研究生: |
葉力溱 Li-Chen Yeh |
---|---|
論文名稱: |
案主被迫結案經驗之質性研究 Clients' Experience of Forced Termination: A Qualitative Study |
指導教授: |
許維素
Hsu, Wei-Su |
學位類別: |
碩士 Master |
系所名稱: |
教育心理與輔導學系 Department of Educational Psychology and Counseling |
論文出版年: | 2013 |
畢業學年度: | 102 |
語文別: | 中文 |
論文頁數: | 210 |
中文關鍵詞: | 案主經驗 、被迫結案 、結案歷程 |
英文關鍵詞: | clients' experience, forced termination, termination process |
論文種類: | 學術論文 |
相關次數: | 點閱:112 下載:12 |
分享至: |
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報 |
本研究旨在了解案主所知覺之被迫結案的經驗與歷程,研究目的包括:(1)了解案主經歷被迫結案經驗的個人故事;(2)了解案主知覺被迫結案的歷程階段與各階段中的經驗;與(3)了解案主對機構與諮商師處理被迫結案的建議。以立意取樣邀請六位曾經歷過被迫結案的案主接受半結構式的深入訪談,並以心理動力取向對諮商與結案的看法為出發點,用質性研究中的主題分析法進行資料歸納與分析。
本研究之研究結果與討論分為四部分:
一、呈現案主經歷被迫結案經驗的個人故事:將六位受訪者經歷被迫結案的歷程與經驗分別描繪,呈現個別背景與脈絡及其結案經驗的發展與影響。
二、呈現案主知覺被迫結案的歷程階段與各階段中的經驗:將被迫結案的歷程階段統整為三個部分:(1)「結案發生—晴天霹靂」,從案主「對結案的心理準備」到案主「產生得知結案消息當下之反應」為止,;(2)「結案處理與反應—風狂雨 驟」,從案主「感受到結案被處理的狀況」到結案發生、結束諮商為止;與(3)「結案過後—雨斂風停 」,從「案主結案後的反應與狀態」到案主「接受訪談時對被迫結案的看法與詮釋」為止。
三、呈現案主對機構與諮商師處理被迫結案的建議:包括「案主對機構與諮商師的被迫結案處理建議」、「案主對諮商師的被迫結案處理建議」與「案主對機構的被迫結案處理建議」等三項。
四、研究者對案主知覺之被迫結案經驗與歷程及被迫結案的處理建議提出討論,除呈現案主在被迫結案歷程中的反應特徵外,也歸納出影響被迫結案歷程與案主反應的因素,強調被迫結案過程中承接案主情緒與陪伴哀悼的重要性,同時結合文獻、案主經驗與研究者自身之看法,提出「盡可能降低被迫結案負面影響的建議」。
最後,研究者根據研究結果與討論,提出本研究之結論與研究限制,針對案主、諮商師、機構三者面對被迫結案的因應方式做出建議,並提供對未來相關研究之建議。
The purpose of this research was to explore the process of the forced termination of a counseling session and how it affects counseling. The goals of this study were: (1) to understand personal experiential stories surrounding forced termination; (2) to explore the process of forced termination from the perspective of the client; and (3) to express and analyze the concerns raised against agencies and counselors that deal with forced termination. A total of six clients who have dealt with forced termination participated in semi-structured deep interviews. Thematic analysis was then used for data analysis and classification.
The results showed that clients went through three stages: the termination occurring stage, the termination processing stage, and the stage after termination. They further revealed many different features of the reactions that clients have during the termination process, and the reciprocal relationship those reactions have with the process itself. After discussion, suggestions were provided to counselors and agencies on how to reduce the negative effects of forced termination to a minimum. Directions for future research were also suggested.
