學術產出-學位論文

題名 外展心理介入有心理症狀但未求助者的初探-以九二一災民為例
作者 吳勢鵬
Wu,Shih-Pon
貢獻者 許文耀
吳勢鵬
Wu,Shih-Pon
關鍵詞 外展
心理介入
創傷壓力疾患
認知行為治療
發現取向
outreach
psychological intervetion
PTSD
CBT
discovery-oriented
日期 2006
上傳時間 17-九月-2009 13:13:31 (UTC+8)
摘要 回顧地震災難心理學的相關研究指出,災難創傷所引起的心理壓力反應具有長期、慢性化的影響,然而許多有心理壓力反應症狀的民眾可能會因為精神疾病的污名化、社會文化的漠視或忽視、應付接踵而至的生活事件、或症狀引起的退縮行為等種種因素,而不願或未求助心理專業的協助,因此相關的研究同時也指出發展外展心理介入計劃的必要性;然而不論在實務或在研究方面,對有心理症狀但未求助的災民實施外展心理介入卻是鮮而少見的。
本篇研究採用已獲多數研究證實有效治療創傷壓力疾患(Posttraumatic Stress Disorder, PTSD)的認知行為治療(Cognitive-Behavioral Therapy, CBT),做為對有症狀但未求助的九二一災民外展心理介入的工作架構,再透過發現取向(discovery-oriented)的研究方法,整理分析介入訪談的資料,以獲得外展心理介入歷程的發現與探討。

整理、分析研究資料發現:災民容易因為災後接踵而至的生活變動或退縮而無法求助心理專業,災民因為地震後引發早期適應不良基模和外在聚焦的因應型態,以致無法覺察沒有求助或造成心理症狀慢性化,此與吳英璋(2000)所論及性格特質與災後處遇因素影響災後心理反應是一致的。外展心理介入以持續、密集的方式與災民建立適當的工作關係,改變災民對人負向的基本信念,讓災民有更深入的敘述與自我覺察,其次在貼近災民的日常生活脈絡中,從日常生活事件反覆地分析與練習,才足以動搖既有的信念與行為反應,使災民對事件產生內在聚焦的因應來增加自我效能和控制感,並且從災民置身所在的環境脈絡裡處理創傷個案的經驗迴避問題。以CBT做為外展心理介入的架構進行介入,比較無法使用家庭作業讓個案學習與練習,需透過個案所及能說的日常生活事件中,對其內在經驗聚焦、反覆辯證以致增加個案正向經驗、辨識刺激控制、以及思考的辨證,使個案增加自我效能、控制感、自我肯定等,以達到增加個人資源與賦權之目的。
There are lots of studies about disaster psychology related earthquakes presenting long-term chronically influence to psychological reactions, and implicating the importance of outreach intervention programs for non-seeking people with traumatic psychological reactions or posttraumatic stress disorder(PTSD). The people might not get help from professionals because stigmatization, apathy or ignore of society, business on going daily events, or withdrawal symptoms. So far as, neither even practicing nor research, there is few article about outreach intervention program for the people with psychological symptoms but non-seeking help. This study applies the framework of cognitive-behavioral therapy(CBT) verified by a lot of studies and practice for PTSD, and uses the discovery-oriented research, to discover and gain the understandings of outreach psychological intervention to non-seeking help people with psychological stress reactions in 921 earthquake. The result finds that people with psychological stress reactions mostly accompany with continuously daily event and withdrawal symptoms to seek help. The early maladaptive schemas invoked by earthquake and the external focus make people difficult to aware the need for help and chronically, and this finding is consistent with the discussion of the psychological reactions influenced by personality trait and disaster management in Wu (2000). Outreach psychological intervention established the working relationship through continuously, condensed schedule changing their negative belief to people, and having them deeper narrative and self-awareness. Secondary, by closed their contextual daily life and repeated exercises by daily event, such impacts are enough to shake their steadily believes and habituated behavioral reactions, then to have people internal focus and increase self-efficacy and controllability; further management is contextual analysis and treatment of experiential avoidance in the ecological context of daily life. The outreach psychological intervention by the framework of cognitive-behavioral therapy, it is difficult to apply homework assignment as review or exercise between sessions; and for regaining personal resource and empowerment, outreach psychological intervention mostly applies internal focus and repeated dialectical discussion to increase positive experience, discriminate of stimulus control, and dialectical thinking, and finally people have more self-efficacy, controllability, and self-assertiveness.
