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題名：親子遊戲治療對婚暴目睹兒童及其受暴母親處遇成效之分析研究
作者：王純琪
校院名稱：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
學位類別：博士
出版日期：2012
主題關鍵詞：親子遊戲治療；目睹兒童；婚姻暴力；受暴母親；嵌入式混合設計；單一受試；跨受試多探測設計；兒童行為；親職壓力；親子關係；親子互動遊戲；改變歷程；改變機制；filial therapy；child witness；domestic violence；battered mother；embedded design of mixed methods；single subject research；mutiple probe design across subjects；child behavior；parenting stress；parent-child relationship；parent-child interaction play；change process；change mechanisms
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本研究採用Landreth的親子遊戲治療方案，以兩對目睹兒童及其受暴母親之親子為對象，進行親子遊戲治療處遇成效之分析。本研究以質量混合研究的嵌入式設計進行，量化研究部分為單一受試中的跨受試多探測設計，質性研究則以課程討論錄音及事後訪談錄音作為分析資料。
本研究的研究的目的共包含三個，一是探究親子遊戲治療對參與親子目睹兒童之處遇成效，以「兒童行為檢核表」、「親職壓力量表」，以及「親子關係量表」做為評估工具，檢視處遇前後目睹兒童之行為問題及適應情形的得分差異、受暴母親之親職壓力得分差異，以及參與親子之親子關係得分差異，所得結果以平均數描述性統計進行分析。研究目的二乃是親子遊戲治療對參與親子在「親子互動遊戲衡鑑」的「親子互動整體行為」、「親子共同參與」、母親之「正向情感」、「干擾」、「肯定」、「注意」、「對兒童情緒的敏感度」、「對兒童與其互動的反應」等八項指標的處遇成效，所得結果則進行單一受試中的視覺分析、C統計數及效果值分析。第三個目的則是探究參與親子之親子互動及關係的變化歷程及改變機制，以開放編碼的方式進行分析。
本研究之研究結果與發現依研究目的描述如下：
一、研究目的一之結果與發現：
（一） 親子遊戲治療對兩位目睹兒童之行為問題，沒有介入的立即效果，但在追蹤效果部分，學校與家庭的效果則有落差。
（二） 親子遊戲治療對兩位目睹兒童之適應能力並沒有介入的立即效果，但其中一位在學校的追蹤測量部分，具有追蹤效果。
（三） 親子遊戲治療對兩位受暴母親之親職壓力具有介入的立即效果，而追蹤效果則有個別差異。
（四） 親子遊戲治療對參與親子之親子關係介入的立即成效呈現個別差異。
二、研究目的一之結果與發現：
（一） 親子遊戲治療對參與親子之親子互動遊戲整體行為有大效果量程度的介入效果，追蹤及類化效果則有個別差異。
（二） 親子遊戲治療對二位參與母親之「正向情感」表現，具有大效果量的介入立即效果，但是沒有追蹤及類化效果。
（三） 親子遊戲治療對二位參與母親之「干擾」行為有大效果量的介入效果。追蹤及類化效果則有個別差異。
（四） 親子遊戲治療對二位參與母親之「肯定」行為，呈現個別差異。
（五） 親子遊戲治療對二位參與母親之「注意」行為，具有介入的立即效果，但是效果量不同。但皆沒有追蹤及維持效果。
（六） 親子遊戲治療對二位參與母親之「對兒童情緒的敏感度」表現上，具有大效果量的介入的立即效果。追蹤及類化效果呈現個別差異。
（七） 親子遊戲治療對二位參與母親之「對兒童與其互動的反應」表現上，皆具有大效果量的立即介入效果，但是都沒有追蹤效果，類化效果則有個別差異。
（八） 親子遊戲治療對二對參與親子之「親子共同參與」，皆具有大效果量的立即介入效果，但是沒有追蹤效果，類化效果則有個別差異。
三、研究目的三的結果與發現：
（一） 兩對參與親子之親子互動及關係變化歷程共可分為親方、子方及親子雙方三方面的發展，彼此之間亦有交互作用的關係。
（二） 兩對參與親子之親子互動及關係之改變機制共包含對孩子的瞭解、明確的參與動機、親職行為的省思、親職心態的揭露、正向的親職態度、調整方向的領悟、親職行為的調整、親職行為的正向改變、孩子的正向改變、正向的互動經驗、對參與的堅持與認同，以及生活及婚姻關係的壓力等要素。
研究者依據研究結果與發現，提出親子遊戲治療對於目睹兒童及受暴婦女之實務及未來研究的建議。
This study was designed to analyze the effectiveness of Landreth’s Filial Therapy Model for two pairs of children who witnessed the domestic violence and their battered mothers. The embedded design of mixed methods was adopted in conducting this study. The part of quantitative method followed a multiple probe design for the single subject across subjects, and the part of qualitative method analyzed the data from the sound recording of the discussion during each section and interview after the course.