台灣輔導與諮商學會(1989):台灣輔導與諮商學會諮商專業倫理守則。取自台灣 輔導與諮商學會網站:http://www.guidance.org.tw/ethic_001.html,2013年9月25日。
考選部(2011):專門職業及技術人員高等考試心理師考試規則。取自考選部網站:http://wwwc.moex.gov.tw/main/ExamQual/wfrmExamQualMap.aspx?kind =2&menu_id=1490&examqual_id=780,2013年9月25日。
吳宜倫、呂旭亞(2009):從一位諮商師意外過世,談機構的危機處理及省思。
輔導季刊,45(3),68-73。
吳秉衛、陳慶福(2006):為什麼個案不再來?—諮商不成熟結案現象與其因應
之道。輔導季刊,42(3),61-71。
李東白(1984):諮商的理論與技術。高雄市:復文。
李佩珊(2002):大專院校學生個別諮商結案之分析研究。國立高雄師範大學輔導
研究所碩士論文。
社團法人中華民國諮商心理師公會全國聯合會(2012):社團法人中華民國諮商心
理師公會全國聯合會諮商心理師專業倫理守則。取自社團法人中華民國諮
商心理師公會全國聯合會網站:
http://www.tcpu.org.tw/front/bin/ptdetail.phtml?Part= law006&Category=41191
3,2013年9月25日。
林淑華(2008):諮商師的結案經驗研究。國立彰化師範大學輔導與諮商學系碩
士論文。
林家興、王麗文(2000):心理治療實務。台北市:心理。
林家興、王麗文(2003):諮商與心理治療進階—心理分析取向的實務指南。台北
市:心理。
邱珍琬(2007):諮商技術與實務。台北市:五南。
邱德才(2006):解決問題的諮商架構。台北市:張老師。
高淑清(2008):質性研究的十八堂課:首航初探之旅。高雄市:麗文。
高淑清(2008):質性研究的十八堂課:揚帆再訪之旅。高雄市:麗文。
高祺淳(2012):不告而別—不成熟結案當事人之內在經驗。國立交通大學教育研
究所碩士論文。
許雅惠(2011):諮商關係改變歷程之研究。全球心理衛生E學刊,2(2),1-24。
許維素(2013):建構解決之道。寧波市:寧波。
陳瑛治(1995):諮商的結束。輔導季刊,31(3),24-30。
張寶珠(1997):在心理治療的歷程裡結案—好好道珍重再見。輔導季刊,33
(2),42-47。
黃惠惠(2006):助人歷程與技巧(增訂版)。台北:張老師。
楊鎧宇(2010):諮商關係學習對人際關係的影響與省思之敘說研究。國立暨南國
際大學輔導與諮商研究所碩士論文。
蔡秀玲(2000):依附理論在諮商中的應用。輔導季刊,36(1),25-31。
成蒂、林方晧譯(1996):短期心理治療。台北:心理。WOLBERG, L. R. (1980)
Handbook of short-term psychotherapy.
沈湘縈譯(1995):圓滿的心理治療。台北:五南。KRAMER, S. A. (1990). Positive
endings in psychotherapy: Bringing meaningful closure to therapeutic
relationships.
林世華、陳柏熹、黃寶園、傅瓊儀與趙如錦譯(2005):社會科學研究法:量化
與質化取向。台北:心理。PUNCH, K. F. (1998). Introduction to social
research: Quantitative and qualitative approaches.
林美珠、田秀蘭譯(2006):助人技巧─探索、洞察與行動的催化(第二版)。台北
市:學富。HILL, C. E. (2006). Helping skills: Facilitating exploration, insight,
and action (2nd ed.).
徐麗明譯(2003):人際歷程心理治療。台北:揚智。TEYBER, E. (2000). Interpersonal
process in psychotherapy: A relational approach.
許維素、李慧貞、潘祥齡、周秀姝與陳素惠譯(2006):建構解決之道的會談。台
北市:心理。DE JONG, P., & BERG, I. K. (2002). Interviewing for solutions (2nd
ed.).
許維素譯(2013):建構解決之道的會談—焦點解決短期治療(第二版)。台北市:
心理。DE JONG, P., & BERG, I. K. (2013). Interviewing for solutions (4th ed.).
陳龍安譯(1982):助人關係—助人過程與技術。台北市:天馬。BRAMMER, L. M.
(1979). The helping relationship: Process and skills.
劉英蘭譯(2007):諮商與心理治療。台北:五南。WEINER, I. B. (1998).
Principles of psychotherapy.
鄭玄藏譯(1994):短期心理諮商。台北:張老師。TILLEY, B. W. (1984). Short-term
counseling¬¬—A psychoanalytic approach.
鍾瑞麗譯(2006):助人歷程與技巧:有效能的助人者。台北:雙葉。EGAN, G. (2002).
The skilled helper: A problem-management and opportunity-development
approach to helping (7th ed.).
American Association for Marriage and Family Therapy (2012, July 1). Code of Ethics.
Retrieved from
http://www.aamft.org/iMIS15/Content/Legal_Ethics/Code_of_Ethics.aspx
American Counseling Association (2005). ACA Code of Ethics. Retrieved from
http://www.counseling.org/Resources/aca-code-of-ethics.pdf
American Mental Health Counselors Association (2010). Principles for AMHCA Code
of Ethics. Retrieved from
http://www.amhca.org/assets/content/AMHCA_Code_of_Ethics_11_30_09b1.pd
f
American Psychological Association (2010, June 1). Ethical Principles of Psychologists
and Code of Conduct. Retrieved from
http://www.apa.org/ethics/code/principles.pdf
Binnie, J. (2012). Using cognitive behavioural therapy with complex cases: Using the
therapeutic relationship to change core beliefs. Issues Ment Health Nurs, 33(7),
480-485.
