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題名:家族治療工作坊現場與後續治療實踐歷程之行動敘說
作者:田廣曉
作者(外文):TIAN,GUANG-XIAO
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:王智弘
郭麗安
學位類別:博士
出版日期:2023
主題關鍵詞:家族治療工作坊案例演示行動研究敘說探究family therapycase demonstration in workshopaction researchnarrative inquiry
原始連結:連回原系統網址new window
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家族治療是一門藝術。每一個家族治療師,都要面對三個問題的挑戰:如何更有效地掌握家族治療的理論與技術?如何發揮自己的能力和特色,創造自己的治療風格?如何催化案家有更好的互動?
本研究以「自我」為探究的主體,研究的主旨為在家族治療工作坊演示中,我擔任副手與會後實際提供案家治療的實踐經驗為何;在家族治療工作坊演示後,我單獨進行家族治療時與案家維持同盟關係的困境與解決策略為何;以及我對兩岸治療師在家族治療工作坊演示後,後續進行治療的倫理實踐與行動。運用行動敘說的方法,來呈現一個新手家族治療師經歷家族治療工作坊演示中擔任副手與會後實際提供案家治療的經驗反思。
在大師級家族治療師的現場演示治療中擔任副手、會後實際為案家提供治療的過程中,我不僅經驗到作為新手治療師與老手從「建立關係上的差異」、「治療氛圍的差異」、「技術使用上的差異」、「性別意識的差異」等方面形成巨大反差;而且在單獨為案家提供治療時,總是處在「個別治療還是家族治療中搖擺」、「學好『溝通技巧』,就能解決家庭問題?」、「單一視框的家族治療師?」、「價值觀中立的家族治療師?」、「效忠誰的權益」的兩難境地與迷茫中,但我並未放棄,而後在一系列實踐家族治療、督導、學習與反思中,我的治療視框和手法也發生了很大的轉變,「從執著症狀病因到『肯認』症狀的功能」、「從系統觀的結構到建構中的結構」、 「從挑戰家庭權力結構到順應家庭權力結構」、「從重技術走向重態度」、「intra到inter的轉變」、「從東施效顰到別具一格」,逐漸將這些理論與經驗內化到自身,形成一種互為主體諮商的家族治療專業型態。
在家族治療工作坊演示後,我單獨進行家族治療,與案家維持同盟關係時,遭遇到「曾經與老手同台演出的壓力和焦慮」、「治療介入無法推進的無力和挫敗感」、「掙紮於個人及家庭需求拔河的倫理兩難困境」、「一直圍繞同樣問題原地踏步,想要破罐破摔」、「夫妻問題積怨已久,難以處理」、「治療中個別與系統間理論的衝突」、「結構學派與女性主義的擺盪」、「維持中立立場的考驗」、「治療師間權力位階差異,讓我戰戰兢兢」、「東施效顰、學不得法,讓我覺得家族治療是最難學會的治療型態」等難題。我採取「工作坊現場案例演示後討論」、「督導」、「與同儕交流與討論」、「持續學習」、「調整目標」、「反映行為互動模式」、「治療技巧的改善」來因應治療中的困境。
兩岸治療師在家族治療工作坊演示並與案家結案後,我繼續展開持續的行動,與同行一起協同前行,「觀摩家族治療錄影帶,分析對話」、「成立系統性家庭治療學習提高小組」、「一起開展系統性家庭治療培訓」、「成立家庭心理健康教育研究院」、「與家庭心理健康教育研究院合作發展家庭的課題研究」,並嘗試在實踐中遭遇到的倫理議題和專家進行探討與修正,呈現工作坊中演示案家應獲得心理服務即具福祉保障流程實踐心得,作為工作坊案例演示之倫理建議,以及分享在大陸展開結構學派家族治療之本土化經驗,豐盈此方面的文獻資料,供同行在相關研究和實務中提供參考。
Family therapy is an art. Every family therapist has to face the challenge of three questions: How to master the theory and technology of family therapy more effectively? How do you give play to one's abilities and characteristics and create one's treatment style? How do we catalyze case families to have better interaction?
This study takes "self" as the subject of inquiry, and the primary purpose of the research is what is the practical experience of actually providing family therapy after I acted as an assistant in the family therapy workshop demonstration; What are the dilemmas and solutions for maintaining an alliance relationship with the clients during treatment; and my ethical practice and actions for follow-up treatment after the demonstration to therapists on both sides of the Taiwan Strait in the family therapy workshop. Using the method of action narrative to present a novice family therapist's reflection on the experience of actually providing family therapy after serving as an assistant in the family therapy workshop demonstration.
In the process of serving as an assistant in the on-site demonstration treatment of a master family therapist and actually providing treatment for the case after the meeting, I not only experienced the "differences in relationship building" and "differences in the treatment atmosphere" between a novice therapist and a veteran. ", "differences in the use of technology," "differences in gender awareness," and other aspects form a huge contrast; and when providing treatment for the case alone, always swinging between "individual treatment or family treatment," "learning" to communicate well "skills," can you solve family problems?", "A family therapist with a single frame of view?", "A family therapist with neutral values?", "Whose rights and interests to be loyal to" the dilemma and confusion, but I did not give up, and then in a series of practice family therapy, supervision, learning, and reflection, my treatment perspective and methods have also undergone significant changes, "from obsessing about the cause of symptoms to "acknowledging" the function of symptoms," "from the structure of systemic perspective to the structure under construction," "from challenging the family power structure to conforming to the family power structure," "from emphasizing technology to emphasizing attitude," "the shift from intra to inter," "from imitating the past to being unique," and gradually internalizing these theories and experiences into itself, forming a kind of the professional style of family therapy in mutual subject counseling.
After the demonstration in the family therapy workshop, when I conducted family therapy alone and maintained an alliance with the clients, I encountered "the pressure and anxiety of performing on the same stage with veterans", "the powerlessness and frustration that the treatment intervention could not advance", " struggling with the ethical dilemma of a tug-of-war between personal and family needs", "I have been lingering around the same problem, wanting to break the pot", "The problem of husband and wife has long accumulated grievances and is difficult to deal with", "The conflict between the theory of the individual and the system in treatment", "The Swaying between Structural School and Feminism", "The test of maintaining a neutral position", "The difference in power rank among therapists makes me terrified", "I don't know how to imitate others, I think family therapy is the most difficult type of therapy to learn" state" and other problems. I adopt "discussion after workshop live case presentation", "supervision", "communication and discussion with peers", "continuous learning", "adjustment of goals", "reflective behavior interaction mode", "improvement of treatment skills" to respond to treatment in the predicament.
After the therapists on both sides of the strait demonstrated in the family therapy workshop and closed the case with the case, I continued to carry out continuous actions and moved forward together with my peers, "watching family therapy videos, analyzing dialogues", "establishing a systematic family therapy learning improvement group ", "carry out systematic family therapy training together", "establish the Family Mental Health Education Research Institute", "cooperate with the Family Mental Health Education Research Institute to develop family research projects", and try to consult with experts when encountered ethical issuesin in practice carring out discussion and revision, and present the practical experience of the well-being guarantee process that the case demonstrater in the workshop should obtain psychological services, as the ethical suggestion for the workshop case demonstration, and share the localized experience of launching structural school family therapy in mainland China, enriching this aspect documentation materials for peers to provide reference in similar research and practice.
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