參考文獻 王文華(2005)。行動研究法在教育行政上的應用。學校行政雙月刊,37,81-95。
吳英璋(2000)。心理的復(重)建與心靈的復(重)建。九二一震災心理復建學術研討會論文集。台北市:教育部學生輔導支援中心。
吳英璋(2001)。從臨床心理學觀點看重建區居民的心理狀況。社區醫療通訊,8。台大醫學院社區醫學研究群,院內九二一相關期刊。http://www.mc.ntu.edu.tw/department/cmrg/921paper/08-04paper.htm
李美枝(2003)。理性與感性:人的雙重面。應用心理研究,17,1-5。
李維倫(1995)。本土心理學必須超越「心理實體論」。本土心理學研究,4,367-379。
汪文聖(2002)。科技化精神疾病醫療的現象學意義回溯-對實徵科學的量性與質性研究法的哲學反思。行政院國家科學委員會輔助專題研究計畫(計畫編號:NSC 91-2411-H-004-005)。
林本堂、呂明憲、陳展航(2003)。集集大地震受災國中學生及家長壓力反應和求助行為之探討。台灣精神醫學,17(4),263-268。
林昌億、黃敏偉、周煌智、歐陽文貞、蔡東杰、陳明招(2004)。大地震倖存者罹患精神疾病接受居家治療的預後與生活品質之追蹤。中台灣醫誌,9,增刊,s9-s15。
林耀盛(2000a)。地震之後,千禧之始:重探心理學與諮商學的共構關係。應用心理研究,5,165-193。
林耀盛(2000b)。創傷、復健與置身所在:再論現代心理學處境,兼回應李維倫教授。應用心理研究,6,54-65。
夏林清(1999)。制度變革中教育實踐的空間:一個行動研究的實例與概念。應用心理研究,1,33-68。
許文耀(2000)。九二一地震災區學生的因應型態與心理症狀的關係。中華心理衛生學刊,13(3),35-59。
許文耀(2004)。從資源變化歷程及影響因子觀點探討災難對人們心理狀況的變與不變(III)。行政院國家科學委員會輔助專題研究計畫(報告編號:NSC 29-2625-Z-004-001)。
許文耀、曾幼涵(2003)。九二一地震後災民的資源變化與心理症狀間的關係。中華心理衛生學刊,16(2),1-19。
陳淑惠、林耀盛、洪福建、曾旭民(2000)。九二一震災受創者社會心理反應之分析-兼論「變」與「不變」間的心理社會意涵。中央大學社會文化學報,10,35-60。
陶蕃瀛(2004)。行動研究:一種增強權能的助人工作方法。應用心理研究,23,33-48。
楊瑞珍、陳美燕、黃璉華(2001)。行動研究法的概念及其在護理的應用。醫護科技學刊,3(3),244-254。
楊聰財、李明濱(2004)。九二一集集大地震災後精神疾病研究論文之分析。台灣醫學,8(3),301-312。
鄭增財(2003)。批判理論與行動研究。商業職業教育,89,47-55。
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders. (4th ed.). Washington, DC: American Psychiatric Association.
Basoglu, M., Kilic, C., Salcioglu, E., & Livanou, M. (2004). Prevalence of posttraumatic stress disorder and comorbid depression in earthquake survivors in Turkey: An epidemiological study[Abstract]. Journal of Traumatic Stress, 17(2), 133-141.
Blagys, M. D., & Hilsenroth, M. J. (2002). Distinctive activities of cognitive-behavioral therapy: A review of the comparative psychotherapy process literature. Clinical Psychology Review, 22, 671-706.
Blake, D. D., & Sonnenberg, R. T. (1998). Outcome research on behavioral and cognitive-behavioral treatments for trauma survivors. In V. M. Follette, J. I. Ruzek, & F. R. Abueg (Eds.). Cognitive-behavioral therapy for trauma (pp. 15-17). New York: Guilford Press.
Breadley, R., Green, J., Russ, E., Dutra, L., & Western, D. (2005). A multidimentional meta-analysis of psychotherapy for PTSD. The American Journal of Psychiatry, 162(2), 214-227.
Brewin, C. R., & Holmes, E. A. (2003). Psychological theories of posttraumatic stress disorder. Clinical Psychology Review, 23, 339-376.
Calhoun, L. G., & Tedeschi, R. G. (1998). Beyond recovery from trauma: Implications for clinical practice and research. Journal of Social Issue, 54, 357-371.
Eells, T. D. (1997). Psychotherapy case formulation: history and current status. In T. D. Eells (Ed.). Handbook of psychotherapy case formulation (pp. 1-25). New York: Guilford Press.
Ehlers, A., & Clark, D. M. (2000). A model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319-345.
Ehlers, A., & Clark, D. M. (2003). Early psychological intervention for adult survivors of trauma: A review. Biological Psychiatry, 53, 817-826.
Erdur, O. (2004). Psychological reactions of Turkish earthquake survivors.Unpublished doctoral dissertation, the University of Texas at Austin.
Foa, E. B., Molnar, C., & Cashman, L. (1995). Change in rape narratives during exposure therapy for PTSD. Journal of Traumatic Stress, 8, 675-690.
Foa, E. B., Steketee, G., & Rothbaum, B. O. (1989). Behavioral/cognitive conceptualization of posttraumatic stress disorder. Behavior Therapy, 20, 155-176.
Follette, V. M., Palm, K. M., & Hall, M. L. R. (2004). Acceptance, mindfulness, and trauma. In S. C. Hayes, V. M. Follette, & M. M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive-behavioral tradition (pp. 192-208). New York: Guilford Press.
Follette, V. M., Ruzek, J. I., & Abueg, F. R. (1998). A contextual analysis of trauma: theoretical considerations. In V. M. Follette, J. I. Ruzek, & F. R. Abueg (Eds.), Cognitive-behavioral therapies for trauma (pp. 3-14). New York: Guilford Press.
Forsyth, D. R., & Strong, S. R. (1986). The scientific study of counseling and psychotherapy: a unificationist view. American Psychologist, 41(2), 113-119.
Goenjian, A. K., Steinberg, A. M. Najarian, L. M., Fairbanks, L. A., Tashjian, M., & Pynoos, R. S. (2000). Prospective study of posttraumatic stress, anxiety, and depressive reactions after earthquake and political violence. American Journal of Psychiatry, 157(6), 911-916.
Goldfried, M. R. (2003). Cognitive-behavior therapy: Reflections on the evolution of a therapeutic orientation. Cognitive Therapy and Research, 27(1), 53-69.
Greenberg, L. S. & Newman, F. L. (1996). An approach to psychotherapy change process research: introduction to the special section. Journal of Consulting and Clinical Psychology, 54(3), 435-438.
Greenberg, L. S. (1986). Change process research. Journal of Consulting and Clinical Psychology, 54(1), 4-9.