Bohart, A. C. (2012). How the therapeutic relationship can help people grow.
psycCRITIQUES, 57(35).
Bostic, J. Q., Shadid, L. G., & Blotcky, M. J. (1996). Our time is up: Forced
terminations during psychotherapy training. American Journal of
Psychotherapy, 50(3), 347-359.
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working
alliance. Psychotherapy: Theory, Research, and Practice, 16, 252-260.
Bram, A. D. (1995). The physically or dying psychotherapist: A review of ethical and
clinical considerations. Psychtherapy, 32(4), 568-580.
Brammer, L. M. (1979). The helping relationship: Process and skills (2nd ed.).
Englewood Cliffs, N.J.: Prentice-Hall.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative
Research in Psychology, 3(2), 77-101.
Brown, D., & Srebalus, D. J. (1996). Introduction to the counseling profession (2nd
ed.). Boston: Allyn & Bacon.
Carkhuff, R. R., & Anthony, W. A. (1979). The skills of helping: An introduction to
counseling skills. Amherst: Human Technology.
Capuzzi, D., & Gross, D. R. (2007). Counseling and psychotherapy: Theories and
interventions (4th ed.). New Jersey: Pearson.
Cartwright, D. (2004). Anticipatory interpretations: Addressing “cautionary tales” and
the problem of premature termination. Bulletin of the Menninger Clinic, 68(2),
95-114.
Cochran, J. L., & Cochran, N. H. (2006). The heart of counseling: A guide to developing
therapeutic relationships. Belmont: Thomson.
Corey, G. (2005). Theory and practice of counseling & psychotherapy (7th ed.).
Belmont, CA: Thomson.
Corey, G., Corey, M. S., & Callanan, P. (2007). Issues and ethics in the helping
professions. Australia, Pacific Grove: Brooks/Cole.
Dewald, P. A. (1965). Reactions to the forced termination of therapy. Psychiatric
Quarterly, 39, 102-126.
Egan, G. (2007). The skilled helper: A problem-management and
opportunity-development approach to helping (8th ed.). Belmont: Brooks/Cole.
Feltham, C. (1999). Understanding the counselling relationship. London: Sage.
Frayn, D. H. (1992). Assessment factors associated with premature psychotherapy
termination. American Journal of Psychotherapy, 46(2), 250-261.
Gelman, C. R. (2009). MSW students’ experience with termination: Implications and
suggestions for classroom and field instruction. Journal of Teaching in Social
Work, 29, 169-187.
Gelman, C. R., Fernandez, P., Hausman, N., Miller, S., & Weiner, M. (2007).
Challenging ending: First year MSW interns’ experiences with forced
termination and discussion points for supervisory. Clinical Social Work Journal,
35, 79-90.
Gelso, C. J., & Hayes, J. A. (1998). The psychotherapy relationship: Theory, research,
and practice. New York: Wiley.
Glick, R. A. (1987). Forced terminations. Journal of the American Academy of
Psychoanalysis, 15(4), 449-463.
Green, J. (2010). Creating the therapeutic relationship in counseling and
psychotherapy. Exeter: Learning Matters.
Greenson, R. R. (1967). The technique and practice of psychoanalysis (Vol. 1). New
York: International Universities Press.
Hackney, H., & Cormier, S. (2005). The professional counselor: A process guide to
helping (5th ed.). Boston: Allyn and Bacon.
Heins, M. J., Knoop, H., & Bleijenberg, G. (2013). The role of the therapeutic
relationship in cognitive behaviour therapy for chronic fatigue syndrome.
Behaviour Research and Therapy, 51(7), 368-376.
Hill, C. E. (2005). Therapist techniques, client involvement, and the therapeutic
relationship: Inextricably intertwined in the therapy process. Psychotherapy:
Theory, Research, Practice, Training, 42(4), 431-442.
Horvath, A. O., & Luborsky, L. (1993). The role of the therapeutic alliance in
psychotherapy. Journal of Consulting and Clinical Psychology, 61(4), 561-573.
Joyce, A. S., Piper, W. E., Ogrodniczuk, J. S., & Klien, R. H. (2007). Termination in
psychotherapy: A psychodynamic model of processes and outcomes.
Washington, DC: American Psychological Association.
Kaplan, A. H., & Rothman, D. (1986). The dying psychotherapist. The American
Journal of Psychiatry, 143(5), 561-572.
