專業助人者、大專教師與邊緣型人格違常學生的互動經驗與適應歷程之研究

The Study of the Interaction Experiences and Adaptation Process Among Borderline Personality Disorder Students, College Teachers and Helping Professionals

研究目的：探討大專校園中的邊緣型人格個案與專業助人者和大專教師的互動經驗與適應歷程，期能增進對大專校園中邊緣型人格個案互動經驗的了解，建立同理心的橋樑，提升對邊緣型人格違常學生的校園處遇知能。研究方法：採用質性研究之個案研究取向，以立意取樣選取研究對象，共訪談兩位BPD案主及其精神科醫師、心理師、輔導老師、導師共7人，以半結構之訪談指南進行深度訪談，並以質性方法分析所得資料作成結論。研究結果：從充滿反移情與情緒的互動過程中看見益處是關係能持續的重要因素，教師對BPD學生之互動知能因專家指導提升，進修與經驗累積提升心理師對BPD案主的心理治療效能，系統的支持、團隊合作的照顧，減輕BPD個案主要照顧者的壓力，系統合作對BPD自殺訊息的危機處理。研究結論：專業助人者、教師與BPD學生的互動經驗是充滿移情與反移情的歷程，因此提升雙方的系統支持至為重要。根據研究結果，提出提升BPD團隊協同與專業支持、對BPD學生提供支持性的教育環境與個別化的學習方案、BPD個案危機處理流程的建立、與未來研究之建議。

Objective: Relationship issues are often one of the core issues of Borderline personality disorder (addressed as BPD below) clients. The purpose of this study is to present the interaction experiences and adaptation process among BPD-related population in college campus such as helping professionals (the psychiatrist and counselors), teachers and the BPD students. In addition to the outcome, this study also aims to increase understanding of BPD cases, and suggest a further intervention framework of providing a better system for BPD student's adjustment in school. Method: This case study incorporated qualitative, semi-structured and in-depth interviews of the participants. The sample consisted of a diverse range of stakeholders including BPD clients and their psychiatrist, counselors, and tutors. An integrated model of prolonged engagement, triangulation and peer-debriefing was served to enhance trustworthiness. Results: The key factor for teachers and professional helpers to sustain relationships with the BPD students was personal and professional growth from counter-transference issues. Continued professional support and education was crucial to promote quality of treatment and related services. Team support effectively reduced stress of BPD students' care givers. Suicidal risk precaution would always be the first working priority in every encounter of BPD students. Conclusions: Support systems would be both important for BPD students and professional team members due to the traits of BPD pathologies and counter-transference issues. School team coordination and cooperation would raise BPD student's adjustment in campus. An individualized education plan should be provided if needed.