Grinage, B. D. (2003). Diagnosis and management of post-traumatic stress disorder. American Family Physician, 68(12), 2041-2048.
Harvey, A. G., Bryant, R. A., & Tarrier, N. (2003). Cognitive behaviour therapy for posttraumatic stress disorder. Clinical Psychology Review, 23, 501-522.
Hayes, S. C., Follette, W. C., & Follette, V. M. (1995). Behavior therapy: A contextual approach. In A. S. Gurman & S. B. Messer (Eds.), Essential psychotherapies: Theory and practice (pp.128-181). New York: Guilford Press.
Herman, J. L. (1992). Trauma and recovery. New York: Basic Book.
Hill, C. E. (1990). Exploration in-session process research in individual psychotherapy: a review. Journal of Consulting and Clinical Psychology, 58(13), 288-194.
Jacobson, N. S., Schmailing, K. B., Holtzworth-Munroe, A., Katt, J. L., Wood, L. F., & Follette, V. M. (1989). Research-structured vs. clinically flexible version of social learning-based material therapy. Behaviour Research and Therapy, 27, 173-180.
Jia, F., Yang, D., Wang, X., Zhang, B., Xue, G.. M., Men, X. M. et al. (1999). Results of the MMPI of those paralyzed in the Tangshan earthquake 21 years later[Abstract]. Chinese Mental Health Journal, 13(5), 297.
Jordan, K. (2001). Working with trauma survivors with PTSD: An overview of assessment, diagnosis, and treatment. Counseling and Human Development, 34(1), 1-12.
Kanfer, F. H. (1985). Target selection for clinical change programs. Behavioral Assessment, 7, 7-20.
KiliA, C., & Ulusoy, M. (2003). Psychological effects of the November 1999 earthquake in Turkey: An epidemiological study. Acta Psychiatrica Scandinavica, 108(3), 232-238.
Klass, C. S. (1996). Home visiting: Promoting healthy parent and child development. Baltimore, Md.: P.H. Brookes Pub. Co.
Kou, C. J., Tang, H. S., Tsay, C. J., Lin, S. K., Hu, W. H., & Chen, C. C. (2003). Prevalence of psychiatric disorders among bereaved survivors of a disastrous earthquake in Taiwan. Psychiatric Services, 54(2), 249-251.
Lai, T. J., Chang, C. M., Connor, K., Lee, L. C., & Davidson, J. (2004). Full and partial PTSD among earthquake survivors in rural Taiwan. Journal of Psychiatric Research, 38(3), 313-322.
Lewis, J. A., Lewis, M. D., Daniel, J. A., & D’Andrea, M. J. (2003). Community counseling empowerment: strategies for a diverse society. Pacific Grove, CA: Brook/Cole.
Linehen, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.
Mahrer, A. R. (1988). Discovery-oriented psychotherapy research: rationale, aims, and methods. American Psychologist, 43(9), 694-702.
Mahrer, A. R., & Boulet, D. B. (1999). How to do discovery-oriented psychotherapy research. Journal of Clinical Psychology, 55(12), 1481-1493.
McFall, M., Malte, C., Fontana, A., & Rosenheck, R. A. (2000). Effects of an outreach intervention on use of mental health services by veterans with posttraumatic stress disorder. Psychiatric Services, 51(3), 369-374.
Meichenbaum, D., & Fong, G. (1993). How individuals control their own minds: A constructive narrative perspective. In D. M. Wegner & J. W. Pennebaker (Eds.), Handbook of mental control (pp. 473-489). New York: Prentice-Hall.
Miller, L. (2002). Psychological intervention for terroristic trauma: Symptoms, syndromes, and treatment strategies. Psychotherapy: Theory, Research, Practice, Training, 39(4), 283-296.
Mowrer, O. H. (1960). Learning theory and behaviors. New York: Wiley.
Myers, D. (1994). Outreach services following disaster. In Diane Myers (Ed.), Disaster and response and recovery: A handbook for mental health professionals. U.S. Department of Health & Human Service, Public Health Service, Substance Abuse and Mental Health Service Administration, Center for Mental Health Service. (陳錦宏等人譯。台北市:心靈工坊文化。)
Norris F. H., & Kaniasty, K. (1996). Received and perceived social support in times of stress: A test of social support deterioration deterrence model. Journal of Personality and social Psychology, 71, 498-511.
Norris, F. H., Kaniasty, K., & Scheer, D. A. (1990). Use of mental health service among victims of crime: frequency, correlates, and subsequent recovery. Journal of Consulting and Clinical Psychology, 58(5), 538-547.
Persons, J. B., & Tompkins, M. A. (1997). Cognitive-behavioral case formulation. In T. D. Eells (Ed), Handbook of psychotherapy case formulation (pp. 314-339). New York: Guilford Press.
Persons, J. B. (2005). Empiricism, mechanism, and the practice of cognitive-behavior therapy. Behavior Therapy, 36, 107-118.
Rappaport, J., & Seidman, E. (2000). Handbook of Community Psychology. New York: Kluwer Academic/Plenum Publishers.
Resick, P. A., & Calhoun, K. S. (2001). Posttraumatic stress disorder. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (3rd ed.) (pp. 60-113). New York: Guilford Press.
Resick, P. A., & Schnicke, M. K. (1992). Cognitive processing therapy for sexual assault victims. Journal of Consulting and Clinical Psychology, 60, 748-756.
Salcioglu, E., Basoglu, M., & Livanou, M. (2003). Long-term psychological outcome for non-treatment-seeking earthquake survivors in Turkey[Abstract]. Journal of Nervous and Mental Disease, 191(3), 154-160.
Steel, K., & Tjassing, H. (1994). Health care moves to the home. World Heath, 47(4), 6-7.
