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研究生: 張娟鳳
Chang Chuan-Feng
論文名稱: 短期心理諮商的效能因素與工作同盟之研究
The Study Of Effective Factors And Working Alliance Of Short-Team Counseling
指導教授: 吳武典
Wu, Wu-Tian
文榮光
Wen, Jung-Kwang
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
畢業學年度: 87
語文別: 中文
論文頁數: 共165頁
中文關鍵詞: 人際困難短期心理諮商效能因素工作同盟人際過程回憶法過程研究
英文關鍵詞: alliance, effective factors, short-team counseling, Interpersonal Process Recall, interpersonal conflict, counseling process
論文種類: 學術論文
相關次數: 點閱:387下載:26
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  • 本研究旨在探討人際困難個案接受短期心理諮商的人際內涵與結果,諮商過程中「效能因素」與「工作同盟」的階段分析及二者之關聯情形。

    研究執行二十個月期間,針對九個有效個案,進行一百次個別諮商與三十四次事後訪談,並實施三種量表與「晤談感受量表」的前後測。事後訪談以「人際過程回憶法」搜集「效能因素」資料,以深度訪談搜集「工作同盟」資料,訪談內容全部謄成逐字稿,質化內容分析結果得到「效能因素」有效資料三百五十三碼與「工作同盟」有效資料一百九十三碼。

    研究結果發現:
    (一) 短期心理諮商的效果呈現個別差異。
    (二) 短期心理諮商的效果有團體一致性的傾向,但工作同盟未達明顯改變。
    (三) 在效能因素的歸類架構中,本研究個案反映「引導」、「表達」的出現頻率高
    於「面質回饋」、「覺察體驗」。可驗證:在短期諮商初期,部份效果來自於「共
    同因素」。
    (四) 「給建議」是本研究個案反映在效能因素的新發現,隱含本土特徵。而三位案主特有的反應為「對諮商員的負反應」,可能與諮商員風格有關。
    (五) 效能因素整合分析結果,反映諮商員的諮商風格為認知行為與問題解決取向。
    (六) 效能因素階段分析結果,反映諮商員介入策略的應用,仍採認知行為與問題解決取向。
    (七) 工作同盟整合分析結果,反映「工作層面」的發展較「情感層面」困難。
    (八) 工作同盟階段分析結果,反映「情感層面」呈現遞增現象,但「工作層面」則無遞增或遞減現象。此外,「工作策略的一致性」在第一階段為排序最高項目,但在第四階段為排序最低項目。
    (九) 案主與諮商員建立工作同盟的方式呈現個別差異,分屬於「抗拒」、「探索」、「依賴」、「信任」等四種類型。
    (十) 案主接受諮商過程中之「效能因素」與「工作同盟」,確實有關聯現象。
    (十一)案主接受事後訪談的內容發現:在心理諮商情境中案主對於諮商員的協助
    與自己的反應存有多樣內隱訊息。
    (十二)本研究結果頗符合「工作工作同盟模式」(Bordin,1980)。

    最後,根據研究結果,研究者對於大專輔導工作的改進,諮商員風格的反省,諮商實務的應用,諮商倫理的考量,「過程研究法」的學術價值,以及未來進一步的研究,提出若干討論與建議。

    ABSTRACT

    This study aimed to investigate the interpersonal conflict issue among college students in the context of Chinese culture, and to investigate the outcome and how these clients go through the therapeutic process in the short-term counseling. It was designed to adopt an exploratory approach to study the counseling process.
    At the end of 20 months study, 9 college students with significant difficulties
    interpersonal conflict completed 12 sessions of dynamic-oriented short-term counseling. Audio-tapes were used to record data of both counselor’s and clients’ verbal content, Interpersonal Process Recall (IPR)was administered every three sessions, and the selected interpersonal episodes from the counseling transcripts were evaluated by follow-up in-depth
    interview conducted by independent raters. Content analyses were also made to assess the effective factors as well as the level and quality of the alliance. The test scores on the counseling effect and the alliance were compared between the intake interviews and the post-therapy interviews.
    The major findings were as the following : (1)In general, the outcome at the end of counseling was quite satisfactory, with majority marked improvement. (2)Among various effective factors, ‘guidance’ was remarkable that may reflect the supportive and educational-oriented connotation in the counseling relationship. (3)The general analysis of alliance showed that the working dimension was more difficult to develop compared to the affective dimension. (4)The four alliance patterns between the counselor and clients are ‘resistance’ , ’exploration’ , ’dependence’ , and ‘trustfulness’.(5)The counselor’s theoretical orientation are cognitive-behavior and problem-solving, which could be identified through IPR assessment, the validity of which could thus be appreciate. In conclusion, the preliminary finding is rather distinct and interesting from the cross-cultural perspective.

