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題名:家庭遊戲治療之家庭評估與父母諮詢探究
作者:吳麗雲 引用關係
作者(外文):Wu,Li-Yun
校院名稱:國立彰化師範大學
系所名稱:輔導與諮商學系所
指導教授:高淑貞
學位類別:博士
出版日期:2010
主題關鍵詞:家庭遊戲治療家庭評估父母諮詢共識質化研究family play therapyfamily assessmentparental consultationResearchConsensual Qualitative
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本研究的目的在探討因焦點兒童問題而來求助家庭之家庭成員,在家庭遊戲治療中的行為互動模式與意涵、父母諮詢的內涵及家庭成員參與家庭遊戲治療的經驗,以探索家庭遊戲治療評估模式於評估家庭成員的功能及效果。兩個研究家庭參與七次之阿德勒取向家庭遊戲治療評估模式,第一次為父母初次晤談、第二~六次為家庭遊戲治療單元、第七次為父母諮詢。家庭遊戲治療單元過程全程錄影,並於五次家庭遊戲治療單元後,子女接受個別訪談,於父母諮詢後父母接受個別訪談。並於第一次訪談一個月後,全部家庭成員接受個別追蹤訪談。本研究採用共識質化分析法進行家庭遊戲治療歷程和文本資料的分析,相關研究結果如下:
一、家庭遊戲治療可運用於家庭成員行為互動之評估:從本研究對兩個家庭在家庭遊戲治療中的評估,可看到「家庭獨特的家庭氣氛」,甲乙兩家呈現行為互動頻率和投入程度不同之冷熱不同的家庭氣氛;夫妻之間常出現夫妻控制、順從的權力衝突,父母衝突後與子女聯盟形成三角關係,呈現出夫妻衝突牽動親子系統的聯盟衝突,使「衝突的婚姻關係漫延對孩子產生負向影響」;「父母控制、否定的態度和不當教養方式強化孩子負向行為」;「家庭價值觀和目標影響孩子之錯誤目標」;「焦點兒童和手足皆呈現不良適應行為目標」,包含甲家兄妹皆呈現出「尋求注意」、「尋求權力」,乙姊呈現「尋求報復」,鹿乙弟呈現「尋求注意」和「尋求報復」之目標;「從家庭星座評估家人知覺之心理地位與重要感」,包含不同出生序和性別的手足權力衝突、父母與孩子彼此之親近行為存在差異、焦點兒童無奈的選擇疏離家人。以及「焦點兒童與家庭成員之間存在負向互動循環」和「每個家庭皆擁有其優勢」,包含家庭關係的優勢、父母願意為了家庭和改善孩子的問題共同努力、父母覺察能力佳,並願意嘗試改變、家庭個別成員的優勢和正向特質。
二、家庭遊戲治療中父母諮詢的內涵有:「諮詢中提供的內容以家庭遊戲治療歷程為依據」,包含家庭遊戲素材與治療師評估的交織、促進對孩子不良適應行為目的之認識和覺察、重新框架焦點兒童的問題、賦權家庭的優勢和鼓勵父母;「父母對家庭成員行為及互動的覺察」,包含從家庭遊戲中更瞭解家人、覺察家庭星座裡家人角色和不同家庭成員親近互動模式、覺察影響家庭氣氛的因素及對孩子的影響、能看到家人的優勢能力和特質;「親職教養方式的討論」,包含促進父母合作教養子女、反映父母教養方式與孩子負向行為之惡性循環、以家庭評估結果為依據教導適當的親子教養技巧、父母主動提問諮詢並肯定家庭評估和父母諮詢的助益。
三、家庭成員參與家庭遊戲治療之經驗有:「家庭遊戲治療提供家人特別的互動及瞭解彼此的方式」,包含呈現家庭互動的縮影、體驗有樂趣、不防衛的家庭互動方式、家人有機會彼此瞭解、燃起家庭正向改變的希望、肯定家庭評估和父母諮詢;「家人的堅持、邀約及如何歸因問題和苦惱程度影響投入家庭遊戲治療」;「家庭遊戲治療促進對家庭成員和家庭互動的覺察」,包含父母覺察自己的行為和教養對孩子的影響,促使主訴問題的轉移、父母覺察對手足的差異對待,造成手足之間競爭、瞭解子女的內在世界與不良適應行為的目的、問題關注焦點從焦點兒童轉為整體家庭系統;「對改變產生的影響」,包含參與家庭遊戲治療啟動家庭和家人多方面正向改變的開關、家人之間的覺察、瞭解、親近和改變影響家庭成員改變;「對後續的預想」,包含面對變與不變的掙扎和疑慮以及對未來家庭遊戲治療實施的預想。
本研究依據研究結果提出具體建議,供諮商實務工作者、家長和未來研究者之參考。
The purpose of this study is to investigate the function and effect of a family play therapy model with family counseling focused on child behavior problems. This study analyze the patterns and meanings of the family members’ interaction, contents of parental consultation in the family play process, and their experience in joining family play therapy. Two families participated in an Adlerian approach family play therapy assessment model for seven sessions. This included a parents intake interview, five family play therapy sessions and parental consultation. The five sessions of family play therapy were tape recorded. After the family play therapy sessions and parental consultation concluded, the children and the parents attended the interview respectively. In addition, a follow-up individual interview was conducted one month after the first interview. All the data was analyzed by using the Consensual Qualitative Research. The findings of this study are presented in the following:
1.Family play therapy can be utilized to assess the patterns of interaction in the family. Based on the assessment of the two families in the study, it shows that “each family has a different family atmosphere”. The atmosphere of the two families varied with how much they involved and how often they interacted with each other. Thus one is enthusiastic; another is cold. Moreover, it also presents control-submit conflict on Couples. After the parents conflict, parents form an alliance with children resulting in Parent-Child Triangulation. The parents’ conflict elicits the parent-child coalition conflict, “the conflict of
marriage gives the children negative influence”. The following are further descriptions of the two families according to the assessment. “The inappropriate parenting style such as rigid controlling and discouragement reinforced the children’s problem behavior”; “The values and goals of family affect children’s mistaken goals”; “focused child and their siblings all present the goal of misbehavior.” For example, the siblings in family A attempted to get attention and struggle for power. Similarly, the siblings in family B attempted to seek revenge as well as to get attention “Assess the family member how to percept their