Stiles, W. B., Shaprio, D. A., & Elliott, R. (1986). ‘Are all psychotherapies equivalent?’ American Psychologist, 41(2), 165-180.
Tedeschi, R. G., & Calhoun, L. G. (1995). Trauma and transformation: Growing in the aftermath of suffering. Thousand Oak, CA, USA: Sage Publications, Inc.
Thomé, B., Dykes, A-K., & Hallberg, I. R. (2003). Home care with regard to definition, care recipients, content and outcome: systematic literature review. Journal of Clinical Nursing, 12, 860-872.
VandenBos, G. R. (1986). Psychotherapy research: a special issue. American Psychologist, 41(2), 111-112.
Wagner, A. W., & Linehan, M. M. (1998). Dissociative behavior. In V. M. Follette, J. I. Ruzek, & F. R. Abueg (Eds.), Cognitive-behavioral therapy for trauma (pp. 191-225). New York: Guilford Press.
Young, J. E. (1990). Cognitive therapy for personality disorders: A schema-focused approach (3rd ed.). Sarasota, FL: Professional Resource Press.
Young, J. E., Weinberger, A. D., & Beck, A. T. (2001). Cognitive Therapy for Depression. In David H. Barlow (Ed.), Clinical handbook of psychological disorders: a step-by-step treatment manual (3rd ed.). New York: Guilford Press
描述 碩士
國立政治大學
心理學研究所
90752021
95
資料來源 http://thesis.lib.nccu.edu.tw/record/#G0090752021
資料類型 thesis
dc.contributor.advisor 許文耀zh_TW
dc.contributor.author (作者) 吳勢鵬zh_TW
dc.contributor.author (作者) Wu,Shih-Ponen_US
dc.creator (作者) 吳勢鵬zh_TW
dc.creator (作者) Wu,Shih-Ponen_US
dc.date (日期) 2006en_US
dc.date.accessioned 17-九月-2009 13:13:31 (UTC+8)-
dc.date.available 17-九月-2009 13:13:31 (UTC+8)-
dc.date.issued (上傳時間) 17-九月-2009 13:13:31 (UTC+8)-
dc.identifier (其他 識別碼) G0090752021en_US
dc.identifier.uri (URI) https://nccur.lib.nccu.edu.tw/handle/140.119/32481-
dc.description (描述) 碩士zh_TW
dc.description (描述) 國立政治大學zh_TW
dc.description (描述) 心理學研究所zh_TW
dc.description (描述) 90752021zh_TW
dc.description (描述) 95zh_TW
dc.description.abstract (摘要) 回顧地震災難心理學的相關研究指出,災難創傷所引起的心理壓力反應具有長期、慢性化的影響,然而許多有心理壓力反應症狀的民眾可能會因為精神疾病的污名化、社會文化的漠視或忽視、應付接踵而至的生活事件、或症狀引起的退縮行為等種種因素,而不願或未求助心理專業的協助,因此相關的研究同時也指出發展外展心理介入計劃的必要性;然而不論在實務或在研究方面,對有心理症狀但未求助的災民實施外展心理介入卻是鮮而少見的。
本篇研究採用已獲多數研究證實有效治療創傷壓力疾患(Posttraumatic Stress Disorder, PTSD)的認知行為治療(Cognitive-Behavioral Therapy, CBT),做為對有症狀但未求助的九二一災民外展心理介入的工作架構,再透過發現取向(discovery-oriented)的研究方法,整理分析介入訪談的資料,以獲得外展心理介入歷程的發現與探討。

整理、分析研究資料發現:災民容易因為災後接踵而至的生活變動或退縮而無法求助心理專業,災民因為地震後引發早期適應不良基模和外在聚焦的因應型態,以致無法覺察沒有求助或造成心理症狀慢性化,此與吳英璋(2000)所論及性格特質與災後處遇因素影響災後心理反應是一致的。外展心理介入以持續、密集的方式與災民建立適當的工作關係,改變災民對人負向的基本信念,讓災民有更深入的敘述與自我覺察,其次在貼近災民的日常生活脈絡中,從日常生活事件反覆地分析與練習,才足以動搖既有的信念與行為反應,使災民對事件產生內在聚焦的因應來增加自我效能和控制感,並且從災民置身所在的環境脈絡裡處理創傷個案的經驗迴避問題。以CBT做為外展心理介入的架構進行介入,比較無法使用家庭作業讓個案學習與練習,需透過個案所及能說的日常生活事件中,對其內在經驗聚焦、反覆辯證以致增加個案正向經驗、辨識刺激控制、以及思考的辨證,使個案增加自我效能、控制感、自我肯定等,以達到增加個人資源與賦權之目的。
zh_TW
dc.description.abstract (摘要) There are lots of studies about disaster psychology related earthquakes presenting long-term chronically influence to psychological reactions, and implicating the importance of outreach intervention programs for non-seeking people with traumatic psychological reactions or posttraumatic stress disorder(PTSD). The people might not get help from professionals because stigmatization, apathy or ignore of society, business on going daily events, or withdrawal symptoms. So far as, neither even practicing nor research, there is few article about outreach intervention program for the people with psychological symptoms but non-seeking help. This study applies the framework of cognitive-behavioral therapy(CBT) verified by a lot of studies and practice for PTSD, and uses the discovery-oriented research, to discover and gain the understandings of outreach psychological intervention to non-seeking help people with psychological stress reactions in 921 earthquake. The result finds that people with psychological stress reactions mostly accompany with continuously daily event and withdrawal symptoms to seek help. The early maladaptive schemas invoked by earthquake and the external focus make people difficult to aware the need for help and chronically, and this finding is consistent with the discussion of the psychological reactions influenced by personality trait and disaster management in Wu (2000). Outreach psychological