大學生對認知治療團體之重要事件知覺分析初探

College Students’ Perceptions of Important Events in Cognitive Group Therapy

認知治療團體對於憂鬱的療效已被許多量化研究所驗證，其療效因子的內涵也經由一些質性研究被提出， 本文試圖進一步針對實際實施於我國憂鬱傾向大學生時會發生的現象及團體歷程進行探索，因此本研究的目的 為：(1)探索我國大學生參與認知治療團體時經驗到的重要事件知覺；(2)探索帶領我國大學生參與認知治療團體 的領導者其經驗到的重要事件知覺。希望研究結果能建立起治療者與被治療者之間的橋樑。 研究方法係以諮商歷程研究法，根據團體實際進行的錄音稿，並於團體的前、中、後期訪談團體成員，以 了解依據Beck 的認知治療團體所設計的治療方案用於我國憂鬱傾向的大學生時，所呈現的現象，及其對團體 的知覺。研究結果分為團體成員及領導者重要事件知覺，如下：（一）團體成員的重要事件知覺有1. 初期覺得 團體的進度過於緩慢；2. 學習認知改變時把內在歷程視覺化效果較佳；3. 學習到改變情緒的責任掌握在自己手 上；4. 在調整想法時會質疑”平衡性想法”技巧的可行性；5. 團體中的互動本身就有支持改變的效果；6. 回家 作業的實際操作是重要的。（二）團體領導者的重要事件知覺有: 1. 成員在團體初期對於區分情緒及想法是有困 難的；2. 「停格」是找出「想法」的重要步驟；3. 駁斥負向的自動化想法需要其他團體成員的協助；4. 結束 後的實作才是改變的開始。

Cognitive group therapy has been found to be effective for treating depression， and related therapeutic factors have been examined. This study explored perceptions in the change process among cognitive group therapy participants in Taiwan， which included (1) participant perception of cognitive group therapy， and (2) therapist perception when conducting cognitive group therapy. Five college students with self-reported depressive symptoms participated in an 8-session cognitive group therapy. Each session was videotaped， and the therapist and each group member were interviewed at the beginning， middle and end of the treatment course. The transcripts were analyzed using process analysis methods. Results showed that clients perceived the following as important: (1) slow group process in the beginning; (2) visual representation of their thought process， including rating moods and writing down thoughts on the board were very helpful; (3) taking personal responsibility for changes in therapy was critical; (4) the feasibility of “balanced thoughts’ was challenging to changing cognition; (5) connection and alliance among group members were important to changes; and (6) homework and practices were important. Group leaders perceived the following as important: (1) in the beginning， members had difficulty differentiating feelings and thoughts; (2) frame-by-frame motion was important to helping members discover their automatic thoughts; (3) group members needed others to help dispute automatic negative thoughts; and (4) action plans were key to making changes.