There were three purposes of this study. The first was to examine the effectiveness of the treatment on the behavior and adaption of the children who witnessed the domestic violence, the parenting stresses of their battered mothers, and the relationship of the children and their mothers. The subjects’ pre and post treatment responses were measured by collecting the Child Behavior Checklist, Parenting Stress Index, and Parent-Child Relationship Scale data which were analyzed by applying the descriptive statistic method. The second was to examine the effectiveness of the treatment on the parent-child interaction playing behavior of subjects’. There were eight codes evaluated as followed: the overall behavior of parent-child interaction play, parent-child involvement, mother’s affection, intrusion, encourage, attention, sensitivity to child’s emotion, and responsiveness to child’s interaction. The subjects’ treatment responses were measured by Parent-Child Interaction Play Recording Sheet which was revised by author. The data was analyzed by applying the visual analysis, the statistic method of Tryon’s C statistics and effect size analysis. And the last was to explore the process and mechanisms, for the mother-child interaction and relationship of change. The data was analyzed by applying the open coding approach.
The results of the research are as follows:
1-1. The intervention had the immediate effect on two children’s behavior problems, but the follow-up effect showed the differences between home and school.
1-2. The intervention had not the immediate effect on two children’s adaption abilities , but had follow-up effect on one of them.
1-3. The intervention had the immediate effect on two mothers’ parenting stress, but the follow-up effect showed individual difference.
1-4. The intervention had the different immediate effect on two pairs of mother-child.
2-1. The intervention had the immediate effect on parent-child interaction play overall behavior, which was categorized as large effect size, while the follow-up and generalized effect showed individual differences.
2-2. The intervention had the immediate effect on two mothers’ affection, which was categorized as large effect size, but did not show the follow-up and generalized effect.
2-3. The intervention had the immediate effect on mothers’ intrusion, which was categorized as large effect size, while the follow-up and generalized effect showed individual differences.
2-4. The immediate effect on encourage showed individual differences.
2-5. The intervention had the immediate effect on mothers’ attention, while effect size differs from each other. The follow-up and generalized effect did not show.
2-6. The intervention had the immediate effect on mothers’ sensitivity to child’s emotion, which was categorized as large effect size, but the follow-up and generalized effect had individual differences.
2-7. The intervention had the immediate effect on mothers’ responsiveness to child’s interaction, which was categorized as large effect size, but did not show the follow-up, generalized effect showed individual differences.
2-8. The intervention had the immediate effect on parent-child involvement, which was categorized as large effect size, but did not show the follow-up effect, and the generalized effect showed individual differences.
3-1. The change process of two pairs of mother-child interaction and relationship included the development of three aspects: mother, child, and mother-child.
3-2. The change mechanisms of the mother-child interaction and relationship were the understanding of children, the obvious involving of motive, the reflection of parenting behavior, the disclosure of parenting attitude, the positive parenting attitude, the enlightment of parenting modulating, the adjustment of parenting behavior, the change of parenting behavior, the change of children’s behavior, the positive experience of mother-child interaction. the identification and perseverance of involving, the pressure of live and marriage relationship.
The implications and recommendations of the results are to discuss to raise the suggestion for the future research and practice work on filial therapy for children who witnessed the domestic violence and battered women.
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