Kottler, J. A., & Brew, L. (2003). One life at a time: Helping skills and interventions.
New York: Brunner-Routledge.
Lamber, M. J., & Thompson, K. C. (1996). Current findings regarding the effectiveness
of counseling: Implications for practice. Journal of Counseling and
Development, 74, 601-607.
Lenzner, A. S. (1955). Countertransference and the resident on leaving the patient.
Journal of Hillside Hospital, 4, 148-150.
Lord, R., Ritvo, S., & Solnit, A. J. (1978). Patients’ reactions to the death of the
psychoanalyst. The International Journal of Psychoanalysis, 59, 189-197.
Martinez, D. (1989). Pains and gains: A study of forced terminations. Journal of the
American Psychoanalytic Association, 37(1), 89-115.
Matsuki, K. (2012). Creating a reliable therapeutic relationship with the patient. Seishin
Shinkeigaku Zasshi, 114(11), 1297-1302.
Mennicke, S. A., Lent, R. W., & Burgoyne, K. L. (1988). Premature termination from
university counseling center: A review. Journal of Counseling and Development,
66, 458-465.
Mikkelsen, E. J., & Gutheil, .T. G. (1979). Stages of forced termination: Use of the
Death Metaphor. Psychiatric Quarterly, 51(1), 15-27.
National Association of Social Workers (2008). Code of Ethics of National Association
of Social Workers. Retrieved from
http://www.socialworkers.org/pubs/code/code.asp
National Board for Certified Counselors (2012, June 8). National Board for Certified
Counselors (NBCC) Code of Ethics. Retrieved from
http://www.nbcc.org/Assets/Ethics/nbcc-codeofethics.pdf
Palm, S. (2000). Introduction to counselling and psychotherapy. London: Sage.
Patterson, L. E., & Welfel, E. R. (1994). The counseling process (4th ed.). Belmont:
Brooks/Cole.
Penn, L. S. (1990). When the therapist must leave: Forced termination of
psychodynamic therapy. Professional Psychology: Research and Practice, 21(5),
379-384.
Pekarik, G. (1992a). Relationship of client’s reasons for dropping out of treatment to
outcome and satisfaction. Journal of Clinical Psychology, 48(1), 91-98.
Renk, K., & Dinger, T. M. (2002). Reason for therapy termination in a university
psychology clinic. Journal of Clinical Psychology, 58(9), 1173-1181.
Rogers, C.R. (1957). The necessary and sufficient conditions of therapeutic personality
change. Journal of Consulting and Clinical Psychology, 21, 95-103.
Roulston, K. (2001). Data analysis and theorizing as ideology. Qualitative Research,
1(3), 279-302.
Sharf, R. S. (2012). Theories of psychotherapy and counseling: Concepts and cases.
Belmont: Brooks/Cole.
Siebold, C. (1991). Termination: When the therapist leaves. Clinical Social Work
Journal, 19(2), 191-204.
Siebold, C. (1992). Forced termination: Reconsidering theory and technique. Smith
College Studies in Social Work, 63(1), 325-341.
Siebold, C. (2007). Everytime we say goodbye: Forced termination revisited, a
commentary. Clinical Social Work Journal, 35, 91-95.
Sikorski, W. (2012). Paralinguistic communication in the therapeutic relationship.
Archives of Psychiatry and Psychotherapy, 14(1), 49-54.
Smith, S. (1982-1983). Interrupted treatment and forced terminations. International
Journal of Psychoanalytic Psychotherapy, 9, 337-352.
Taber, B. J., Leibert, T. W., & Agaskar, V. R. (2011). Relationships among
client-therapist personality congruence, working alliance, and therapeutic
outcome. Psychotherapy, 48(4), 376-380.
Teyber, E. (1992). Interpersonal process in psychotherapy: A guide for clinical training
(2nd ed.). California: Brooks/Cole.
Teyber, E. (2000). Interpersonal process in psychotherapy: A relational approach (4th
ed.). Belmont: Brooks/Cole.
Topor, A., & Denhov, A. (2012). Helping relationship and time: Inside the black box of
the working alliance. American Journal of Psychiatric Rehabilitation, 15(3),
239-254.
United States Association for Body Psychotherapy (2007, September). Ethics
Guidelines. Retrieved from
http://www.usabp.org/associations/1808/files/USABPethics.pdf
Weiner, I. B. (1998). Principles of psychotherapy. New York: John Wiley & Sons.
Zuckerman, A., & Mitchell, C. L. (2004). Psychology interns' perspectives on the forced
termination of psychotherapy. The Clinical Supervisor, 23(1), 55-70.