諮商中的抗拒研究

A Qualitative Study of Resistance in Counseling

本研究旨在探討諮商歷程中個案抗拒的形成、抗拒的反應、諮商員的處理策略與技巧、以及抗拒與諮商進展的關連，以暸解諮商中抗拒的內涵，本研究採取發現式取向（Discovery-Oriented）諮商研究程序，資料分析方法參考樣版式分析風格（Template Analysis Style），針對一個大學女生接受十次個別諮商的錄音帶進行質的分析。本研究的結果有下列發現：1.本研究中個案抗拒出現的時段遍佈整個諮商過程，但主要集中在諮商中期。抗拒的出現和諮商主題有關連，重要且困難的核心主題會使個案的抗拒增加，其中以「自我」有關的主題最易產生抗拒。2.本研究中個案的抗拒形式以「抗拒覺察」最多，其次依序為「抗拒諮商員」、「抗拒表達痛苦的情感」及「抗拒回憶」，最少的是「抗拒改變」。3.本研究中個案抗拒處理的結果約有70%都有突破或進展，其中又以「抗拒改變」和「抗拒諮商員」兩種的突破比例最高，其次依序為「抗拒回憶」「抗拒覺察」及「抗拒表達痛苦的情感」。4.本研究中個案在諮商中抗拒的發展和諮商主題脈絡是並行發展的，而處理個案核心問題和處理個案抗拒反應是同時並進的。抗拒在諮商中顯示出其連續性、發展性、互動性及功能性的特徵。5.關於諮商員對抗拒現象的處理策略與技巧上，本研究則有下列發現：（1）本研究的個案無論是在諮商中哪一個段落出現抗拒，諮商員予以同理、支持與鼓勵，抗拒的突破就會增加；（2）本研究諮商員會持續地幫助個案面對抗拒，並拓展出新的主題或帶給諮商正面且深入的影響，使抗拒得以突破或進展；（3）本研究諮商員要同時使用策略與技巧，且以情感和認知介入互相輔助的多元方式來處理個案的抗拒。在本研究中，諮商員有效的處理策略和技巧包含有：策略性的引導、聯結過去相關的經驗或主題、同理與探問的交互使用、由開放探問到具體探問、保證、鼓勵與讚賞、以及立即性的回饋探索此時此刻狀態（包括口語與非口語）等。而以同理、探問、引導、面質、解釋、分析等技巧相互輔助的方式做情感和認知的介入。本研究就上述結果加以討論，並針對諮商員的訓練及後續的研究分別提出建議。

The study aimed to understand the components of resistance in counseling. Therefore, the study discussed the formation of resistance, the response of the client, the strategies and counseling techniques, and how resistance was related to counseling process.The study investigated the client auditape data through by qualitative analysis which revised from Template Analysis Style with Discovery-Oriented counseling research procedure. The findings were as followings:1) In the study, resistance of the client distributed over the counseling process, but particurlarly concentrated on the middle of the counseling. Resistance are related to counseling issue, the difficult and important core issue would increase the client resistance, among them, the issue about ”self”.2) The most popular form of clients' resistance was ”oppose to insight” (43.1%), and the followings were ”oppose to counselor” (20.7%), ”oppose to express painful feelings” (17.2%), and ”oppose to recall” (15.5%). The least ”oppose to change” (5.2%).3) By treatment, approximately 70% of the client's resistance were broken through or made progress. Most of the ”oppose to change” (66.9%) and ”oppose to counselor” (50.0%) were successfully broken through, and the followings were ”oppose to recall” (37.5%), ”oppose to insight” (32.0%) and ”oppose to express painful feelings” (30.0%).4) The development of the resistance paralleled the counseling issues. Dealing with core issue and coping with resistance were at the same time. During the process of counseling, resistance showed its characteristics including continual, developmental, interactive, and functional.5) The findings of strategies and techniques were as followings: (1) Whenever resistance appeared during the counseling process, the support and encouragement the counselor provided would increase the possibility of resovlving. (2) To break the resistance through the counselor continued to help the client to face the resistance, to explore new issue or to affect client positively and deeply. (3) The counselor had the multiple ways to resolve the resistance. By emotional and cognitive treatment interactively, the counselor used strategies and counseling technique at the same time. The effective strategies in the counseling including guiding strategically, connecting the past concerned experience or issue, empathizing and probing interactively, opened question and closed question, approval-reassurance, supporting, verbal and nonverbal immediate feedback, and etc.Suggestions were made for counselor training. Future studies were also discussed.