intervention established the working relationship through continuously, condensed schedule changing their negative belief to people, and having them deeper narrative and self-awareness. Secondary, by closed their contextual daily life and repeated exercises by daily event, such impacts are enough to shake their steadily believes and habituated behavioral reactions, then to have people internal focus and increase self-efficacy and controllability; further management is contextual analysis and treatment of experiential avoidance in the ecological context of daily life. The outreach psychological intervention by the framework of cognitive-behavioral therapy, it is difficult to apply homework assignment as review or exercise between sessions; and for regaining personal resource and empowerment, outreach psychological intervention mostly applies internal focus and repeated dialectical discussion to increase positive experience, discriminate of stimulus control, and dialectical thinking, and finally people have more self-efficacy, controllability, and self-assertiveness.en_US
dc.description.tableofcontents 第一章 緒論 1
第二章 文獻探討
第一節 從災難創傷經驗邁向心理健康的道路 5
第二節 外展直接服務 10
第三節 創傷壓力疾患的心理治療 13
第四節 發現取向的心理治療研究 19
第五節 研究目的 22
第三章 研究方法
第一節 心理學的本質與質性研究 23
第二節 行動研究 25
第三節 認知行為個案概念化 27
第四節 研究者 30
第五節 研究對象 30
第六節 心理症狀反應問卷 31
第七節 研究進行程序 32
第四章 結果與討論
第一節 外展心理介入結果概述 37
第二節 個案S結果與分析 40
第三節 個案D結果與分析 48
第五章 綜合討論
第一節 外展心理介入的「成」與「敗」 63
第二節 外展心理介入的發現 64
第三節 外展心理介入的進行 66
第四節 CBT與外展心理介入 69
第六章 研究限制與建議 70
研究省思 72
參考文獻 74

附 錄
附錄一 心理反應症狀問卷 78
附錄二 參與研究同意書 80
附錄三 以創傷後可能會有的症狀,來說明功能分析的範疇 81
附錄四 部分持續訪談介入資料摘要 82
第一節 個案M訪談資料 82
第二節 個案W訪談資料 84
第三節 個案C訪談資料 88
附錄五 持續訪談介入之資料整理 91
第一節 個案S訪談資料 91
第二節 個案S訪談之「條件、操作、結果」整理分析表 148
第三節 個案D訪談資料 153
第四節 個案D訪談之「條件、操作、結果」整理分析表 240

表 次
表 1 社區心理健康之工作大綱 11
表 2 認知行為功能分析之變項矩陣 17
表 3 第一波訪視結果 33
表 4 第二波訪視結果 34
表 5 未符合研究對象的災民資料摘要 37
表 6 研究對象的背景資料摘要 38
表 7 主訴困擾與其相關資料 39

圖 次
圖 1 活力與資源之生活事件因應 6
圖 2 活力與資源之災變因應 6
圖 3 影響災變後心理反應的三個因素 7
圖 4 研究進行架構圖 22
圖 5 個案S訪談反應型態 42
圖 6 個案S與CBT 43
圖 7 個案S與A關係變化歷程 44
圖 8 B與前妻聯繫造成個案S困擾之變化歷程 45
圖 9 個案S心理歷程之整理 47
圖 1 個案D與求職問題 53
圖 11 個案D與「母親找麻煩」之一 56
圖 12 個案D與「母親找麻煩」之二 57
圖 13 個案D與「母親找麻煩」之三 58
圖 14 個案D心理歷程之整理 62
zh_TW
dc.format.extent 75814 bytes-
dc.format.extent 136889 bytes-
dc.format.extent 130633 bytes-
dc.format.extent 132923 bytes-
dc.format.extent 466996 bytes-
dc.format.extent 271997 bytes-
dc.format.extent 761613 bytes-
dc.format.extent 246642 bytes-
dc.format.extent 135471 bytes-
dc.format.extent 1503057 bytes-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.language.iso en_US-
dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0090752021en_US
dc.subject (關鍵詞) 外展zh_TW
dc.subject (關鍵詞) 心理介入zh_TW
dc.subject (關鍵詞) 創傷壓力疾患zh_TW
dc.subject (關鍵詞) 認知行為治療zh_TW
dc.subject (關鍵詞) 發現取向zh_TW
dc.subject (關鍵詞) outreachen_US
dc.subject (關鍵詞) psychological intervetionen_US
dc.subject (關鍵詞) PTSDen_US
dc.subject (關鍵詞) CBTen_US
dc.subject (關鍵詞) discovery-orienteden_US
dc.title (題名) 外展心理介入有心理症狀但未求助者的初探-以九二一災民為例zh_TW
dc.type (資料類型) thesisen
dc.relation.reference (參考文獻) 王文華(2005)。行動研究法在教育行政上的應用。學校行政雙月刊,37,81-95。zh_TW
dc.relation.reference (參考文獻) 吳英璋(2000)。心理的復(重)建與心靈的復(重)建。九二一震災心理復建學術研討會論文集。台北市:教育部學生輔導支援中心。zh_TW
dc.relation.reference (參考文獻) 吳英璋(2001)。從臨床心理學觀點看重建區居民的心理狀況。社區醫療通訊,8。台大醫學院社區醫學研究群,院內九二一相關期刊。http://www.mc.ntu.edu.tw/department/cmrg/921paper/08-04paper.htmzh_TW
dc.relation.reference (參考文獻) 李美枝(2003)。理性與感性:人的雙重面。應用心理研究,17,1-5。zh_TW
dc.relation.reference (參考文獻) 李維倫(1995)。本土心理學必須超越「心理實體論」。本土心理學研究,4,367-379。zh_TW
dc.relation.reference (參考文獻) 汪文聖(2002)。科技化精神疾病醫療的現象學意義回溯-對實徵科學的量性與質性研究法的哲學反思。行政院國家科學委員會輔助專題研究計畫(計畫編號:NSC 91-2411-H-004-005)。zh_TW
dc.relation.reference (參考文獻) 林本堂、呂明憲、陳展航(2003)。集集大地震受災國中學生及家長壓力反應和求助行為之探討。台灣精神醫學,17(4),263-268。zh_TW
dc.relation.reference (參考文獻) 林昌億、黃敏偉、周煌智、歐陽文貞、蔡東杰、陳明招(2004)。大地震倖存者罹患精神疾病接受居家治療的預後與生活品質之追蹤。中台灣醫誌,9,增刊,s9-s15。zh_TW
dc.relation.reference (參考文獻) 林耀盛(2000a)。地震之後,千禧之始:重探心理學與諮商學的共構關係。應用心理研究,5,165-193。zh_TW
dc.relation.reference (參考文獻) 林耀盛(2000b)。創傷、復健與置身所在:再論現代心理學處境,兼回應李維倫教授。應用心理研究,6,54-65。zh_TW
dc.relation.reference (參考文獻) 夏林清(1999)。制度變革中教育實踐的空間:一個行動研究的實例與概念。應用心理研究,1,33-68。zh_TW
dc.relation.reference (參考文獻) 許文耀(2000)。九二一地震災區學生的因應型態與心理症狀的關係。中華心理衛生學刊,13(3),35-59。zh_TW
