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題名:網路親子遊戲治療對注意力不足過動兒童與家長之成效
作者:劉秀菊
作者(外文):LIU, HSIU-CHU
校院名稱:國立彰化師範大學
系所名稱:輔導與諮商學系
指導教授:高淑貞
學位類別:博士
出版日期:2020
主題關鍵詞:網路親子遊戲治療ADHD兒童親職教育親職壓力團體療效因子online filial therapychildren with ADHDparenting educationparental stressgroup therapeutic factors
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中文摘要
本研究採用網路親子遊戲治療團體與網路親子遊戲治療親職教育兩種模式探究網路親子遊戲治療對ADHD兒童與家長之成效。本研究採用前後測準實驗研究設計加上訪談的質量混合研究方法。量化研究以27位(團體組15位,親職教育組12位)有情緒行為困擾之ADHD兒童與家長為對象,團體組分三小組進行,親職教育組直接以一大組進行處理,兩組均以「兒童行為檢核表」、「親職壓力量表簡式版」、「父母後設情緒理念量表短版」,以及「團體治療性因素量表簡版」做為評估工具,檢視兩組處遇前、後,以及結束四週後上述量表之得分,並進行相依樣本重複量數t考驗,來了解兩組處遇後之效果,同時也對兩組進行獨立樣本單因子共變數分析,以探討兩組實驗處理在立即與追蹤效果是否有顯著差異。此外,也針對兩組「團體治療性因素量表簡版」之得分以平均數進行分析。質性部分,在團體結束後對團體組7位家長,親職教育組6位家長進行個別訪談,以探究ADHD兒童家長參與親子遊戲治療之影響與經驗。
研究主要結論如下:
一、網路親子遊戲治療團體與網路親子遊戲治療親職教育對ADHD兒童之焦慮/憂鬱、退縮、內化問題、社會問題、思考問題、注意力、違反規範與攻擊行為等內化與外化問題及整體問題均有立即與追蹤效果,也一致對ADHD兒童之身體抱怨問題無立即成效,卻有追蹤成效。
二、網路親子遊戲治療團體與網路親子遊戲治療親職教育對ADHD兒童家長親職壓力之父母困擾、親子失功能互動與困難兒童等三個分量表與全量表均有立即與追蹤成效。
三、網路親子遊戲治療團體能持續提升家長對ADHD孩子生氣情緒的接納與減少教養時情緒的失控;網路親子遊戲治療親職教育則能立即與持續提升家長對AD-HD孩子生氣情緒的接納,也能持續改善家長對ADHD孩子情緒的理解與處理,以及持續減少教養時情緒的失控。
四、網路親子遊戲治療團體與網路親子遊戲治療親職教育對ADHD兒童與家長之介入在「兒童行為檢核表」、「親職壓力簡式版」與「父母後設情緒理念」之立即與追蹤成效均無顯著差異。
五、網路親子遊戲治療團體與網路親子遊戲治療親職教育對ADHD兒童與家長之成效無顯著差異。
六、網路親子遊戲治療團體與網路親子遊戲治療親職教育均有團體療效性,且兩組沒有顯著差異,然治療團體對團體療效因子仍有略高的評價,對團體正向的感受較多、參與之經驗也略較豐富。
七、網路親子遊戲治療團體與網路親子遊戲治療親職教育均能促進ADHD兒童家長的覺察、對孩子的了解、教養方式正向改變和看見孩子的進步,以及改善家人關係。
八、ADHD兒童家長對網路親子遊戲治療均有正向的網路團體經驗與感受。
最後,根據研究的結果與結論,提出具體建議,提供學校輔導工作及未來相關研究之參考。
關鍵詞:網路親子遊戲治療、ADHD兒童、親職教育、親職壓力、團體療效
因子
Abstract
This study adopted the online group filial therapy and online filial therapy for parenting education to explore the effects of online filial therapy on children with ADHD and their parents. A quasi-experimental research design with pre-tests and post-tests, accompanied by interviews, was applied in this research, including qualitative and quantitative studies. The quantitative research involved 27 children suffering from ADHD and their parents, among which 15 were in the group therapy group and 12 in the parenting education group. The group therapy group was divided into three subgroups, while the participants in the parenting education group were studied together as a single big group. Both the group therapy and parenting education groups were assessed with the “Child Behavior Checklist”, “Parenting Stress Index: Short Form”, “Simplified Parental Meta-Emotion Philosophy Scale”, and “Simplified Group Therapeutic Factors Scale” before and after the therapy and again four weeks after the therapy. Besides dependent samples, repeated measures t-tests that were conducted to examine the therapeutic effects on the two groups after the therapy, a one-way analysis of covariance on the two groups was performed to find out whether there were significant differences between the immediate and tracking effects of the therapies tested on the two groups. Moreover, this study analyzed the mean of the scores the two groups obtained in the “Simplified Group Therapeutic Factors Scale.” Regarding the qualitative research, this study conducted individual interviews with seven parents from the group therapy group and six parents from the parenting education group to understand the influence of the filial therapy on parents of children with ADHD and their experiences.
The major research findings are as follows:
I. The online group filial therapy and online filial therapy for parenting education had immediate and tracking effects on internalization, externalization, and overall issues seen in children with ADHD, such as anxiety/depression, withdrawal, internalization, social issues, conceptualizing issues, attention, rule violations, and offensive behaviors. Although neither of the two therapies had immediate effects on children with ADHD complaining about physical illness, both had tracking effects on said issues.
II. The online group filial therapy and online filial therapy for parenting education had immediate and tracking effects on all scales, especially parental stress caused by parenting children with ADHD, dysfunctional parent-child interactions, and unruly children.
III. The online group filial therapy continued to enhance parents’ acceptance of the tantrums of children with ADHD and reduced the outbursts of anger during parenting. Similarly, the online filial therapy for parenting education immediately enhanced parents’ acceptance of the tantrums of children with ADHD, helped them improve their understanding and handling of children’s emotions, and reduced the outbursts of anger during parenting.
IV. Regarding the intervention of the online group filial therapy and online filial therapy for parenting education on children with ADHD and their parents, the “Child Behavior Checklist”, “Parenting Stress Index: Short Form”, and “Simplified Parental Meta-Emotion Philosophy Scale” did not reflect any significant differences between the immediate and tracking effects of the two.
V. There was no significant difference between the effects of the online group filial therapy and online filial therapy for parenting education on children with ADHD and their parents.
VI. Both the online group filial therapy and online filial therapy for parenting education had group therapeutic effects; there was no significant difference between the effectiveness of the two. However, participants in the group therapy group gave more positive feedback about the therapeutic effects than did their counterparts in the parenting education group. They also had stronger positive feelings for their group and engaged in the therapy more actively.
VII. The online group filial therapy and online filial therapy for parenting education helped parents enhance their awareness of ADHD in their children, improved their understanding of their children, prompted positive changes in parenting, noticed the progress their children made, and improved the relationships between family members.
VIII. Parents of children with ADHD had positive experiences with, and feelings towards, the online filial therapy.
Lastly, specific recommendations are provided based on the research findings and conclusion, which can serve as a reference for counseling at schools and for future research.
Keywords: online filial therapy, children with ADHD, parenting education, parental stress, group therapeutic factors
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