婚姻治療中賦權使能的歷程：一病態嫉妒個案的經驗

The Process of Empowerment in Couple therapy: Experiences of a Case of Morbid Jealousy

本文的目的在於探討婚姻治療中增益個案能力，即賦權使能的歷程。認為治療同時是達成治療目標和賦權使能的歷程，而此兩者是相互影響的；治療者在治療歷程中有較優勢的影響力，要如何去影響個案的內在結構，使其能力滋生是治療的核心議題。本文藉由分析病態嫉妒個案的治療內容，來探討賦權使能及達成治療目標的歷程，發現治療者的積極參與治療歷程，在與個案的互動中，在訊息層次、參與者、所討論的議題及主題、互動模式、以及各種不同程度涉入個案的姿態等各方面作選擇及回應，去開拓個案「知、情、意、行和關係」等面向的「空間」及達成治療階段任務，促成賦權使能。文中以治療內容為例來闡明介入處遇的細節，並提出賦權使能的原因為：（1）治療者的積極參與；（2）在與個案接觸時，就開始建立賦權使能的「先決條件」；（3）「構配」歷程中治療者在態度及理念上的堅持；（4）個案有轉圜的「空間」；及（5）個案更知道自己要什麼及如何去做。本文提供了對病態嫉妒個案的婚姻治療實務、治療者的權力運用、賦權使能及達成治療目標的歷程等方面的知識，希望這樣的資料能補療效研究的不足，並有助於累積特定治療模式與個案類型的治療經驗。

This research is an attempt to the process of empowerment in couple therapy. The therapy per se is seen as a process of empowerment while achieving therapeutic goals. After analyzing the contents of therapy of a case of morbid jealousy, the author notes that the therapist‘s active participating in the therapy and selecting information of feeding back to the client, contribute to enhance the flexibility of internal structure of the client. These efforts accomplish goals of therapy and empower the client. In this article, the therapist’s endeavors of intervention are illustrated by excerpts of therapy. Reasons of empowerment are suggested as: (1) the therapist’s active participation; (2) the process of empowerment begins as soon as contacting with the client, at that time the therapist starts to establish the antecedent conditions of empowerment; (3) the therapist and clients are in the process of ‘structural coupling’, so the therapist’s persistence of some attitudes and concepts might be able to induce clients’ accommodation; (4) when there is flexibility of internal structure, clients are able to rethink, to share the feelings, to be motivated, and to re-decide; and (5) clients know what they want and how to do.