什麼是初級預防？臺北市起步家庭支持輔導方案推動經驗之探討

「起步家庭支持輔導方案」為臺北市首創的家庭暴力初級預防服務方案，從2013年辦理至2019年，共推行近六年的時間，方案秉持著「預防勝於治療」的理念，為起步家庭提供支持性服務，以預防較嚴重的家庭問題產生。本研究旨在深入探討「起步家庭支持輔導方案」的推行歷程與經驗，並從方案的服務經驗出發，討論如何辦理家庭暴力之初級預防工作，以作為未來相關預防性政策及方案之參考。為此，本研究採用質性研究方法，邀請五位與方案相關的工作者參與訪談。主要研究發現如下：一、方案的推行經驗方案採用跨領域合作的策略，結合社會工作以及家庭教育專業，透過風險篩選、提供情緒支持與家庭教育服務、落實社政轉介的方式推展服務。推行過程中經歷過跨專業理念不同、實際運作上的限制以及成效評估的困難，最終，方案在效益不易評估的情況下予以轉型，將既有服務回歸至社政體系之下，不過，其中的跨領域合作經驗仍備受肯定。二、針對初級預防工作的看法與建議以社會工作角度來說，認為資源應優先聚焦於有潛在風險的家庭，因此重視風險篩選制度；以家庭教育角度來說，認為初級預防服務應更為普及。從另外一個角度來看，公部門受訪者重視社會福利服務的建置與推行；第三部門受訪者則建議透過社政、教育、醫療與民間單位間的合作將有助於初級預防服務的推行。根據研究發現，研究者提出以下建議：在政策制度面上，重視家庭暴力的初級預防工作，釐清初級預防工作的分工，同時加強各部會之間的連結與合作；在相關服務方案上，清楚定位服務方案的目標、發展因地制宜的服務內容，並建立一套初級預防工作的評估模式。

關鍵字

起步家庭；家庭暴力；初級預防；社會工作

並列摘要

Starting from 2013 to 2019, the Support Program for the Beginning Families is the domestic violence primary prevention services that are conducted by Taipei city’s government. Following the concept of “prevention is better than cure”, this program helps the newlyweds and the new parents with support services in order to forestall severe family issues. The purpose of this study is to explain the implemental progress and experiences of the “Support Program for the Beginning Families” in Taipei. After that, based on the previous involvement with the program, this thesis will also provide some suggestions for primary prevention to achieve a better standard procedure. Therefore, this study is performed by qualitative research where five participants who are associated with the program are invited. The research findings are as follow: I.The program implementation progress This program was adopted with an inter-disciplinary approach to promoting communication between social work and family education professionals. The service was forwarded through risk screening, offering emotional support, providing family education services, and applying referrals to the social administration system. Despite the experience of the inter-disciplinary cooperation in the program was a meaningful start, it was not easy to evaluate the results with it. Eventually, the program was halted and reverted to previous existing social services. II.Recommendations for primary prevention From the perspective of social work, the importance of risk screening systems and applying resources to families with potential risks cannot be overemphasized. On the other hand, the priority from the family education point of view is to universalizing programs. Yet, the participants from the public institution consider otherwise, they believe that the establishment and implementation of social welfare services should be strengthened. Participants from the third sector suggest reinforcing the systematic cooperation between social services, education, health care, and the private sector would smooth the way for the implementation of primary prevention services. According to the research, a number of recommendations can be proposed from different stages. Starting from the policy system, the organization should put more effort into domestic violence primary prevention services, clarify the division of labor of the primary prevention service also strengthen the bond between each government's department. To the similar programs, it is critical to target the goal of each program, develop into a service content that responds to community needs. Last but not least, reconsider a better evaluation method of primary prevention.