從焦點團體看精神障礙者工作復健的困境

Representation the Struggles in the Psychiatric Rehabilitation from the Focus Group

吳台齡(Tai-Ling Wu)

《中華團體心理治療》 16卷3期 (2010/09) Pp. 25-38

https://doi.org/10.30060/CGP.201009.0003

摘要

目的：以焦點團體(focus group)做為一種團體心理治療的模式，經由敘述研究(narrative study)來進行質化分析，從患者主體性(subjective)的敘說工作經驗資料中，試圖探討精神病患者在工作復健中面臨的各種問題。方法：從日間病房的住院患者中，邀請十三位精神分裂症或躁鬱症患者，參加工作支持團體心理治療，他們在發病後曾有工作經驗或目前正在工作。團體總共進行八次，每次團體進行九十分鐘，治療者由二位精神科專科醫師負責，另有三位觀察者。團體進行前由二位治療者，針對每位參加成員安排評估會談一次。團體進行中均聚焦在與工作有關的各樣話題，再從錄音文字稿中，加以進行敘述的詮釋分析，探討工作復建的主體性經驗。結果：經由成員在團體中的敘說，呈現了工作中的人際關係、工作態度、工作價位觀、擁有一份工作對患者個人或家人的意義、工作期間與家人的互動關係、如何調適工作壓力、工作能力的自信心、如何接受工作訓練、工作期間發生症狀不穩定或藥物副作用的影響時應該如何處理、工作場所男女朋友交往或面臨適婚年齡的壓力、是否告知自己為精神病患者等等問題。結論：焦點團體協助了解精神病患者在工作復健中所常遇見的問題，而團體心理治療本身也同時會帶給成員彼此之間的支持、同理、傾聽、鼓勵。

關鍵字

焦點團體 ； 主體性 ； 敘述分析 ； 精神復健

並列摘要

Objectives: We reflected the problems in the psychiatric rehabilitation through the qualitative research methods in focus group.Methods: We invited thirteen psychotic patients to the work support group who were in the vocational rehabilitation program at the Psychiatric Day ward in Veteran General Hospital Taipei. The researchers acted as facilitators in this process with a view to empowering participants at each stage in the action research cycles.Results: Narrative representations of personal work experience through focus group have showed us kinds of problems in psychiatric rehabilitation such us low self-esteem, family interaction conflict, interpersonal relationship, worried about psychotic relapse, drugs side effect, marriage or not, working ability, job training program, stress during work, low frustration tolerance, fear of failure again. avolition to work. Focus group is not only revealing the narrative true during psychiatric rehabilitation but also a way of support, empowerment and empathy understanding these patients.Conclusions: The reconstructed narratives told us ”research as therapy”. Hermeneutic conversation between the therapist and group members is a way of empowerment through reciprocity therapeutic relationship of group process. While describing the job experience of individual lives, narratives also illuminate the interpretation and reconstruction of individual experience.

並列關鍵字

Focus Group ； Subjective ； Narrative Analysis ； Psychiatric Rehabilitation