, the members leave the group with hope.

並列關鍵字

dynamically interpersonal groups ； depressive ； group climate ； therapeutic factors