dc.relation.reference (參考文獻) 許文耀(2004)。從資源變化歷程及影響因子觀點探討災難對人們心理狀況的變與不變(III)。行政院國家科學委員會輔助專題研究計畫(報告編號:NSC 29-2625-Z-004-001)。zh_TW
dc.relation.reference (參考文獻) 許文耀、曾幼涵(2003)。九二一地震後災民的資源變化與心理症狀間的關係。中華心理衛生學刊,16(2),1-19。zh_TW
dc.relation.reference (參考文獻) 陳淑惠、林耀盛、洪福建、曾旭民(2000)。九二一震災受創者社會心理反應之分析-兼論「變」與「不變」間的心理社會意涵。中央大學社會文化學報,10,35-60。zh_TW
dc.relation.reference (參考文獻) 陶蕃瀛(2004)。行動研究:一種增強權能的助人工作方法。應用心理研究,23,33-48。zh_TW
dc.relation.reference (參考文獻) 楊瑞珍、陳美燕、黃璉華(2001)。行動研究法的概念及其在護理的應用。醫護科技學刊,3(3),244-254。zh_TW
dc.relation.reference (參考文獻) 楊聰財、李明濱(2004)。九二一集集大地震災後精神疾病研究論文之分析。台灣醫學,8(3),301-312。zh_TW
dc.relation.reference (參考文獻) 鄭增財(2003)。批判理論與行動研究。商業職業教育,89,47-55。zh_TW
dc.relation.reference (參考文獻) American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders. (4th ed.). Washington, DC: American Psychiatric Association.zh_TW
dc.relation.reference (參考文獻) Basoglu, M., Kilic, C., Salcioglu, E., & Livanou, M. (2004). Prevalence of posttraumatic stress disorder and comorbid depression in earthquake survivors in Turkey: An epidemiological study[Abstract]. Journal of Traumatic Stress, 17(2), 133-141.zh_TW
dc.relation.reference (參考文獻) Blagys, M. D., & Hilsenroth, M. J. (2002). Distinctive activities of cognitive-behavioral therapy: A review of the comparative psychotherapy process literature. Clinical Psychology Review, 22, 671-706.zh_TW
dc.relation.reference (參考文獻) Blake, D. D., & Sonnenberg, R. T. (1998). Outcome research on behavioral and cognitive-behavioral treatments for trauma survivors. In V. M. Follette, J. I. Ruzek, & F. R. Abueg (Eds.). Cognitive-behavioral therapy for trauma (pp. 15-17). New York: Guilford Press.zh_TW
dc.relation.reference (參考文獻) Breadley, R., Green, J., Russ, E., Dutra, L., & Western, D. (2005). A multidimentional meta-analysis of psychotherapy for PTSD. The American Journal of Psychiatry, 162(2), 214-227.zh_TW
dc.relation.reference (參考文獻) Brewin, C. R., & Holmes, E. A. (2003). Psychological theories of posttraumatic stress disorder. Clinical Psychology Review, 23, 339-376.zh_TW
dc.relation.reference (參考文獻) Calhoun, L. G., & Tedeschi, R. G. (1998). Beyond recovery from trauma: Implications for clinical practice and research. Journal of Social Issue, 54, 357-371.zh_TW
dc.relation.reference (參考文獻) Eells, T. D. (1997). Psychotherapy case formulation: history and current status. In T. D. Eells (Ed.). Handbook of psychotherapy case formulation (pp. 1-25). New York: Guilford Press.zh_TW
dc.relation.reference (參考文獻) Ehlers, A., & Clark, D. M. (2000). A model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319-345.zh_TW
dc.relation.reference (參考文獻) Ehlers, A., & Clark, D. M. (2003). Early psychological intervention for adult survivors of trauma: A review. Biological Psychiatry, 53, 817-826.zh_TW
dc.relation.reference (參考文獻) Erdur, O. (2004). Psychological reactions of Turkish earthquake survivors.Unpublished doctoral dissertation, the University of Texas at Austin.zh_TW
dc.relation.reference (參考文獻) Foa, E. B., Molnar, C., & Cashman, L. (1995). Change in rape narratives during exposure therapy for PTSD. Journal of Traumatic Stress, 8, 675-690.zh_TW
dc.relation.reference (參考文獻) Foa, E. B., Steketee, G., & Rothbaum, B. O. (1989). Behavioral/cognitive conceptualization of posttraumatic stress disorder. Behavior Therapy, 20, 155-176.zh_TW
dc.relation.reference (參考文獻) Follette, V. M., Palm, K. M., & Hall, M. L. R. (2004). Acceptance, mindfulness, and trauma. In S. C. Hayes, V. M. Follette, & M. M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive-behavioral tradition (pp. 192-208). New York: Guilford Press.zh_TW
dc.relation.reference (參考文獻) Follette, V. M., Ruzek, J. I., & Abueg, F. R. (1998). A contextual analysis of trauma: theoretical considerations. In V. M. Follette, J. I. Ruzek, & F. R. Abueg (Eds.), Cognitive-behavioral therapies for trauma (pp. 3-14). New York: Guilford Press.zh_TW
dc.relation.reference (參考文獻) Forsyth, D. R., & Strong, S. R. (1986). The scientific study of counseling and psychotherapy: a unificationist view. American Psychologist, 41(2), 113-119.zh_TW
