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對立性反抗疾患兒童之沙遊治療歷程分析研究

The Process Study of the Sandplay Therapy on Oppositional Defiant Disorder

摘要


本研究以一位國小五年級男孩(診斷為對立性反抗疾患)為研究對象,旨在直接描述此男孩運用沙遊治療表達內在經驗的沙圖表現,並在沙遊治療前、中、結束和五個月的追蹤時期等四個時間點,間接評量行為問題與生活適應的變化情形。本研究採用個案研究法,在四個時間點訪談及評量兒童、教師、家長及同儕等,以搜集量化、質化資料並與外來稽核同伴共同分析、校正資料。本研究發現如下: 一、就內在經驗表達變化(即沙圖變化)而言:依據正負向主題分析兒童的20個沙圖發現,兒童的沙圖以正向主題出現較多,且在後期密集出現。沙圖常以正向的「創造性」主題轉化經常出現的「孤立無援」負向主題,可見沙遊治療可能活化兒童的心靈,並促進心室的發展與成長。依據自我發展階段分析,發現沙圖依序循環發展;而對第一盤沙圖與最後一盤沙圖比較分析,可看到沙圖的變化是由空洞與缺乏活力,轉變為具有整體性與穩定性的現象;依據個體化歷程分析,發現沙圖並未完成終極的個體化目標,但是能發揮個人潛能。 二、就行為問題變化而言:兒童的行為問題在沙遊治療前具有非常嚴重性,在治療期間及追蹤期間,則持續進步中。 三、就生活適應變化而言:兒童的整體生活適應普遍欠佳,但不致達到最欠佳的生活適應,且隨著沙遊治療的進展漸有改善。在追蹤期間,則因受各項因素的影響,兒童反而退步至與前測的程度。 本研究同時就研究結果進行討論,並針對輔導實務及後續研究的進行,提供各項具體之建議。

並列摘要


The major purpose of this study was to investigate one 5th grade elementary school boy with oppositional defiant disorder. For the purposes of this study, sand miniatures were used as a tool to facilitate expression of internal experiences and changes in behavior problem and life adjustment by the boy in the four stages of the pre-therapy, mid-therapy, post-therapy and 5 months follow-up. This study adopted case study and participant observation method. The Sandplay therapy consisted of 24 sessions with 40 minutes per session. Each session was videotaped, and the 20 sandpictures the child made were taken for Consensual Qualitative Analysis. The conclusions of this study were as following: The changes of the boy's internal experiences in terms of the sandpictures analysis were various: 1) the positive themes were more than the negative themes; 2) the child expressed the ”creation” theme to decrease the ”isolation” theme's impact; The changes of the boy's behavior problems kept on improving according to the Children Behavior Inventory in the stages of the post-therapy and follow-up. The changes of the boy's life adjustment were: 1) in the stage of the pre-therapy, the child showed a poor life adjustment in the Landscape Montages Life Adjustment Indicators (LMI); 2) in the stage of mid-therapy and post-therapy, he has shown signs of progressed; 3) in the stage of the follow-up, he regressed to the pre-therapy level due to many influential factors. Recommendations for future therapy and research were made.

參考文獻


Amatruda, K.,Simpson, P. H.(1997).Sandplay the sacred heating: A guide to symbolic process.Novato:Trance Sand Dance Press.
Amatruda, K.,Simpson, P. H.(1997).Sandplay the sacred healing: A guide to symbolic process.Novato:Trance Sand Dance Press.
Boik, B. L.,Goodwin, E. A.(2000).Sandplay therapy: A step by step manual for psychotherapists of divers orientation.N. Y.:W. W. Norton & Company.
Boik, B. L.,Goodwin, E. A.(2000).Sandplay therapy: A step by step manual for psychotherapists of divers orientation.N. Y.:W. W. Norton & Company.
Bradway, K.,McCoard, B.(1997).Sandplay: Silent workshop of the psyche.New York:Routledge.

被引用紀錄


林金釵(2009)。資深諮商工作者個人沙遊歷程之探究〔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=U0021-1610201315165146
許皓宜(2010)。家庭治療四步模式的治療歷程與療效研究〔博士論文,國立臺灣師範大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0021-1610201315193595
張碧琴(2012)。依附取向親子治療歷程研究-以依附創傷兒童為例〔博士論文,國立臺灣師範大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0021-1610201315280517
張鈞弼、刑志彬、吳怡珍(2019)。個案研究方法在心理治療實務研究之應用與回顧輔導季刊55(2),34-43。https://www.airitilibrary.com/Article/Detail?DocID=19966822-201906-201907090010-201907090010-34-43

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