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研究生: 張碧琴
Pi-Chin Chang
論文名稱: 依附取向親子治療歷程研究-以依附創傷兒童為例
Process Research of Attachment-Focused Psychotherapy: Children with Attachment Trauma as Example
指導教授: 陳秉華
Chen, Ping-Wha
學位類別: 博士
Doctor
系所名稱: 教育心理與輔導學系
Department of Educational Psychology and Counseling
論文出版年: 2012
畢業學年度: 100
語文別: 中文
論文頁數: 272
中文關鍵詞: 依附取向親子治療任務分析敘說分析歷程研究依附創傷兒童
英文關鍵詞: Attachment-Focused Psychotherapy, task analysis, narrative analysis, process research, children with attachment trauma
論文種類: 學術論文
相關次數: 點閱:824下載:97
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  • 本研究以三組依附創傷兒童及其主要照顧者為對象,探討治療師如何應用修正後的依附取向親子治療模式,促成兒童與照顧者依附關係之改變,以及照顧者內在的依附教養改變歷程。
    在研究方法上,本研究分為二個子研究,研究一為任務分析研究,其階段一為模式建構階段,研究者藉由文獻與經驗整理,根據D. Hughes所發展之依附取向親子治療模式的理念整理出初步的治療要件,接著蒐集實際治療的錄影帶、治療歷程逐字稿、治療師記錄,透過假設與實際行為的不斷比對,以建構更細部的「依附取向親子治療模式之理念模式」。階段一的研究參與者為一名曾經歷親人死亡分離之10歲女童及其照顧者,研究者以發現取向之精神進行資料蒐集與分析,在協同分析者與資深督導之合作下,逐步澄清模式中的相關要件,建構出初始理念模式。
    階段二為檢証模式階段,研究者向社區召募3組男童及其照顧者,分別進行7至10次的親子治療,蒐集治療錄影與逐字稿,逐步修正依附取向親子治療的任務與要件,最後得出親方會談部份有4大任務、8項治療要件與17個細部要件,聯合會談部份則有3大任務、8項要件與18個細部要件。本研究並綜合對歷程之觀察提出治療流程圖,以呈現治療之動態發展。
    研究二為敘說分析,邀請3組5位參與之照顧者在治療後進行敘說訪談,以了解照顧者對教養困境的認知與因應、參與治療前後其依附教養之意義改變歷程,以探索依附取向親子治療可如何調整以更貼近華人家長的需求。研究最後亦整合任務分析與敘說訪談之分析結果,從華人親子文化的角度探討成功組與未成功組的治療歷程,並建議修正原模式為有文化觀點的親子治療模式。

    The purpose of this study is to modify the Attachment- Focused Psychotherapy model developed by Daniel Hughes (1999), based on the experiences of three children with attachment trauma and their parents, and to explore the change process of their attachment relationship and caregivers’ constructs on attachment parenting.

    This study includes two research, task analysis research and narrative research. The former consists of two steps; the first step is to establish the indigenous rational model of Attachment-Focused Psychotherapy; the next is to collect the practice records of video, verbatim, and relative documents in order to compare and refine this model. The participants of the first research are a caretaker and a 10-year-old girl. The girl had suffered from her parents’ death and separated from her families. The researcher has teamed up with co-researchers and the supervisor to develop the tasks and components of the rational model based on one psychotherapy session with the caretaker and the girl.

    The second step is to testify the model. The researcher recruited 3 boys and their caretakers, and a therapist conducted 7-10 sessions of therapy individually. Based on the analysis of the video and verbatim, it was found the refined model includes 2 sections, the parent section and the filial section. The parent section consists of 4 tasks, 8 components and 17 items; the filial section consists of 3 tasks, 8 components and 18 items. The flow chart was draw and showed the dynamics of the therapy.

    The second research, narrative research, interviewed 5 caretakers from 3 families to elaborate their experiences of parenting difficulties, the changes of their attachment parenting attitudes, and their perceived therapeutic factors. At last, the researcher integrates the results of task analysis and narrative analysis to delineate the successful and unsuccessful therapy process, and to refine the Attachment-Focused Psychotherapy model in Taiwan.

    誌謝詞……………………………………………………………………………………ⅰ 中文摘要………………………………………………………………………………..ⅲ 英文摘要…………………………………………………………………………..…….ⅴ 目次……………………………………………………………………………………..ⅵ 表次………………………………………………………………………………….....ⅸ 圖次 …………………………………………………………………………………….x 第一章 緒論……………………………………………………………………………1 第一節 研究動機……………………………………………………………….......…1 第二節 研究問題與目的………………………………………………………………6 第三節 名辭定義………………………………………………………………….......7 第二章 文獻探討 …………………………………………………………………......9 第一節 兒童依附創傷………………………………………………………………….9 第二節 依附取向親子治療之理論脈絡………………………………………………14 第三節 華人親子依附與治療之相關研究︰多元文化觀點…………………….27 第四節 華人親子依附取向親子治療之初始理念模式 ……………………..........38 第五節 前導研究:依附關係治療成效 ……………………...........……………49 第三章 研究一:依附取向親子治療模式之任務分析 ……………………..........53 壹、任務分析研究法 ……………………..............……………………..........53 貳、研究對象……………………..............…………………….......................60 參、研究工具……………………..............…………………….......................64 肆、研究程序……………………..............……………………........................68 伍、資料分析方法……………………..............…………………….................71 陸、研究信效度之檢核 ……………………..............………………….….........74 柒、研究倫理……………………..............…………………….......................75 捌、研究結果……………………..............…………………….......................76 第四章 研究二︰依附取向親子治療照顧者內在改變經驗之敘說分析...........129 壹、敘說分析之研究焦點..……………………..............……………………....129 貳、研究參與者……………………..............……………………..................130 參、研究工具……………………..............…………………….....................132 肆、研究程序……………………..............………………….............…........133 伍、資料分析方法……………………..............…………………......…........134 陸、研究信效度之檢核……………………..............…………………….......136 柒、研究倫理……………………..............……………………....................137 捌、研究結果……………………..............…………………............…........137 第五章 綜合討論……………………..............………………......……........193 第一節 修正後依附取向親子治療模式與理念模式之比較……......…………193 第二節 成功與不成功組任務分析結果之討論……………….....….…..........199 第三節 親子治療歷程的任務組型及運用之反思……………..…….…..........201 第四節 華人父母依附教養的改變歷程︰文化觀點…………..…….…..........208 第五節 修正後依附取向親子治療實施於華人文化的挑戰…….….…..…......213 第六節  整合任務分析與敘說研究之結果討論…………………...............216 第六章 結論與建議…………………......…………………......……..…..……219 第一節 結論…………………......…………………......…………....……......219 第二節 研究限制…………………......…………………......……..……….….225 第三節 研究與實務建議…………………......…………………......…….…….227 參考文獻 中文文獻………………………………………………………………………….…230 英文文獻……………………………………………………………………….……240 附錄 附錄一 研究邀請函……………………………………………………………..…262 附錄二 兒童與家庭生活況:治療前…………………………………………..…263 附錄三 照顧者初步訪談大綱…………………………………………………..…264 附錄四 研究參與同意書……………………………………………………….….265 附錄五 錄音錄影轉錄原則……………………………………………………..…266 附錄六 謄稿保密同意書………………………………………………………..…268 附錄七 兒童家庭生活現況:治療後…………………………………………..…269 附錄八 研究日誌………………………………………………………………..…270 附錄九 敘說訪談大綱………………………………………………………..……271 附錄十 符合程度評估表……………………………………………………….….272

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