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研究生:許峰益
研究生(外文):Feng-I Hsu
論文名稱:心理師在過動症家長諮詢的經驗與歷程之探究
論文名稱(外文):The Experience and Process of Psychologists in Parental Consultation of Children with ADHD
指導教授:林美珠林美珠引用關係
指導教授(外文):Meei-Ju Lin
口試委員:劉志如林美珠
口試委員(外文):Chih-Ju LiuMeei-Ju Lin
口試日期:2019-01-04
學位類別:碩士
校院名稱:國立東華大學
系所名稱:諮商與臨床心理學系
學門:社會及行為科學學門
學類:心理學類
論文種類:學術論文
論文出版年:2019
畢業學年度:107
語文別:中文
論文頁數:180
中文關鍵詞:過動症家長諮詢
外文關鍵詞:ADHDparental consultation
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本文主旨為探究心理師在過動症的家長諮詢中,所採用的諮詢架構與內容、和家長的互動並建立合作關係的過程、所知覺到的家長狀態,及心理師在諮詢過程中的倫理抉擇與行動。本研究採取半結構的一對一深度訪談,共邀請七位心理師闡述其在過動症家長諮詢中的經驗,並以現象學研究方法進行研究資料的分析,分析後形成研究結果,並做綜合性的討論。研究結果:一、心理師的過動症家長諮詢架構因諮詢目的、次數等因素考量,而有不同的設計;然而諮詢內容常是相同,包括:過動症和藥物的衛教、心理師與家長對於過動症兒童觀點的交流、教養技巧的學習與調整等。二、心理師知覺家長在過動症家長諮詢時,對心理師有其過去經驗的投射,且在諮詢中呈現其各自的狀態,心理師覺知家長狀態並採用適合方式回應家長,以幫助家長投入諮詢中。三、心理師知覺到家長狀態有與過動症兒童共同受苦性、面對過動症兒童的衝突性、自身限制性與自我懷疑性等的特質。四、心理師於過動症家長諮詢中,常面臨時間有限下之諮詢焦點、合作關係、關照家長或討論兒童議題、治療完整性,及自身專業能力的挑戰,在諮詢的當下得衡量以做適當的倫理抉擇。
整體而言,依據研究結果進一步提出四項研究建議:1. 心理師應加家長諮詢納入過動症兒童的處遇計畫之中。2. 衛教是過動症家長諮詢的重要基礎之一,且衛教應包含過動症狀在兒童行為上的呈現樣貌、協助家長做出兒童處遇選擇等內容。 3. 諮詢中討論的教養技巧需要經歷討論、實作然後修訂的歷程。 4. 心理師在諮詢中面對家長呈現其情緒狀態時,評估可用的時間、兒童此時的狀態、家長狀態的嚴重及影響程度、還有哪些資源可以幫助家長處理其情緒狀態等,以回應諮詢現場家長的需要,做出當下平衡兒童及家長需求的倫理抉擇。最後,本研究以上述研究發現與討論,並對未來研究方向及實務工作方向提出建議。
This study aimed to explore the structure and content of consultation, the process of interaction and collaborative relationship building with parents, the parental status perceived, and the ethical choices and actions of psychologists during the parental consultation of children with ADHD. The participants consisted of seven psychologists. Through a series of semi-structured, one-on-on interviews with the subjects, the researcher applied the phenomenological approach of method to analyze the data collected. The findings indicated that: 1. The consultation structure is varied by the psychologist's purpose and the length of consultation, however there are similarities in terms of consultation content, including: ADHD and drug education, exchange of views between psychologists and parents on children with hyperactivity, learning and adjustment of parenting skills. 2. The psychologists perceive the parents’ projection of their past experience and their respective status present in the consultation, and respond to the parents in a suitable way to help the parents engage in the consultation. 3. The psychologists perceive the state of the parents as mutual suffering of children with ADHD, conflicting of children with ADHD, self-restriction and self-doubt. 4. Psychologists often face the challenges of consultation from focusing issue due to limited time, collaborative relationship, caring for parents or discussion for children's issues, treatment integrity, and their professional competence for making appropriate ethical choices in the consultation.
Further research suggestions based on the research results are:.1. Treatment plan for children with ADHD should include parental consultation. 2. Health education is one of the important foundation for parental consultation of children with ADHD, and it should include the appearance of hyperactive symptoms from children's behaviors, and assist parents in making choices for children's treatment. 3. The parenting skills discussed in the consultation need to go through discussions, practice, and revisions. 4. The psychologist evaluates the available time, the state of the child at the time, the severity and influence of the parental status, and what resources can help the parents respond to parents' needs and to make ethical choices that balance the needs of children and parents when the parents present their state in the consultation. Finally, based on research findings and discussions, future research directions and practical work are suggested.
謝誌 ………………………………………………………………………………………………………………………. I
中文摘要 ………………………………………………………………………………………………………………. III
英文摘要 ………………………………………………………………………………………………………………. IV
目次 ………………………………………………………………………………………………………………………. VI
表目次 …………………………………………………………………………………………………………………… VIII
圖目次 …………………………………………………………………………………………………………………… VIII
第一章 研究動機與目的 …………………………………………………………………………………… 1
第一節 問題意識與背景 ………………………………………………………………………….. 1
第二節 研究目的與問題 ………………………………………………………………………….. 3
第三節 名詞釋義 ……………………………………………………………………………………… 3
第二章 文獻探討 ………………………………………………………………………………………………. 7
第一節 過動症兒童的自身顯現 ………………………………………………………………. 7
第二節 過動症兒童在學校的顯現 …………………………………………………………… 12
第三節 過動症兒童父母的顯現 ………………………………………………………………. 15
第四節 專業人員與過動症兒童及其父母的遭逢 ……………………………………. 20
第三章 研究方法 ………………………………………………………………………………………………. 25
第一節 研究參與者 ………………………………………………………………………………….. 25
第二節 研究工具 ……………………………………………………………………………………… 26
第三節 研究程序 ……………………………………………………………………………………… 29
第四節 資料整理與分析 ………………………………………………………………………….. 31
第五節 研究倫理 ……………………………………………………………………………………… 32
第四章 研究結果與討論 …………………………………………………………………………………… 35
第一節 過動症兒童家長諮詢的架構與內容 …………………………………………… 35
第二節 諮詢中心理師與過動症兒童家長的互動 ……………………………………. 90
第三節 心理師知覺到過動症兒童家長所面臨的處境 ……………………………. 111
第四節 在諮詢與家長遭逢中,心理師的挑戰及其倫理抉擇 ………………… 130
第五節 綜合討論 ……………………………………………………………………………………… 152
第五章 結論與建議 …………………………………………………………………………………………… 159
第一節 研究結論 ……………………………………………………………………………………… 159
第二節 研究者的反思 ……………………………………………………………………………… 160
第三節 研究建議 ……………………………………………………………………………………… 162
第四節 研究限制 ……………………………………………………………………………………… 163
參考文獻 ………………………………………………………………………………………………………………. 165
中文文獻 ……………………………………………………………………………………………………… 165
英文文獻 ……………………………………………………………………………………………………… 167
附件一 研究參與邀請函 …………………………………………………………………………………… 178
附件二 研究參與同意書 …………………………………………………………………………………… 179
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