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研究生: 張莉莉
Li-li Chang
論文名稱: 性侵害倖存少女心理劇治療歷程與結果之個案研究
Case Study of Process and Outcomes of Psychodrama on Two Sexually Abused Female Adolescents
指導教授: 陳秉華
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: 2003
畢業學年度: 91
語文別: 中文
論文頁數: 186
中文關鍵詞: 心理劇性侵害少女倖存者
英文關鍵詞: psychodrama, sexual abuse, adolescent, female, survivor
論文種類: 學術論文
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本研究旨在瞭解性侵害倖存少女心理劇治療之演出階段的導劇歷程、主角改變歷程、治療改變要件與治療改變結果,並試圖建立性侵害倖存少女心理劇治療歷程初步架構。本研究以中途學校兩位倖存少女參加龔鉥導演的性侵害心理劇治療,擇取心理劇治療歷程中的演出階段之錄影帶、錄音帶資料轉錄成逐字稿進行資料分析。另以訪談法收集兩位少女在心理劇治療後立即治療結果、一週治療結果及一個月後治療結果之訪問逐字槁加以整理,再依紮根理論原則進行導演導劇歷程、主角改變歷程、治療改變要件及治療結果之分析。最後以故事線、流程圖及分類表呈現研究結果。研究結果發現:導演導劇歷程分為導演導劇步驟與導演介入技巧。心理劇治療導劇步驟共分為建立連結、暖身/社會關係調查、重建創傷景、治療景、自我整合對話景及結束等六項。導演依據導劇步驟介入技巧有四類:第一類是傳統已知的心理劇技巧;第二類為心理劇輔助技巧;第三類則藉助一般談話性心理治療的技巧;第四類技巧則為龔鉥獨創技巧。主角改變歷程共分為自我揭露期、自我分列期、自我改變期、自愛期四個階段。導演導劇歷程治療改變要件分別是建立安全的同盟關係、拯救內在小孩群組、身體復愈群組、自我概念重整群組與性侵害受創自我之接納與整合等五個治療改變要件。心理劇工作坊後治療結果分佈在生理/身體、情緒、認知、自我、人際/社會及行為等六個範疇。本研究根據兩位個案資料形成倖存少女心理劇治療歷程初步架構,並依據研究結果提出建議,以作為未來研究與諮商實務工作者之參考。

The purposes of the study were to analyze the psychodrama process, protagonist change process, effective change components and outcomes of psychodrama on two sexually abused female adolescents and to construct an initial framework of psychodrama. The study involved two alternative-school adolescents from southern Taiwan who have gone through Gong Shu’s psychodrama theater. The participation processes of two subjects in the psychodrama were videotaped and transcribed verbatim. The data were analyzed based on grounded theory. In-depth interviews about immediate outcome, one-week follow-up, and one-month follow-up after the psychodrama session were conducted in each of the two cases. The results were presented by using story-line, flowcharts, and category tables. There were four main findings in this study: The psychodrama process was divided into directing procedures and directing intervening skills. The directing procedures passed through six following procedures in the psychodrama enactment stage, included building affiliation; warm-up/investigating history of sexual abuse; rebuilding the scene of sexual abuse; therapeutic work; dialogue with vulnerable self; and closure. The directing intervening skills included four groups of skills. These were traditional psychodrama skills, auxiliary skills, ordinary therapy skills, and Gong Shu’s creative skills. The protagonist change process involved four stages: self-disclosure, self- dichotomy , self-change, and self-love. The five effective change components of the psychodrama process included the following: building safety affiliation; rescuing inner child; body work; modifying of self concept; and accepting and integrating of vulnerable self caused by sexual abuse. The outcomes shown in the two cases immediately, one-week, and one-month after the psychodrama concerned six areas: physical/somatic, emotional, cognitive, self, behavioral and interpersonal/social. Based on the results of this study, suggestions for future research and psychodrama practice were provided.

