嚴重精神病人參與音樂創作團體的療癒歷程

The Healing Process of People with Severe Mental Illness in Music-creating Group

背景：嚴重精神病人是一群沒有聲音且被汙名化的弱勢團體，音樂創作團體乃透過填寫歌詞、改編歌詞，或作曲，以便讓病人投射於日間留院接受復健訓練的歷程。目的：探究嚴重精神病人參與音樂創作團體的療癒歷程。方法：通過某精神專科教學醫院人體試驗委員會審查後（TCHIRB-1030502），以參與觀察方式，探討以賦權、創作、同質原理及轉移原理為設計理念的音樂創作團體，在激發病人覺醒的同時，鼓勵集體參與、對話、反思，將復健訓練轉化為歌曲的創作，並錄製成CD出版，為精神復健歷程留下紀錄與聲音。自2014年5月5日至12月30日，每週一次，共32次，每次90分鐘，透過26位病人的心得感想、每週上課團體紀錄、創作歌詞與脈絡及研究日誌等收集資料，進行內容分析。結果：嚴重精神病人參與音樂創作團體的療癒歷程：1、回憶過去生活經驗。2、覺察發病的症狀與行為。3、發展對應抗精神病藥物副作用―代謝症候群的認知及行動。4、與病共存，帶病生活。5、引發自主生活力。而影響療癒歷程的關鍵有四：賦權的應用、歌曲的創作、同質原理（Iso Principle）及轉移原理（Diversion）的應用。實務應用：透過音樂創作團體的投射，有助於嚴重精神病人的發聲及主體意識的發展。

Background: People with severe mental illness are a disadvantaged group which can't voice and be stigmatized. The music-creating group project the process of rehabilitation in the hospital during the daycare via filling in lyrics, adapting lyrics, or composing. Purpose: To explore the healing process of people with severe mental illness participating the music-creating group. Method: After the examination by the psychiatry hospital IRB (TCHIRB-1030502), and use the observational way to explore the music-created group which empowering, creating, and using Iso Principle and diversion. When stimulating patients awakening, also encourage them to join, to communicate, to reflect, and let the rehabilitation become a creations of music. Moreover, record it to CD and publish. These are all for the records and voices of spirit rehabilitation. From 2014/5/5 to 2014/12/30, once a week , total 32 times, and each time they spent 90 minutes. Analyze contents and gather information via 26 patients' feedbacks, group class records every week, creations of lyrics, and contexts of studying diaries. Result: The healing process of people with severe mental illness who joining the musiccreated group. First, recollecting past life experiences. Second, perceiving symptoms and behaviors of pathogenesis. Third, developing the way to cope with antipsychotics side effect-cognitions and actions of metabolic syndrome. Forth, living with diseases. Fifth, cultivating independent viability. Furthermore, there have four key points to influence the healing process: empowerment, creative, Iso Principle, and diversion. Application: It's helpful to make severe psychiatric patients voice and develop consciousness by projecting the music-creating group.