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題名:諮商心理師行使告知後同意之倫理經驗分析
作者:蘇以青
校院名稱:國立高雄師範大學
系所名稱:輔導與諮商研究所
指導教授:戴嘉南
顏正芳
學位類別:博士
出版日期:2011
主題關鍵詞:諮商心理師告知後同意倫理經驗倫理意涵現象學counselorinformed consentethical experiencesethical meaningphenomenology
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(2) 博士論文(0) 專書(0) 專書論文(0)
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  • 點閱點閱:67
本研究目的在於開顯諮商心理師行使諮商中告知後同意過程的倫理經驗,以現象學的方法探問諮商心理師行使告知後同意過程的倫理意涵。本研究以立意取樣的方式邀請具一年以上實務經驗的執業諮商心理師進行深度訪談。接受邀請並同意參與的研究參與者共10人,女性7人,男性3人,平均年齡36.5歲,皆具備諮商心理師執照且目前皆有登記執業,服務對象以成人和學生為主。
研究結果如下:研究參與者呈現行使告知後同意過程的樣貌,可以分為說什麼和怎麼說,說什麼是指諮商心理師行使告知後同意所說明的內容,可以歸納為三個主題:架構的素材,教育的用心以及治療的契機。告知後同意過程的說明內容透過說明方式(怎麼說)表達出來,統整串聯成一整體,持續發生於整個諮商歷程中,讓諮商工作。
當研究參與者描述他們的經驗世界時,他們的共同經驗是其中蘊含著諮商心理師與案主互動交織的倫理故事。由倫理故事為脈絡,運用現象學分析方法,深入探討分析研究參與者的敘說文本,獲取支撐研究參與者行使告知後同意的信念與價值及其倫理行動背後的倫理意涵,共分析出五個共同主題,形成諮商心理師行使告知後同意過程的倫理意涵。分別為:一、以人為本,回歸個案的主體性,二、描繪藍圖、規劃方圓,三、專業立足的可能性,四、創造平衡與合作的空間,五、回到諮商自身。這五個共同主題下分別有二到五個個別主題。「以人為本,回歸個案的主體性」和「描繪藍圖、規劃方圓」是站在以個案為中心的考量,「專業立足的可能性」和「回到諮商自身」則是強調對專業的護持,並透過「創造平衡與合作的空間」使得諮商心理師與案主共同譜出曼妙的旋律。
諮商心理師行使告知後同意過程與諮商關係發展兩者之間的變化,依時間軸可分為領航、共振和靠岸。以呈顯告知後同意的過程與諮商關係在互動中交織前進,相輔相成的現象。
根據本研究結果,本研究建議對於執業中的諮商心理師仍需有系統的提供專業倫理繼續教育,而且應加入案例的討論。且針對學校諮商工作應制定符合其需求的專業規範和倫理守則。另外也對未來的研究方向提供建議。
The purpose of this study was to present counselors’ ethical experiences in the process of obtaining informed consent during counseling. This study explored the ethical meaning of the informed consent process by using phenomenology. We invited counselors who had practiced counseling for over an year for in-depth interviews by purposive sampling. A total of 10 counselors (7 females, 3 males) with a mean age of 36.5 years were recruited. All counselors were licensed and in practice. Most of their clients were adults and students.
Based upon the participants' experiences, we identified the contents and methods of the informed consent process. The contents included 3 categories: material of frame, education with heart, and opportunity of psychotherapy. Throughout the counseling process, these contents were communicated through conducted methods to make counseling work.
The common experience of these participants was the ethical story composed by the counselors and clients. Using the ethical story as the context, we adopted a phenomenological approach to analyze the interview transcripts to explore the participants’ beliefs and values in the informed consent process and the ethical meaning. Five themes were identified: (a) person-based and returning to clients’ subjectivity, (b) portraying blueprint and planning boundary, (c) probability of building on expertise, (d) creating space for balance and collaboration, and (e) returning to counseling in itself. Each theme contained 2 to 5 individual sub-themes. The “person-based and returning to clients’ subjectivity” and “portraying blueprint and planning boundary” took person-centered principles into consideration, and the “probability of building on expertise” and “returning to counseling in itself” emphasized the maintenance of professionalism. Through “creating space for balance and collaboration,” all of those above made counselors and their clients work together and compose graceful melody.
The relationship between the informed consent process and the development of counseling relationship was illuminated by timelines as navigation, resonance, and coming ashore. The finding indicated that the informed consent process and the development of counseling relationship were complementary to each other during counseling.
This study suggests that both systematic continuing education in professional ethics and case based discussion be provided for counselors in practice. Professional norms and ethical codes that meet the needs for the implementation of school counseling should also be developed. This study also provides suggestions for future research studies.
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