dc.relation.reference (參考文獻) Goenjian, A. K., Steinberg, A. M. Najarian, L. M., Fairbanks, L. A., Tashjian, M., & Pynoos, R. S. (2000). Prospective study of posttraumatic stress, anxiety, and depressive reactions after earthquake and political violence. American Journal of Psychiatry, 157(6), 911-916.zh_TW
dc.relation.reference (參考文獻) Goldfried, M. R. (2003). Cognitive-behavior therapy: Reflections on the evolution of a therapeutic orientation. Cognitive Therapy and Research, 27(1), 53-69.zh_TW
dc.relation.reference (參考文獻) Greenberg, L. S. & Newman, F. L. (1996). An approach to psychotherapy change process research: introduction to the special section. Journal of Consulting and Clinical Psychology, 54(3), 435-438.zh_TW
dc.relation.reference (參考文獻) Greenberg, L. S. (1986). Change process research. Journal of Consulting and Clinical Psychology, 54(1), 4-9.zh_TW
dc.relation.reference (參考文獻) Grinage, B. D. (2003). Diagnosis and management of post-traumatic stress disorder. American Family Physician, 68(12), 2041-2048.zh_TW
dc.relation.reference (參考文獻) Harvey, A. G., Bryant, R. A., & Tarrier, N. (2003). Cognitive behaviour therapy for posttraumatic stress disorder. Clinical Psychology Review, 23, 501-522.zh_TW
dc.relation.reference (參考文獻) Hayes, S. C., Follette, W. C., & Follette, V. M. (1995). Behavior therapy: A contextual approach. In A. S. Gurman & S. B. Messer (Eds.), Essential psychotherapies: Theory and practice (pp.128-181). New York: Guilford Press.zh_TW
dc.relation.reference (參考文獻) Herman, J. L. (1992). Trauma and recovery. New York: Basic Book.zh_TW
dc.relation.reference (參考文獻) Hill, C. E. (1990). Exploration in-session process research in individual psychotherapy: a review. Journal of Consulting and Clinical Psychology, 58(13), 288-194.zh_TW
dc.relation.reference (參考文獻) Jacobson, N. S., Schmailing, K. B., Holtzworth-Munroe, A., Katt, J. L., Wood, L. F., & Follette, V. M. (1989). Research-structured vs. clinically flexible version of social learning-based material therapy. Behaviour Research and Therapy, 27, 173-180.zh_TW
dc.relation.reference (參考文獻) Jia, F., Yang, D., Wang, X., Zhang, B., Xue, G.. M., Men, X. M. et al. (1999). Results of the MMPI of those paralyzed in the Tangshan earthquake 21 years later[Abstract]. Chinese Mental Health Journal, 13(5), 297.zh_TW
dc.relation.reference (參考文獻) Jordan, K. (2001). Working with trauma survivors with PTSD: An overview of assessment, diagnosis, and treatment. Counseling and Human Development, 34(1), 1-12.zh_TW
dc.relation.reference (參考文獻) Kanfer, F. H. (1985). Target selection for clinical change programs. Behavioral Assessment, 7, 7-20.zh_TW
dc.relation.reference (參考文獻) KiliA, C., & Ulusoy, M. (2003). Psychological effects of the November 1999 earthquake in Turkey: An epidemiological study. Acta Psychiatrica Scandinavica, 108(3), 232-238.zh_TW
dc.relation.reference (參考文獻) Klass, C. S. (1996). Home visiting: Promoting healthy parent and child development. Baltimore, Md.: P.H. Brookes Pub. Co.zh_TW
dc.relation.reference (參考文獻) Kou, C. J., Tang, H. S., Tsay, C. J., Lin, S. K., Hu, W. H., & Chen, C. C. (2003). Prevalence of psychiatric disorders among bereaved survivors of a disastrous earthquake in Taiwan. Psychiatric Services, 54(2), 249-251.zh_TW
dc.relation.reference (參考文獻) Lai, T. J., Chang, C. M., Connor, K., Lee, L. C., & Davidson, J. (2004). Full and partial PTSD among earthquake survivors in rural Taiwan. Journal of Psychiatric Research, 38(3), 313-322.zh_TW
dc.relation.reference (參考文獻) Lewis, J. A., Lewis, M. D., Daniel, J. A., & D’Andrea, M. J. (2003). Community counseling empowerment: strategies for a diverse society. Pacific Grove, CA: Brook/Cole.zh_TW
dc.relation.reference (參考文獻) Linehen, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.zh_TW
dc.relation.reference (參考文獻) Mahrer, A. R. (1988). Discovery-oriented psychotherapy research: rationale, aims, and methods. American Psychologist, 43(9), 694-702.zh_TW
dc.relation.reference (參考文獻) Mahrer, A. R., & Boulet, D. B. (1999). How to do discovery-oriented psychotherapy research. Journal of Clinical Psychology, 55(12), 1481-1493.zh_TW
dc.relation.reference (參考文獻) McFall, M., Malte, C., Fontana, A., & Rosenheck, R. A. (2000). Effects of an outreach intervention on use of mental health services by veterans with posttraumatic stress disorder. Psychiatric Services, 51(3), 369-374.zh_TW