status and significance in family from the family constellation.” The siblings who are in different birth order and gender had power struggle conflicts. There was a difference in intimacy between the parents and children. The focused child was left no choice but to become disengaged from the family. “There are circularity of negative interaction between focused child and their family members” “Each family has its advantage.” For example, if in the family relationship, the parents are willing to cooperate with their family and put in effort to overcome the children’s problems. Moreover, parents can be made aware of and then modify their view to cope with it. The individual member has advantages and positive characteristics.
2. The contents of parental consultation in the family play therapy are as follows: (1) The communication and issues raised in the parental consultation were based on the five family play therapy sessions, such as the play process interwoven with the therapist’s assessment, encouraging parents to recognize and be aware of the goals of children’s misbehavior as a motivational typology, reframe focused children’s problems, and empower advantages for the family and encourage parents. (2) Parents become more aware of the family member’s interaction patterns and behavior and thus understand them better. For instance, parents are aware of family members’ behavior, the role of family, and the interactive pattern of intimacy by the family constellation. Also, they become aware of the factors that affect family atmosphere as well as the influence of the family atmosphere on children. Parents are able to appreciate family members’ strength and characteristic. (3) The discussions about parenting styles include the following aspects: encourage parents to cooperate with each other on parenting, reflect how inappropriate parenting styles create a vicious circle on children’s misbehaviors , develop appropriate parenting skills based on the results of the family assessment, and how participating in the consultation help parents with their problems. What is more, participants in the consultation even took the initiative to ask questions.
3. After participating in the family play therapy, family members gain the following experience: “family play therapy provides family members with special ways of interacting and understanding each other”. The family presents the epitome of the interaction among family members; it also provides enjoyable, undefended ways of interaction among family members, which create great family opportunities to understand each other, bring to family the hope of positive changes, and confirm the effect of family evaluation and parental consultation. “The family members’ insistence and inviting, and to what family members attribute their problems and how distress they are affect members’ involvement in family play therapy.” “Family play therapy helps family become more aware of the family member’s interaction patterns and behavior.” Parents become aware of how their behavior and parenting influences their children, thus causing the major problems to transfer, of how their treatment of their children elicit competition among the children, and of the psychology of their children and the goals of their children’s misbehavior, and of the fact that they should pay their attention to the whole family system rather than focused children. The changes caused by family play therapy have the following influences, including providing family the momentum towards positive changes in many ways. Family members have a better understanding of and closer relationship between each other, making each member change in positive ways. “The following expectations” include facing the dilemma: whether to change or not, and the implementation of family play therapy in the future.
The results and analysis offer some concrete suggestions to practical workers of counseling, parents and researchers.
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