正向心理學對於毒品處遇應用之探討

The Application of Positive Psychology to Substance Abuse Treatment

近年來藥物濫用問題日益猖獗，使用非法藥物的人口也日益增加，毒品已成為當前台灣社會的嚴重問題。2003年因非法使用藥物遭起訴的毒品犯有14,974人，2016已增至50,179人，人數增加3倍之多；另根據台灣法務部專題報告，2013年新收10,434名在監毒品犯中，有76.7%有毒品前科（台灣法務部法務統計資訊網）。換言之，逾四分之三以上的毒品犯有再犯情形。面對如此高的犯罪率與再犯率，如何找到毒品使用的問題癥結並對問題採取有效的戒治作為已是當務之急。非法藥品的施用與復發，其危險因子有很多是與負向情緒、壓力，以及缺乏正向因應壓力的技巧有關，正向心理學的作用在於促進個人正向的情緒，適可評估做為毒品戒治處遇的另一種選擇。據過去許多實證研究顯示，正向心理學相關元素，如表達感恩、回想三件好事、發掘自我的長處及增進自我效能等，對於不同年齡層之心理健康及幸福感均有增進的效果，近年來各國矯正機構也逐漸對這些以發掘優點為根基的處遇模式產生興趣，並且開始在藥癮處遇中融入正向心理學的一些原則，如增進藥癮者正向情緒、教導因應壓力與困境的技巧以及強化自我效能等，以避免藥癮者以藥物來紓解情緒及壓力，影響處遇的成效。正向心理學及其相關概念，例如正念、瑜珈以及優活生活模式（good life model）等，在毒品矯治處遇的運用上尚屬起步階段，相關系統性及縱貫性的研究仍有不足，目前研究以歐美國家居多，亞洲國家則尚乏相關資料。鑑於融合正向心理的處遇設計迄今仍無一致性的指標，課程的長度、內容及方案設計等亦尚無一定的標準，期待有更多的專家及資源能投入研究，讓處遇的內容更符合事實之需，也更具實際效益。 A drug-abuse problem has been rampant in recent years and is an important concern for society in Taiwan. The population involved in illicit drug use is increasing dramatically. In the year 2003, 14,974 persons were indicted with the offense of illicit drug use, while in 2016, 50,179 persons were indicted with drug using offense. Indictments in 2016 were more than three times that of 2003 indictments. According to a special report from the Ministry of Justice in Taiwan, among the 10,434 newly incarcerated drug offenders in 2013, 76.7% of them had a previous history of conviction in drug offenses. In other words, more than four thirds of the drug offenders recidivated and were re-arrested. With such a high offending and recidivism rate, there is an urgent need to understand what elements involved in the treatment are beneficial to individuals' recovery from substance abuse. Negative emotions, stress, and the lack of positive stress-coping skills are clearly related to illicit drug use and relapse. Empirical studies have found that the elements in positive psychology interventions-e.g., recalling three good things per day, and developing self-strength and self-efficacy- can improve one's mental health. In recent years, clinicians and researchers have started to incorporate positive psychology principles into treatment to help rehabilitate ex-offenders and ex-drug users. The application of positive psychology and related concepts (e.g., mindfulness, Yoga, and good-life model) to substance abuse treatment is still in its initial stages. Systematic studies with longitudinal data are not sufficient. Most of the existing studies have been conducted in Western countries, and empirical studies in Asian countries are rare. Currently, there is no standard operation and practice in positive psychology interventions. Moreover, there are no guidelines in terms of course design. Thus, from case to case, the length and content of the related courses may vary. There is a need for more studies that examine how program design in positive psychology intervention can benefit the treatment of drug abusers.