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研究生: 李慧玟
Huei Wen Lee
論文名稱: 校園高關懷國中生介入方案-優勢取向小團體諮商之效果
Outcome study of a strength-based small group counseling for hig risk junior high female students
指導教授: 陳秉華
Chen, Ping-Wha
學位類別: 博士
Doctor
系所名稱: 教育心理與輔導學系
Department of Educational Psychology and Counseling
論文出版年: 2012
畢業學年度: 100
語文別: 中文
論文頁數: 245
中文關鍵詞: 優勢取向高關懷青少年中文版長處與困難量表(SDQ)小團體諮商
英文關鍵詞: strength-based, high risk, youth, chinese version SDQ, small group counseling
論文種類: 學術論文
相關次數: 點閱:233下載:57
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  • 青少年心理議題一直受到重視,但除了生病後的治療外,也希望能以預防概念,運用高敏感度的青少年心理量表,檢測出高關懷之青少年,並建構以優勢導向之小團體諮商模式,注入心理疫苗優勢能力。
    本研究除檢驗中文版青少年長處與困難(SDQ)自填量表,在臨床之預測力及篩檢高關懷青少年之切截點,另一目的為考驗優勢取向小團體諮商在高關懷國中女學生之介入效果。
    第一階段研究參與者共273位,均為國中及高中學生,其中114位(男80位,女34位)來自醫院青年保健門診,159位(男87位,女72位)來自學校。以調查研究設計進行SDQ量表臨床預測力考驗,並以皮爾遜積差相關檢驗中文版青年長處與困難自填量表(SDQ)與台灣兒童青少年關係量表(TRICA)之相關,及以T檢定比較兩組在SDQ與TRICA間之差異。結果SDQ量表內部一致性係數( Cronbach’s α)為.505 ~.757,具有中度以上信度水準,兩組在SDQ表現差異除正向行為無差異外,其餘均達顯著差異;敏感度為74.5%、特異度為65.0%,陽性相似比為2.13倍;高關懷切截點定為SDQ困難總分≧20分。
    SDQ與TRICA經相關分析,顯示除SDQ困難總分與正向師生及正向母子無顯著相關外,其餘困難量表與負向人際關係均達顯著正相關,與正向人際關係均為顯著負相關,SDQ與IAR之相關係數亦達顯著相關,SDQ困難總分及其他分量表與IAR總量表與分量表均成負相關。TRICA及IAR可輔助SDQ評估青少年在人際關係及復原力向度。
    第二階段前測樣本為北市某國中七年級生,共236位(男105位、女131位),以SDQ高關懷切截點(≧20分)分為高關懷組34位(男16位、女18位)及非高關懷組202位(男89位、女113位)。高關懷女生經隨機分派為實驗組(7人)及控制組(8人),實驗組進入優勢取向小團體諮商介入方案,團體諮商每次50分鐘共八次,以SDQ、TRICA及青少年自我復原力量表(IAR)檢驗實驗介入後第4、8週及團體後一個月之變化,同時收集實驗組個別訪談資料、團體帶領者觀察記錄及團體帶領者與協同者之自評資料。以無母數統計曼-惠特尼U檢定(Mann–Whitney U Test)比較,兩組不管在第4、8及第12週在三個量表之比較均未達統計差異;實驗組以魏克森兩樣本檢定(Wilcoxon Matched-Pairs Signed-Rank Test)進行前測與三次後測比較,於追蹤測在IAR之希望與樂觀達統計差異(p<.05)。
    依據以上二階段研究結果的結論是SDQ是一個具高敏感度適用於青少年心理健康篩檢工具,而TRICA在檢驗青少年社會人際關係與SDQ間具有顯著相關,IAR在青少年自我復原力的檢測與SDQ間亦有高相關。優勢取向小團體諮商之效果性,研究結果僅支持部分研究假設,但在個別訪談質性資料中顯示成員凝聚力很快建立、溝通態度用語、同儕關係及部分人際關係均有一半以上成員改善,也建立正確理性認知及學習到具體方法。
    依據研究結果之建議, SDQ量表對社區青少年心理健康篩檢具有高預測力值得未來研究運用,其次進一步對中文版父母版及教師版SDQ量表之信效度,例如以兒童為樣本,及增加檢驗多受試者信度之統計考驗力,最後繼續深入研究並推展優勢取向小團體諮商,讓兒童青少年在成長歷程中能面對困境、解決問題,從困境中學習到更多的優勢能力。