中文摘要 英文摘要 第一章緒論1 第一節研究動機與目的2 第二節名詞釋義4 第二章文獻探討6 第一節心理劇基本概念、理論、實務應用與相關研究6 第二節性侵害倖存少女相關治療理論、實務與研究23 第三節性侵害倖存少女心理劇治療理念、工作方式與改變歷程之文獻探討35 第三章研究方法46 第一節研究方法的理論基礎46 第二節研究參與者50 第三節研究工具55 第四節研究步驟57 第五節資料分析方法61 第四章結果與討論67 第一節兩位性侵害倖存少女在心理劇導演導劇與主角改變之共同歷程67 第二節兩位性侵害倖存少女在心理劇治療改變之共同要件99 第三節兩位性侵害倖存少女心理劇治療結果120 第四節兩位性侵害倖存少女在心理劇治療歷程與治療結果之個別差異152第五章結論與建議157 第一節研究發現與討論157 第二節研究限制168 第三節 建議170 參考文獻174 附 錄 次 附錄一參與研究同意書183 附錄二資料發表同意書184 表 次 表2-1 常用的心理演劇技巧及其定義與功能17 表2-2 特別技巧與一般技巧的關係表18 表2-3 不同的性侵害行為所影響的受害等級(陳若璋,民89)24 表2-4 常見的性困難一覽表(Schover et al,1980;Dale, 1993)26 表2-5 不同學者對性侵害治療效果範疇之觀點一覽表31 表2-6 倖存者於復原過程之效果32 表3-1 主角基本資料52 表3-2 主角過去性侵害受害背景資料52 表3-3 研究者心理劇學習時數及受教之心理劇老師學、經歷簡介53 表3-4 協同研究資料分析者學、經歷及背景一覽表54 表3-5 導演協助者學、經歷及專業相關訓練一覽表54 表3-6 理論範例:資料收集與分析的關係62 表4-1 導演導劇步驟分類表67 表4-2 導演介入技巧分類表69 表4-3 主角改變歷程分類表70 表4-4 建立內在小孩景之心理劇介入技巧一覽76 表4-5 導演導劇步驟、主角改變歷程與導演介入技巧在”治療景” 之對應表現對照表78 表4-6 言語激勵技巧一覽表79 表4-7 情緒宣洩技巧一覽表81 表4-8 與自我/父母/加害者對話景之部分技巧一覽表84 表4-9 不同學者對心理劇治療性侵害倖存者歷程一覽表91 表4-10 治療改變要件分類系統99 表4-11 性侵害治療之治療改變要件一覽表115 表4-12 Hudgins和龔鉥性侵害倖存者心理劇治療之治療改變要件比較 表116 表4-13 性侵害倖存少女心理劇治療歷程(導演導劇步驟、治療改變要 件、導演介入技巧)初步架構117 表4-14 心理劇治療結果分類表120 表4-15 兩位主角治療結果範疇在不同時間點變化情形一覽表122 表4-16 心理劇治療前後之治療結果改變範疇一覽表122 表4-17 心理劇治療在生理/身體範疇上之立即治療結果、一週後治療 結果及一月後之治療結果124 表4-18 心理劇治療在情緒範疇上之立即治療結果、一週後治療結果 及一月後之治療結果126 表4-19 心理劇治療在認知範疇上之立即治療結果、一週後治療結果 及一月後之治療結果129 表4-20 心理劇治療在自我範疇上之立即治療結果、一週後治療結果 及一月後之治療結果134 表4-21 心理劇治療在行為範疇上之立即治療結果、一週後治療結果 及一月後之治療結果137 表4-22 心理劇治療在人際/社會範疇上之立即治療結果、一週後治療 結果及一月後之治療結果138 表4-23 兩位主角在創傷後壓力症候群中的變化情形一覽表149 圖 次 圖2-1 Hollander心理演劇曲線圖12 圖2-2 Goldman& Morrison心理演劇歷程螺旋圖13 圖2-3 Schramski心理演劇系統模式流程圖14 圖2-4 Kipper的心理演劇團體結構14 圖2-5 演劇階段的內在結構15 圖2-6 性侵害倖存者復原過程 (Hung,2000)31 圖3-1 資料分析流程62 圖4-1 導演導劇歷程87 圖4-2 主角改變歷程89 圖4-3 性侵害心理劇治療曲線91 圖4-4 督脈經穴圖94 圖4-5 主角改變流程圖(趙如錦,民89)96 圖4-6 “建立安全的同盟關係”治療改變要件之資料分析101 圖4-7 “接觸性侵害記憶”治療改變要件之資料分析102 圖4-8 “建立內在小孩連結”治療改變要件之資料分析103 圖4-9 “拯救內在小孩/身體力量體驗”治療改變要件之資料分析104 圖4-10 “身體創傷記憶處理”治療改變要件之資料分析106 圖4-11 “身體新記憶培植”治療改變要件之資料分析108 圖4-12 “性侵害受創自我之認知重整”治療改變要件之資料分析109 圖4-13 “情緒宣洩”治療改變要件之資料分析110 圖4-14 “關係暖化”治療改變要件之資料分析111 圖4-15 “性侵害受創自我之接納與整合”治療改變要件之資料分析113 圖4-16 情緒的波動狀態144 圖4-17 記憶之循環147 圖4-18 自我界限陳述的連續層次圖148 圖5-1 性侵害倖存少女心理劇治療結果分析圖160 圖5-2 性侵害倖存成人心理劇治療歷程與效應分析圖161 圖5-3到圖5-7 性侵害治療復原過程之比喻連續圖列165

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