- 期刊
難治型憂鬱症患者認知行為團體治療成效之前趨研究
A Pilot Study of the Efficacy of A Cognitive Behavioral Therapy Group for Patients with Treatment-resistant Depression
摘要
慢性鬱症患者之藥物及非藥物處置模式同等重要，然而鮮少有研究探討認知心理團體治療（group-based cognitive behavioral therapy, CBT-G）之成效。目的：探討CBT-G對難治型憂鬱症患者之短期療效，並以亞隆11項團體療效因子模式為分析工具。方法：符合診斷標準之病患由醫師轉介參加本CBT-G團體治療。25人次共分四梯次進行、每梯次為期6－8週、每週一次，每次兩小時。每週討論的主要內容涵蓋自我心情關照、壓力管理、社區再融入；以提升患者之情緒穩定度與社區參與度為目標。團體討論過程與結果製成逐字稿，以亞隆療效因子做為階層式逐步分析之參考，分析討論內容的基本單元及主題。結果：研究結果可歸納為四大主題，反映成員關注焦點暨療效：發病原因與近況、疾病相關主題分享、個人自我評價或覺察、及亞隆團體療效因子。其中療效因子以灌輸希望、普同感、資訊傳遞—指導性指示／給予建議、利他等出現頻率最高。多數成員藉由團體學習轉念、心情溫度自我評估、壓力管理技巧，發展出良好的人際學習模式，增加問題解決能力、進而形成新的人際交友圈，提升復元潛能。結論：短期認知行為團體治療有助於提升難治型憂鬱症病患之自我照顧能力與復元潛能，建議未來持續追蹤團體治療之長期效益。
並列摘要
Medication and non-medication treatments are equally important for patients with chronic major depression. However, there is lacking of studies related to group-based cognitive behavioral therapy (CBT-G) for these patients. Purpose: The study used the 11 therapeutic factors of Yalom's group intervention model as the analytical tool to explore the short-term effects of the CBT-G among clinical patients with treatment-resistant depression (TRD). Method: All the participants with the diagnosis of TRD were referred to this study. Twenty-five patients with TRD were designated into one of four CBT-G groups. Each group lasted for 6 to 8 weeks and two-hour long per week. In order to promote mood stability and activity participation, the weekly themes were designed to facilitate discussion, including self-awareness of mental distress, stress management, and community reintegration. The group process was transcribed with verbatim for stepwise content analysis based on the Yalom's model. The basic units and main themes were identified. Results: The findings were categorized into four main themes that reflected the concerns or effects of the participants, including reasons and recent conditions of the mental illnesses, specific illness-related concerns for sharing, self-evaluation or awareness, and Yalom's therapeutic factors existent of these participants. Most common therapeutic factors were found to be instilling hope, universality, information transmission (both instructions and advice), and being altruistic. The majority of the participants developed an improved interpersonal skills though thought changes, awareness of the mood thermometer, and stress-management concept reflection. The participants also increased problem-solving abilities through interpersonal learning, which facilitated their recovery potentials. Conclusion: The short-term supportive cognitive behavioral therapeutic group could benefit patients with TRD to enhance self-care and recovery. The long-term effectiveness of CBT-G is suggested to be researched in future studies.
參考文獻
延伸閱讀
- 范琬君（2012）。內觀認知治療團體於憂鬱症緩解患者之療效研究〔碩士論文，國立臺灣師範大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0021-1610201315271717
- 鄭朮均（2012）。內觀認知治療團體對憂鬱症病人的症狀療效－一年追蹤研究。臨床心理學刊，6(1)，80-80。https://www.airitilibrary.com/Article/Detail?DocID=18136419-201206-201406040001-201406040001-80-80
- 藍育慧（1995）。認知行為治療對一位焦慮症個案應用成效之探討。弘光醫專學報，(25)，105-118。https://doi.org/10.6615/BHIMNT.199501.25.05
- 蔡元瑛（2009）。正向情緒焦點認知治療團體運用於憂鬱患者：療效評估與改變因子之探討〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-2207200903325100
- 謝玉萍（2008）。The Effectiveness of Group Cognitive Behavioral Therapy for Outpatient Adolescents With Depression: A Pilot Study〔碩士論文，臺北醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0007-2107200814093700