遊戲治療師實務困境與因應之探究分析

Exploration and Analysis of Therapeutic Predicaments of Play Therapists

高淑貞(Shu-Chen Kao) ； 蔡群瑞(Chiun-Ruei Tsai)

《中華輔導與諮商學報》 26期 (2009/09) Pp. 1-45

https://doi.org/10.7082/CJGC.200909.0001

摘要

遊戲治療是兒童心理工作的主要模式，但是國內目前對遊戲治療的訓練與督導資源並不足夠，而遊戲治療是一門獨特的專業領域，要有效發揮遊戲治療對兒童的心理療癒功效，治療師必須要有一定的訓練，以面對進行遊戲治療過程中的諸多挑戰。研究者因此想探究目前國內的遊戲治療師在使用遊戲治療模式時，其所遭遇的困難有哪些？本研究採用質性方法，藉由深度訪談十七位從事遊戲治療的實務工作者，以瞭解其主觀治療困境並進行跨案例綜合性分析。研究結果整理出十四個困境要素，分別是運用技術的不確定與困難、遊戲治療師的焦慮議題、來自個案的挑戰、個案概念化的困難、不確定評估的內涵與指標、預期具體效果的壓力、來自家庭的阻力、工作環境的壓力、督導資源的貧乏、期望協助專業知能的提升、理想督導的期待、具體發揮對孩子的正向影響力、成就感與動機、以及尋求解決專業困境的管道。可進一步歸納為五大主題：遊戲治療歷程中的困難、評估遊戲治療效果的困難、來自脈絡因素的干擾、遊戲治療督導不足與期待、以及回應困境的自我調整。本文針對上述主題分述受訪者與研究者觀點並加討論。最後，根據研究結果進行相關困境主題的討論，並提出因應之道與建議，以供遊戲治療師、訓練與督導者、專業發展關注之參考。

關鍵字

治療困境 ； 遊戲治療 ； 遊戲治療師 ； 督導

並列摘要

Play therapy is the current dominant model in working with child-clients. However, resources for training and supervision are not sufficient to meet the needs in continuing education of play therapists. Play therapy is a specialty which requires special trainings. The researcher believes that proper continuing education can be provided only through accurate understandings of play therapists' work difficulties. Reflecting this viewpoint, this study focuses on investigating and exploring the difficulties in play therapists' experiences. The research data was gathered by qualitative methods through interviewing with 17 play therapists and analyzing the interview transcripts.
Results show that play therapists reported fourteen factors belonging to five main themes of therapeutic predicaments. They are unsureness and difficulties of techniques, anxiety issues of the play therapist, challenges from clients, difficulties of case conceptualization, unsureness of assessment, pressure from expected effectiveness, disturbances from clients' families, pressure from work environment, lack of supervision resource, desire of promoting professional abilities, expectation of an ideal supervisor, positive effects on the child, sense of achievement and motivation, and ways to resolve predicaments. The five main themes include difficulties in the play therapy process, unsureness of effectiveness of play therapy, pressure and conflict from the working context, unmeet supervision needs, and self-adapting to the difficulties.
According to the findings, it is evident that play therapists confront various challenges in their clinical work. Based on the results, meaning of the findings and continuing education and supervision concerns for the play therapists are discussed. Suggestions for play therapy educators and practitioners as well as for further research are given.

並列關鍵字

play therapy ； play therapist ； supervision ； therapeutic predicament

參考文獻

高淑貞(2005)。因何而為？遊戲治療師之治療態度探究。中華輔導學報。18，1-36。

梁培勇(2006)。兒童遊戲治療起始期的困境。中華心理衛生學刊。19(3)，255-278。

Voluntary play therapy practice guidelines

APT Play therapy credentialing program guide

Axline, V. M.(1947).Play therapy.New York:Ballantine.