以全球資訊網為介面之認知治療網路即時諮商研究：以憂鬱情緒當事人為例

A Study of Web-based Online Cognitive Therapy: Examples of Clients with Depressive Mood

本研究目的為瞭解以全球資訊網為網路即時諮商介面運用認知治療於憂鬱情緒當事人之經驗。本研究邀請三位女性憂鬱情緒當事人分別參與9 次、12 次及23 次網路即時諮商。研究方法以質性研究之內容分析法為主，並收集「貝克憂鬱量表第二版」分數之量化資料。研究結果發現與討論分為兩部分，1.當事人之經驗：（1）辨識自動化思考與往下想技巧有助於當事人的認知檢核，行為技術可運用於嚴重憂鬱情緒之當事人；（2）認知治療網路諮商對中度憂鬱情緒當事人A 與當事人B 之憂鬱情緒減緩有所助益，對重度憂鬱情緒當事人C 則具支持作用。2.諮商員之經驗：（1）文字溝通能清楚呈現當事人的想法與認知歷程，有助於介入策略的實施；（2）諮商內容紀錄可作為家庭作業素材，亦有利督導；（3）表情符號功能有助於諮商員掌握當事人的情緒狀態；（4）資料傳輸功能有助時間規劃與不良功能認知紀錄表等介入策略。最後再提出具體建議，供網路諮商實務工作者與未來研究參考。

This study aimed at understanding the client experience when cognitive therapy for depression was applied via in-vivo counseling through world-wide web. Three female clients with depressive mood were invited to participate in 9， 12， or 23 on-line counseling sessions. Qualitative methodology was used and content analysis was applied. Data from the Beck Depression Inventory (2nd Edition) were also collected. Results are reported and discussed in two sections. 1. Client experience: (1) identifying automatic thoughts and downward arrow techniques were helpful for clients to evaluate their cognitions; behavior techniques could be used for clients with severe depressive mood. (2) web-based online cognitive therapy helped reduce the depressive mood of client A and client B who had mild depressive mood， and helped provide support for Client C who had severe depressive mood. 2. Counselor experience. (1) Communicating through words helped clients clearly recognize their thoughts and cognitive journey， which was helpful for implementation of intervention strategies; (2) Records of counseling content could be used for homework assignment and for clinical supervision; (3) emoticons could help counselors grasp clients’ emotional states. (4) data transmission functions could help session time planning and introducing intervention strategies such as attaching record of dysfunctional cognitions. Finally， practical suggestions were provided for future research and practice of web-based counseling.