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題名:家族治療師處理與文化議題有關的有效治療經驗之研究
作者:牛文菡
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:郭麗安
劉淑慧
學位類別:博士
出版日期:2012
主題關鍵詞:家族治療師文化議題有效治療經驗family therapistcultural issueseffective therapy experience
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家族治療師處理與文化議題有關的有效治療經驗之研究
摘要
本研究的目的在於探究家族治療師之有效治療經驗中,家族治療師是如何處理文化議題的,以及找出影響處理文化議題的因素有哪些。本研究採行質性研究中的現象學研究方法,進行研究。研究參與者是六位具有系統觀、知覺個人曾有有效治療經驗、豐富治療經驗、文化敏感度的專家家族治療師。研究者與每位研究參與者進行二至三次不等的深度訪談,暸解其處理文化議題的有效治療經驗。研究者根據每位研究參與者描述之治療經驗,進行資料分析與整理。
研究發現,家族治療師處理之文化議題有男尊女卑、「男主外、女主內」、以孝為先、以和為貴四個文化議題;處理此四個文化議題的治療進行方式,可分成順應文化、順應與鬆動文化並行、鬆動文化三種進行方式。屬於順應文化的進行方式,有三種:連結家人的愛,不撼動男尊女卑文化;推動真和諧互動模式,未感受以和為貴的文化;引導案家覺察孝順行為的影響,遵循以孝為先文化。屬於順應與鬆動文化並行的進行方式,有三種:支持以孝為先為前提,鬆動以孝為先負面效應;順應「男主外」,鬆動「女主內」母職文化;順應「男尊女卑」文化,鬆動「男尊」的影響。鬆動文化的進行方式,則是關注「男尊女卑」文化之下的男女,鬆動「男尊女卑」的文化框架,重新建構女性主體性。
此外,影響研究參與者處理文化議題的有效治療因素,有掌握治療脈絡、啟動案家動力、運用有效的治療處遇、強化治療專業等四大類因素。掌握治療脈絡因素,包括:建立治療關係、跟隨案家文化脈絡;啟動案家動力因素,包括:提昇案家治療動機、看見並啟動女性正向力量、極力邀請男性參與治療與改變男性觀念、連結案家成員關係;運用有效的治療處遇因素,包括:善用治療性語言與循環問句、運用體驗性治療處遇;強化治療專業因素,包括:敏感於文化議題的專業知識、建立專業權威地位、導入有效的督導團隊。
最後,研究者依據上述研究發現,進行研究者與研究參與者經驗的反思,並提出具體建議,做為實務工作者、未來研究的參考。
關鍵字:家族治療師、文化議題、有效治療經驗
The Study on the Family Therapists, Effective Therapy Experience for Cultural issues
Abstract
This study aimed to explore how the family therapists dealt with the cultural issues in their effective therapy experience. Meanwhile, this study also intended to find out the factors which influenced the therapists’ treatment for the cultural issues. This study adopted the phenomenological qualitative research method. The participants of this study were six family therapists who not only had the systems perspective, but also recognized themselves as an effective and experienced counselor with cultural sensitivity. The researcher had depth interview with each participant for two or three times, in order to understand their effective therapy experience of dealing with the cultural issues. The data collection and analysis was based on the therapeutic experience which every participant described.
In the result of this study, it was shown that the main cultural issues which the family therapists dealt with were male superiority and female inferiority, the traditional role of men as breadwinner and women as housekeeper, the priority of filial piety and the emphasis of interpersonal harmony. The treatment for the four cultural issues were categorized as simply accommodating the culture, both accommodating and releasing the culture, simply releasing the culture. There were three ways to accommodate the culture—(a) to connect the affection of family and not to shake the culture of male superiority and female inferiority; (b) to promote the model of true and harmonic interaction without the awareness of the culture of interpersonal harmony; (c) to guide the clients to recognize the influence of the behavior of filial piety and follow the culture of filial piety. As for the treatment of accommodating and releasing the culture, there were also three ways—(a) to support the priority of filial piety to be an prerequisite and release the negative effect caused by the priority of filial piety; (b) to accommodate the role of men as breadwinner and release the maternal role of women as housekeeper; (c) to accommodate the culture of male superiority and female inferiority and release the influence of male superiority. As for the treatment of simply releasing the culture, there were also three ways—(a) to regard the male and female clients living with the culture of male superiority and female inferiority; (b) to release the cultural frame of male superiority and female inferiority; (c) to reconstruct the female subjectivity.
Moreover, the four therapeutic factors that facilitated the effective treatment for cultural issues included taking good control of the counseling context, initiating the clients’ dynamic, using effective treatment and strengthening the counselors’ profession. First of all, taking good control of the counseling context included establishing the therapeutic relationship and following the clients’ cultural context. Secondly, the factor of initiating the clients’ dynamic included raising the clients’ motivation for counseling, seeing and initiating female clients’ positive power, inviting male clients’ to join the counseling, changing the male clients’ concept and connecting the relationship of clients’ family. Thirdly, the factor of using effective treatment included properly using the therapeutic language and cyclic questions as well as utilizing experiential therapy. Fourthly, the factor of strengthening the profession included having sensitivity and professional knowledge about the cultural issues, establishing the status of professional authority and receiving help from the effective supervision teams.
Finally, according to the result of this study, the researcher proposed the reflection on the researcher’s and the participants’ experience and also provided the specific suggestions for counselors and future studies.
Keywords: family therapist, cultural issues, effective therapy experience
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