    致謝詞 中文摘要 英文摘要 第一章 緒論 第一節 研究動機 第二節 研究目的與問題 一、 研究目的 二、 研究問題 第三節 名詞釋義 一、 人際困難案主 二、 短期心理諮商 三、 效能因素 四、 工作同盟 五、 事後訪談 六、 人際過程回憶法 七、 深度訪談 八、 內容分析 第四節 研究限制 一、 結果的推論 二、 量表的編製 三、 對工作同盟的干擾 四、 質化研究的模式 第二章 文獻探討 第一節 短期心理諮商的發展 一、 短期心理諮商的涵義 二、 當代動力取向短期心理諮商的代表人物 三、 動力取向短期心理諮商的概要 第二節 諮商效能因素的研究 一、 何謂「效能因素 二、 「共同因素」與「特殊因素 三、 國內有關「效能因素」的研究 第三節 工作同盟在諮商中角色的研究 一、 工作同盟的涵義 二、 諮商初期工作同盟的形成 三、 工作同盟在諮商歷程的兩個關鍵期 四、 工作同盟的測量與未來研究趨勢 第四節 人際過程回憶法 一、 結合「發現式導向」與「重要事件」研究典範的特色 二、 發展歷史與執行要點 三、 諮商實務上的應用 第三章 研究方法 第一節 研究者的自我涉入與檢核 一、 研究者專業背景與選擇研究主題的關係 二、 研究過程中的自我反省 第二節 研究架構 第三節 研究對象 一、 諮商員 二、 案主 第四節 研究設計 一、 個案工作流程 二、 人力分配 三、 前導性研究 四、 量表的修訂與信、效度建立 五、 諮商 六、 事後訪談 七、 效能因素的內容分析 八、 工作同盟的內容分析 九、 諮商效果的評估 第五節 研究工具 一、 修訂貝爾客體關係量表 二、 諮商工作同盟量表 三、 柯氏性格量表(1994)題本 第六節 研究程序 一、 計畫醞釀階段 二、 研究前預備階段 三、 正式實驗階段 四、 量化資料分析與質化內容分析階段 五、 論文寫作階段 第四章 結果與討論 第一節 案主接受短期心理諮商的人際困難內涵與效果 一、 案主接受短期心理諮商的人際困難內涵 二、 案主接受短期心理諮商三種量表的前後測比較 三、 案主接受短期心理諮商「諮商感受量表」的前後測比較 第二節 案主接受短期心理諮商之效能因素的階段分析 一、 建構諮商效能因素的歸類架構 二、 效能因素的整合分析、階段分析與個案分析 第三節 案主接受短期心理諮商之工作同盟的階段分析與類型 一、 建構諮商工作同盟的歸類架構 二、 工作同盟的整合分析、階段分析與個案分析 第四節 案主與諮商員建立工作同盟的類型與討論 一、 案主與諮商員建立工作同盟的類型 二、 諮商員風格的反省 第五章 結論與建議 第一節 結論 一、 短期心理諮商的效果呈現個別差異,但工作同盟未達明顯改變 二、 效能因素的整合與階段分析結果,顯示諮商員的風格偏向問題解決 三、 工作同盟的整合與階段分析結果,顯示「工作層面」較「情感層面」困難 四、 案主與諮商員建立工作同盟的類型呈現個別差異 五、 大專輔導工作應用短期心理諮商的提醒 六、 本研究在諮商實務上的應用 七、 諮商倫理的考量 八、 本研究採「發現導向」的學術價值 九、 簡化「人際過程回憶法」的執行方法 十、 質化分析部份,宜增加「案主檢核效度」 第二節 建議 一、 短期心理諮商的確可達到效果,可多應用 二、 心理諮商研究設計的擴充 三、 加強心理諮商支持與教育的功能 四、 進一步探索效能因素與工作同盟的後設因素 五、 針對Luborsky的工作同盟架構進一步研究 六、 研究對象可擴展到「被性侵害者」、「臨終病人」與「中輟生」等特殊樣本群 七、 人際困難的諮商策略可轉換成溝通分析取向或團體諮商方式,進一步研究其效果之差異 八、 以「核心衝突關係主題法」進一步分析諮商內容 參考文獻 一、 中文部份 二、 英文部份 附錄 一、 短期心理諮商與事後訪談同意書 二、 謄寫事後訪談逐字稿須知 三、 諮商段落回憶問卷 四、 個案二---訪談帶逐字稿(二) 五、 訪談逐字稿整理成六個標準化問題 六、 修訂貝爾客體關係量表 七、 諮商工作同盟量表 表目次 表2 - 1 體驗諮商效能因素的主題分析 表2 - 2 各心理諮商學派共有的「共同因素」 表2 - 3 各心理諮商學派共有的「特殊因素」 表3 - 1 案主基本資料與人際困難內涵 表3 - 2 個案工作流程表 表3 - 3 訪談指南 表3 - 4 效能因素評分者間信度歸類畫記表(舉例) 表3 - 5 效能因素內容分析前後期之評分者間信度 表3 - 6 修訂貝爾客體關係量表之因素分析與內部一致 表3 - 7 修訂貝爾客體關係量表之各因素間的相關 表3 - 8 修訂貝爾客體關係量表與柯氏性格量表的相關 表3- 9 諮商工作同盟量表之因素分析與內部一致性信度 表3-10 諮商工作同盟量表之各因素間的相關 表4 - 1 個案諮商次數、主要問題、與諮商目標 表4 - 2 修訂貝爾客體關係量表前後測比較結果 表4 - 3 柯氏性格量表前後測比較結果 表4 - 4 諮商工作同盟量表前後測比較結果 表4 - 5 修訂貝爾客體關係量表前後測T分數比較 表4 - 6 柯氏性格量表T分數 表4 - 7 諮商工作同盟量表前後測T分數比較 表4 - 8 「諮商感受量表」前測與後測結果 表4 - 9 本研究諮商效能因素的歸類大綱 表4-10 諮商效能因素排序表 表4-11 諮商出現頻率最高之前三項效能因素 表4-12 個案之效能因素次數統計表 表4-13 諮商工作同盟歸類大綱 表4-14 諮商工作同盟次數統計表 表4-15 諮商工作同盟出現頻率最高與最低因素 圖目次 圖2 – 1 心理治療次數與進步百分比之相關圖 圖2 – 2 工作工作同盟的模式 圖3 - 1 本研究架構 圖3 - 2 本研究執行工作甘梯圖

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