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題名:表達性藝術治療家庭評估模式之應用分析:以對立性反抗兒童之家庭為例
作者:張歆昀
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:黃宗堅
學位類別:博士
出版日期:2017
主題關鍵詞:表達性藝術治療家庭評估對立性反抗兒童expressive art therapyfamily assessmentchildren with ODD
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本研究目的在於探討家有對立性反抗兒童之家庭,經由表達性藝術治療家庭評估模式所獲得之家庭成員及次系統間互動經驗及內涵,來了解形成對立性反抗兒童情緒經驗與行為問題之家庭動力,並在此家庭動力下了解對立反抗性行為之意涵,期能對家庭及家庭中的兒童獲致更深的認識,作為後續相關治療之基礎。研究者以Bowen家庭系統理論及表達性藝術治療為基礎,設計共六次之表達性家庭藝術治療評估活動,包含第一次「父母初次訪談」、第二次「父母親原生家庭活動」、第三至五次「家庭評估活動」以及第六次「父母諮詢」。
本研究共有兩個家庭參與,焦點兒童皆為男孩。每個家庭都接受六次家庭評估之活動,並於家庭創作活動單元過程中全程錄影。研究結果為分析第二至第五次父母親原生家庭訪談及家庭成員互動錄影資料。本研究以去病理化的詮釋現象學觀點,貼近家庭互動之經驗,透過「家庭互動脈絡」、「圖像象徵脈絡」及「父母原生家庭脈絡」等三條途徑,形成對於家庭動力及對立性反抗兒童之理解。
研究結果如下:分別以第一個家庭故事「各自努力做好自己的事情,各自努力解決自己的困難」,及第二家庭故事「父母給予寬廣的界限,孩子自由卻不安」來說明家庭成員及次系統間之互動經驗。研究發現,對立性反抗行為表象為不順從之行為,實則為內化家庭潛規則,牽動整個家庭動力之結果。A家庭焦點兒童內化了「做好、做對」的家庭潛規則,因精細動作困難無法達到目標行為而產生的挫折感,啟動了整個家庭的挫折經驗。B家庭焦點兒童內化了「情感連結跟凝聚,不能衝突」的家庭潛規則,同時具有連結家庭情感之功能。綜合結果發現對立性反抗行為是代替整個家庭在反抗家庭潛規則之結果。
最後研究者提出對於本評估模式之檢討與建議,並提出對於家長諮詢與實務工作及研究之建議。
The purpose of this study is to explore families that have children with oppositional defiant disorder, ODD. Through the family members, sub-system interactive experience and contents obtained through the expressive art therapy family assessment model, an insight was gained into the family dynamics forming the emotional experience and behavioral problems of the children with ODD as well as the implications behind the oppositional defiant behavior under such family dynamics, in the hope of gaining a deeper understanding of the families and the children in these families who shall serve as the basis for related follow-up treatments. The researcher adopted Bowen’s family system theory and expressive art therapy as the bases. Six expressive family art therapy assessment activities were designed, including the first activity “first interview with the parents, “the second activity “activities in parents’ family of origin, “the third to the fifth activities “family assessment activities, “and the sixth activity “parent counseling.”
In this study, two families participated, and the children of focus were all boys. Each family accepted the six family assessment activities. The entire family creation activity unit process was recorded on video. The research results include the second through the fifth interviews with the parents’ maiden family and family members. This study used the “non-pathological empirical phenomenology “viewpoint to take a step closer to the family interaction experience. Through three pathways, namely, “family interaction context,” “image symbol context” and “parents’ maiden family context,” the family dynamics were formed to understand children with ODD.
The research results are as follows: the story of the first family “Each making an effort to do their own thing; each making an effort to solve their own problems “and the story of the second family “Parents give broad boundaries; children are free but disturbed” were adopted to explain the interactive experience between the family members and the sub-system. The findings show that opposition a defiant behaviors appear to be not obedient, but in reality, they internalize unspoken family rules and affect the results of the entire family dynamics. The focused children in Family A internalized the unspoken family rule of “Do things good, do them right. “Since the detailed actions were difficult, the targeted behavior failed to be achieved, resulting in frustration and triggered the whole family’s frustrating experience. The focus children in Family B internalized the unspoken family rule of “emotional connection with cohesion but no conflict, “which also had the function of connecting the emotional family bond. The consolidated results show that the oppositional defiant behaviors are the result of defying unspoken family rules on behalf of the entire family.
Finally, the researcher proposed reviews and recommendations for this assessment model and put forward recommendations for parent counseling, as well as practical work and research.
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