dc.relation.reference (參考文獻) Meichenbaum, D., & Fong, G. (1993). How individuals control their own minds: A constructive narrative perspective. In D. M. Wegner & J. W. Pennebaker (Eds.), Handbook of mental control (pp. 473-489). New York: Prentice-Hall.zh_TW
dc.relation.reference (參考文獻) Miller, L. (2002). Psychological intervention for terroristic trauma: Symptoms, syndromes, and treatment strategies. Psychotherapy: Theory, Research, Practice, Training, 39(4), 283-296.zh_TW
dc.relation.reference (參考文獻) Mowrer, O. H. (1960). Learning theory and behaviors. New York: Wiley.zh_TW
dc.relation.reference (參考文獻) Myers, D. (1994). Outreach services following disaster. In Diane Myers (Ed.), Disaster and response and recovery: A handbook for mental health professionals. U.S. Department of Health & Human Service, Public Health Service, Substance Abuse and Mental Health Service Administration, Center for Mental Health Service. (陳錦宏等人譯。台北市:心靈工坊文化。)zh_TW
dc.relation.reference (參考文獻) Norris F. H., & Kaniasty, K. (1996). Received and perceived social support in times of stress: A test of social support deterioration deterrence model. Journal of Personality and social Psychology, 71, 498-511.zh_TW
dc.relation.reference (參考文獻) Norris, F. H., Kaniasty, K., & Scheer, D. A. (1990). Use of mental health service among victims of crime: frequency, correlates, and subsequent recovery. Journal of Consulting and Clinical Psychology, 58(5), 538-547.zh_TW
dc.relation.reference (參考文獻) Persons, J. B., & Tompkins, M. A. (1997). Cognitive-behavioral case formulation. In T. D. Eells (Ed), Handbook of psychotherapy case formulation (pp. 314-339). New York: Guilford Press.zh_TW
dc.relation.reference (參考文獻) Persons, J. B. (2005). Empiricism, mechanism, and the practice of cognitive-behavior therapy. Behavior Therapy, 36, 107-118.zh_TW
dc.relation.reference (參考文獻) Rappaport, J., & Seidman, E. (2000). Handbook of Community Psychology. New York: Kluwer Academic/Plenum Publishers.zh_TW
dc.relation.reference (參考文獻) Resick, P. A., & Calhoun, K. S. (2001). Posttraumatic stress disorder. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (3rd ed.) (pp. 60-113). New York: Guilford Press.zh_TW
dc.relation.reference (參考文獻) Resick, P. A., & Schnicke, M. K. (1992). Cognitive processing therapy for sexual assault victims. Journal of Consulting and Clinical Psychology, 60, 748-756.zh_TW
dc.relation.reference (參考文獻) Salcioglu, E., Basoglu, M., & Livanou, M. (2003). Long-term psychological outcome for non-treatment-seeking earthquake survivors in Turkey[Abstract]. Journal of Nervous and Mental Disease, 191(3), 154-160.zh_TW
dc.relation.reference (參考文獻) Steel, K., & Tjassing, H. (1994). Health care moves to the home. World Heath, 47(4), 6-7.zh_TW
dc.relation.reference (參考文獻) Stiles, W. B., Shaprio, D. A., & Elliott, R. (1986). ‘Are all psychotherapies equivalent?’ American Psychologist, 41(2), 165-180.zh_TW
dc.relation.reference (參考文獻) Tedeschi, R. G., & Calhoun, L. G. (1995). Trauma and transformation: Growing in the aftermath of suffering. Thousand Oak, CA, USA: Sage Publications, Inc.zh_TW
dc.relation.reference (參考文獻) Thomé, B., Dykes, A-K., & Hallberg, I. R. (2003). Home care with regard to definition, care recipients, content and outcome: systematic literature review. Journal of Clinical Nursing, 12, 860-872.zh_TW
dc.relation.reference (參考文獻) VandenBos, G. R. (1986). Psychotherapy research: a special issue. American Psychologist, 41(2), 111-112.zh_TW
dc.relation.reference (參考文獻) Wagner, A. W., & Linehan, M. M. (1998). Dissociative behavior. In V. M. Follette, J. I. Ruzek, & F. R. Abueg (Eds.), Cognitive-behavioral therapy for trauma (pp. 191-225). New York: Guilford Press.zh_TW
dc.relation.reference (參考文獻) Young, J. E. (1990). Cognitive therapy for personality disorders: A schema-focused approach (3rd ed.). Sarasota, FL: Professional Resource Press.zh_TW
dc.relation.reference (參考文獻) Young, J. E., Weinberger, A. D., & Beck, A. T. (2001). Cognitive Therapy for Depression. In David H. Barlow (Ed.), Clinical handbook of psychological disorders: a step-by-step treatment manual (3rd ed.). New York: Guilford Presszh_TW