創傷治療的新取向－－敘事暴露治療之發展與研究綜探

A New Approach to Treat PTSD: Review of the Development and Research on Narrative Exposure Therapy

創傷後壓力症候群是今日社會重要的公共健康問題，而長期經歷多重創傷的個體更不在少數。敘事暴露治療原先的設計理念是要服務戰亂頻仍地區的難民，特別是組織暴力、大規模暴力、種族屠殺或國家恐怖主義的受害者。敘事暴露治療結合見證治療與暴露技術，是一個短期、聚焦的個別治療取向，重點在協助個體藉由敘說暴露於創傷事件，緩解創傷後壓力症狀。本研究介紹敘事暴露治療的歷史源流、理論基礎、治療歷程，並整理敘事暴露治療的實徵研究，從研究對象、研究地點、研究設計、療程、效果測量工具、結論、建議等欄位，進行摘要與登錄，比較並說明各研究的優缺點。最後，本文提出敘事暴露治療的貢獻、限制與批評，並從多元文化的觀點看敘事暴露治療，以供有興趣的學者及實務工作者參考。

Posttraumatic stress disorder (PTSD) has become an important public health issue nowadays. Thousands of survivors suffer from multiple traumatic events over long periods as a result of organized violence, mass violence, genocide or state-sponsored violence. Narrative Exposure Therapy (NET) combines testimony therapy with exposure therapy. It is a short-term individual treatment to reduce PTSD symptoms by constructing a detailed, chronological narrative about traumatic events and it makes the clients confronting and habituating the memories of the traumatic events. This article introduced the theoretical backgrounds, rationale, treatment sessions and procedures of NET, reviewed empirical research of the currently available literature, investigating its subjects, methods, results and effectiveness. This review also presents the contribution and limitation of NET, and suggestions from multicultural perspectives.