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題名:「無惱療法」對思覺失調症個案的臨床療效研究--以正念正知原理為基礎
作者:林伯彥
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:吳秀碧博士
張景然博士
學位類別:博士
出版日期:2015
主題關鍵詞:正念正知原理無惱療法思覺失調症臨床療效Mindfulness and Clear Comprehension PrinciplesNon-suffering TherapySchizophreniaClinical Outcome
原始連結:連回原系統網址new window
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本研究旨在探究以正念正知原理為基礎的「無惱療法--思覺失調症方案」對思覺失調症個案的臨床療效。本研究以符合思覺失調症緩解期的十二位住院個案為研究對象,研究方法包含量化與質化兩種。研究設計採取「等組前後測實驗設計」,將十二位研究參與者隨機分派到實驗組與控制組。本研究量化部分的自變項為「無惱療法--思覺失調症方案」團體治療,實驗組的研究參與者接受十六次團體治療,控制組的研究參與者沒有接受任何團體治療。兩組研究參與者除了自變項不同之外,其餘醫療處置皆相同。而依變項的部分則為正性症狀、負性症狀、一般精神病理、以及個人與社會功能等項目,並以「正性與負性症狀量表」、「個人與社會功能量表-照護者中文版本」、與臨床整體評估表評估所得的分數來表示。質性部分主要採取關鍵事件研究法,對於實驗組的研究參與者進行關鍵性治療事件的訪談,作為質性分析的依據,以協助量化資料的解釋與建構團體成員改變的機制和歷程。本研究主要發現如下:
一、本方案適用於緩解期思覺失調症個案。
二、本方案對於緩解期思覺失調症個案具有臨床療效,包括負性症狀、一般精神病理、以及個人與社會功能項目。
三、緩解期思覺失調症個案的臨床療效與其知覺的幫助內容,依內觀禪修技術的知覺程度以及改變機制和歷程的不同,具有不一樣的結果。
根據研究結果,本研究針對「無惱療法--思覺失調症方案」對思覺失調症個案的臨床療效提出建議,包括在臨床治療和諮商實務方面的建議,以及未來研究上的建議,以供精神醫學與諮商實務工作者以及未來研究者參考。
The study aimed to investigate the clinical outcomes of “Non-suffering therapy”, which based on mindfulness and clear comprehension principles, toward patients with schizophrenia. Twelve remitted schizophrenic inpatients were the study subjects, and quantitative and qualitative methods were used in this study. In the experimental protest-posttest control group design study, twelve inpatients are randomly assigned into the experimental group and the control group. The independent variable in the quantitative part is the group treatment for “Non-suffering Therapy.” The experimental group received sixteen sessions of group therapy, and the control group didn’t receive any group therapy. Except for the independent variables, these two groups were under the same medical treatments. The dependent variables including of positive symptoms, negative symptoms, general psychopathology, and personal and social functions were assessed by Positive and Negative Symptoms Scales, Personal and Social Performance Scales, Chinese Caregiver Version , and Clinical Global Impression. Meanwhile, Critical Incident Analysis were used in the qualitative part, the six members in the experiment group were interviewed with Critical Incident Technique after each session. The qualitative results were used to help for the interpretation of the quantitative results, and the construction of the group members’ changing mechanisms and processes. The followings were the findings of this study:
1. “Non-suffering therapy” was applicable to the remitted schizophrenic patients.
2. “Non-suffering therapy” showed clinical therapeutic outcome to the negative symptoms, general psychopathology, and personal and social function.
3. “Non-suffering therapy” has inconsistent results towards the clinical therapeutic outcome and the perception of helpful contents of the remitted schizophrenic patients according to different perception levels of insight meditation techniques and changing mechanisms and processes.
According to the study results, this study proposed suggestions regarding the clinical outcome of “Non-suffering therapy” towards the schizophrenic patients including suggestions about the clinical treatment and the practice of counseling and suggestions regarding future studies, so as to serve as references for psychiatric practitioners and counselors and further researchers.
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范琬君(2011)。內觀認知治療團體於憂鬱症緩解患者之療效研究(未出版之碩
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黃祐寧(2013)。正念減壓團體於乳癌患者之效果研究(未出版之碩士論文)。國立台北教育大學心理與諮商學系研究所,台北市。
鄭雅之(2013)。人格特質及作業執行情形對正念療法成效之預測(未出版之碩士論文)。國立中山醫學大學心理系研究所,台中市。
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