    This study has two aims, first, to test the sensitivity and specificity and to find cutting point of Chinese version Strengths and Difficulties Questionnaire ( SDQ) for high risk youth; second, to conduct a strength based small group counseling for the high risk youth and to evaluate the efficacy of such intervention. This study includes two stages. In the first stage, 273 participants were recruited, including a clinical sample of 114 adolescents (80 malesand 34 females) from two hospital adolescent clinic and community sample of 159 adolescents (87 males and 72 females) from local junior and senior high schools. All the participants completed the SDQ and Taiwan Relationship Inventory for Child and Adolescent(TRICA) and the results showed that the SDQ has high predictive power in emotion and behavior difficulties with high internal consistency (Cronbach's α between .757 ~ .505). Compared the clinical and community groups by t-test, significant differences were found on SDQ’s total scores of difficulty, emotional, hyperactivity , deviant behavior, and peer problem subscale. No difference was found on pro-social behavior between the two groups; SDQ’s sensitivity is 74.5% and specificity is 65.0%, positive likelihood ratio is 2.13 times and high risk cutoff point of SDQ is above 20 .
    In the second stage, 236 7th-grade students (105 males, 131 females) from a junior high school in Taipei city were screened and 34 high risk students (16 males, 18 females) were identified. Fifteen high risk female students were randomly assigned into the experimental group (n = 7) and the control groups (n = 8), to receive the strength-based small group counseling and no treatment respectively. Repeated evaluations of SDQ/TRICA and Inventory of Adolescent Resilience ( IAR) for both experimental and control groups were conducted at three points of time: group session 4, 8 and one-month follow-up. The qualitative data for the experimental group were collected collaterally via individual interviews at session 4, 8, and one-month follow-up, as well as observation records and self rating by the group leader and the co-leader. With Pearson correlation analysis, the results showed high significant correlation between SDQ and TRICA, as well as SDQ and IAR.
    There were no significant differences found between the two groups at session 4, 8, and 12 assessment on SDQ、TRICA and IAR. Compared the experimental group’s pre-test and the session 4 and 8 assessment, there were no significant differences found on SDQ, TRICA and IAR. But compared the experimental group’s pre-test and the session 12 assessment, there were significant differences on hope and optimism subscale of IAR (p <.05).
    SDQ is a highly sensitive screening instrument with high validity to apply to adolescents ' mental health, TRICA has significant relation with SDQ, is a good instrument for measuring interpersonal relationship for adolescent. IAR is a good instrument to assess the resilience of youth .Although the efficacy of the strength-based small group counseling is not well supported by the quantitative data in this study, but the qualitative data displayed good group cohesion and more than half of members in the experimental group showed improvement in communication, positive verbal expression and peer relationships, and developed positive perspective to obstacle and good problem-solving methods. Although the strength-based small group counseling is not the only way for helping high risk youth, but it does provide teachers a positive view on valuing the assets, strengths, capabilities and resources of the teenagers to reconstruct their self-resilience.

    目錄 誌謝 …………………………………………………………………………….i 中文摘要 …………………………………………………………………………...iii 英文摘要 ……………………………………………………………………………v 目錄 …………………………………………………………………………..vii 附錄 …………………………………………………………………………...ix 表目錄 …………………………………………………………………………...xi 圖目錄 ……………………………………………………………………..........xii 第一章 緒論……………………………………………………………………………………………...........1 第一節 研究動機與目的……………………………………………………………………………….2 第二節 研究問題與假設……………………………………………………………………………..13 第三節 名詞解釋…………………………………………………………………………………........14 第二章 文獻探討…………………………………………………………………………………………….17 第一節 優勢諮商理論的發展與諮商之運用………………………………………………17 第二節 青少年小團體諮商…………………………………………………………………………36 第三節 SDQ/TRICA/IAR之發展及臨床之運用………………………………………..46 第三章 研究方法…………………………………………………………………………………………….57 第一節 第一階段研究…………………………………………………………………………………57 第二節 第二階段研究………………………………………………………………………………..59 第三節 優勢取向小團體諮商方案…………………………………………………………….65 第四節 研究工具………………………………………………………………………………………..71 第四章 研究結果……………………………………………………………………………………………77 第一節 SDQ的臨床檢驗結果……………………………………………………………………77 第二節 校園高關懷組與非高關懷組學生在SDQ、 TRICA、與IAR的差異比較………………………………………………………..87 第三節 優勢取向小團體諮商介入之量化研究結果………………………………….91 第四節 團體歷程質化資料分析…………………………………………………………………99 第五章 討論………………………………………………………………………………………………….113 第一節 SDQ、TRICA、與IAR的臨床檢測…………………………………………..113 第二節 第二階段優勢取向小團體諮商介入之研究結果………………………..123 第三節 優勢取向小團體諮商方案討論……………………………………………………128 第六章 結論與建議………………………………………………………………………………………139 第一節 結論………………………………………………………………………………………………140 第二節 研究限制………………………………………………………………………………………142 第三節 建議………………………………………………………………………………………………144 參考文獻………………………………………………………………………………………………………………….149 中文部分………………………………………………………………………………………………………….149 英文部分………………………………………………………………………………………………………….152

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