臺灣精神醫療機構心理劇發展回顧

Review of the Development of Psychodrama in Mental Health Institutions in Taiwan

本文將回顧臺灣精神醫療機構推展心理劇的歷程，1974年11月由臺大醫院精神科陳珠璋教授帶領醫療團隊組成自我訓練小組，1975年4月開啟心理劇治療的序幕，至今己將近50年了。整個歷程依參與的機構數及聯合訓練方式分為五個時期：第一期（1974-1980）：2家醫院分別每週提供一次心理劇，兩家醫院各自每週舉辦一次自主訓練研習會，來培育心理劇導演。兩院也聯合辦理訓練研習會；第二期（1980-1984）：新增3家醫院提供心理劇治療，這5家醫院的成員聯合訓練研習會每月舉辦一次；第三期（1984-1987）：再新增6家醫院，使心理劇推展至全臺灣北、中、南部都有醫院提供心理劇。這11家醫院聯合訓練研習會改為每年舉辦4次；第四期（1987-1994）：再新增5家醫院提供心理劇，這16家醫院聯合訓練研習會仍維持每年舉辦4次；第五期（1994-2021）：再新增3家醫院提供心理劇治療。由於1994年成立「中華團體心理治療學會」及2010年成立「臺灣心理劇學會」，原有聯合訓練活動至2002年停辦，由學會來承接訓練活動。精神醫療機構在推展心理劇也遇到一些困境，如：各醫院人力配置低標、健保費給付、導演培育及醫事人力異動等因素，導致部份醫院停止心理劇。建議未來由心理劇學會提供良好的導演的培育計畫與資格認證、心理劇團隊組成的調整、增加門診治療對象及治療費合理的調整等，讓精神醫療機構能夠持續提供心理劇治療以造福病人。

This article reviews the history of promoting psychodrama in the mental health institutions in Taiwan. It has been almost 50 years since Professor Chu-chang Chen organized a group of self-training psychodrama for his medical team at Psychiatric Department in National Taiwan University in November 1974. Such a history can be categorized into five phases based on the time when different institutions joined and the way how trainings were handled. Phase I (1974-1980): Only two hospitals joined and provided weekly psychodrama, with each one held its own self-training seminar once a week to train their drama director. These two hospitals also conducted seminars of joint training. Phase II (1980-1984): Three more hospitals joined and provided weekly psychodrama. These five offered the seminars of joint training once a month. Phase III (1984-1987): Six more jointed, with psychodrama services offered throughout to the north, central, and southern parts of Taiwan. These eleven hospitals offered the joint training seminar four times a year. Phase IV (1987-1994): Five more joined, and all of them held the joint training seminars four times a year. Phase V (1994-2021): Three more joined to provide psychodrama. During this period, two associations got established, the Chinese Association of Group Psychotherapy in 1994, and the Taiwan Association of Psychodrama in 2010. At this time, the old format joint training activities were held regularly only up to 2002. Then it got undertaken by the two associations afterwards. This change was due to some difficulties encountered by the mental health hospitals, such as: the shortage of the hospital manpower, the premium payment from the health insurance, the training of a new psychodrama director, the change of medical personnel, and some other related factors, that forced some hospitals to stop their psychodrama service. Therefore, some suggestions offered for the future development include, Taiwan Psychodrama Association needs to bear more responsibilities to train psychodrama director, as well as to verify the director’s qualification if via recruiting. Moreover, reviewing the members of the psychodrama team, increasing the number of outpatient treatment, and rationalizing the treatment cost are also important. Only by doing so, the mental health hospitals could continue to provide psychodrama, pursuing its goal for the benefit of patients.