嚴重情緒障礙學生自我決策及其家庭參與在轉銜服務歷程之探討—以又一村情障班個案為例

The Decision Making and Family Involvement in the Transition Process of the Serious Emotional Disorders Adolescent: The Students’ Experience in “The Other Village”

張如杏(Chang, Juhsing)

指導教授 ： 林幸台

國立臺灣師範大學/教育學院/特殊教育學系/博士(2007年)

摘要

嚴重情緒障礙學生是特教的對象，他們比其他障礙學生較晚成為特殊教育學生，學生離校後發展有更多問題，離校前的轉銜服務對於其日後的發展尤其重要。
身心障礙者轉銜服務模式，強調障礙者參與及自我決策、家庭支持與參與的重要性，本研究以青少年日間留院「又一村」的「情障班」學員為對象，透過訪談，了解這類學生的進入與離開又一村的轉銜服務運作過程，參與及進行決策的歷程。研究資料分析的結果如下：
受訪個案認知功能的缺損對半結構問題的理解有困難，語言表達比較表淺。家長和專業人員對於個案的決策參與比較保留，學員的身心障礙與特教資格、未來生涯規劃與轉銜安置都是家人和專業人員共同決定，嚴重情緒障礙學生參與自我決策有限。
受訪家庭社會經濟不利的比例偏高，家庭的保護功能較弱。專業人員與家長對問題的看法不同，家長對於專業服務的運作與決策參與比較被動，在缺乏準備下進行決策。
「特教醫療化」的現象明顯，教育專業人員依賴醫療診斷，忽略這類學生的病程與其他障礙不同，缺乏針對情障學生的特殊性設計教學。
嚴重情緒障礙的特殊性需要結合各體系的專業共同合作，目前專業合作難以跳脫醫療模式，各專業對於家庭的服務又各行其道，缺乏整合的多元服務。
受訪者覺得又一村的教育功能比較不足，老師缺乏特教訓練，現行課程比較鬆散，缺乏依學生特質規劃個別教學，對學生的轉銜計畫偏重環保就業訓練，未能整合各專業服務。
作者認為又一村的服務架構將嚴重情緒障礙者隔離教育的作法，對於部分嚴重情緒障學生確有需要，但是教育階段結束後的轉銜規劃比較侷限缺乏與其他專業的連結，不利功能較好的學生，日後需要加強專業的整合與連結，強化轉銜服務才能提升整體服務成效，吸引有需要的學生。

關鍵字

嚴重情緒障礙 ； 轉銜服務 ； 家庭參與 ； 自我決策

並列摘要

Serious emotional disorder is one of the categories in special education in Taiwan. Serious emotional disorders onset at the early adolescent and it will impact the youths’ outcome in the future. It is importance that the transition service of the disability students in the special education; it’s especially for the serious emotional disorder students. They need the special education, psychiatric services, and social welfare and so on; the multi-system services will supply the more comprehensive services for the students and their family.
“The other village” is combined with the psychiatric medical and special education services for the students with serious emotional disorders; it is the placement for the cooperation by the Department of Education Taipei City and the Taipei City Hospital, Songde branch. “The other village” is one of the special education class for the emotional disorders students who onset the psychiatric disorders before 22 years old. “The other village” is a day care center for the young psychiatric adolescents; it is also a more protective education and rehabilitation place for the young psychiatric students. They can also get the work training and transition service in “The other village”.
This is the qualitative research for the young psychiatrics and their family, I interview 8 participations and 5 of the participations’ families in “The other village”, I used the semi-structural questions and reviewed their charters, I also interviewed the professionals who serve the emotional disorders students, including the case managers, special educational teachers, child psychiatrist, head nurse, et al. I will analysis the data by the hermeneutics approach.
The first finding is about the impact of the participations’ cognitive function deficit in their understanding and their communication level. The interviewees can’t comprehensive communicate to the interviewer, they need more explanation about the interview questions and their feedback are simplicity. Therefore the decision-making of the interviewee and the involvement for the leaving school transition is limited. The family makes more protection and decision for the low level adolescents. The family is the first protection for the young psychiatrics.
Second, the poorer, single parent, and the other disability in the family I interviewed. This is the same with the Wanger’s finding. The protective function of the family is weak and deficit for the participations. It’s important to establish the protective network from social resource or outside the family; it can reinforce the family protective function. The family center service will empower the family protective function and good for the emotional disorders students. The family involvement in the special education is unprepared, even they join and discuss in the meeting. The families ask for more explanation about the professional services and transition services for the involvement and making-decisions.
Third, the medicalization is the core problem in the special educational professionals, there are many different services for the emotional disorders students and their families; the cooperation in the professionals is diversity and fragment. The professionals should emphasis their cooperation in the service. But the special educators need more active and leading the multi-system cooperation.
Finally, “The other village” is a placement for emotional disorder student, the more professionals’ inclusion in the special educational and psychiatric services will help prompt the service outcome. The more cooperation between the professionals and the more emphasis the special educations are need for future.
This article will discuss the characteristics of the serious emotional disorder and their need in the transition services. The author hope the professionals can more understanding the transition needs of the serious emotional disorders and their family, and provide the more comprehensive services for them.

並列關鍵字

serious emotional disorder ； transition service ； family involvement ； decision-making

參考文獻

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