精神疾患家庭之未成年子女的預防介入策略初探

Preventive interventions for children of parents with mental illness: A preliminary study

背景：當父母有情緒困擾或是精神疾病時，面對學齡期兒童與青少年的發展需要，往往無法理解與提供足夠的支持與照顧；同時，年幼兒童更可能面臨無法自我照顧的窘困。有鑑於兒童少年發展的不可回逆性，面對未成年子女在父母罹患精神疾病的家庭成長，及早家庭預防介入是必要的。目的：精神疾患家庭介入強調「準備」是事前連結最重要的關鍵，重視選擇性的預防介入。方法：透過文獻回顧的文本資料分析，以家庭風險與家庭互動研究為取向，強調精神疾患家庭介入的服務輸送流程設計，應將學校社工、教師、身心科門診醫護人員、精神科社工、心理師以及諮商輔導師納入跨專業服務團隊，協助兒童少年準備與發展因應精神疾病的技巧。結果：針對未成年子女處於父母有精神疾病之家庭，本文建議介入工作流程包括：（一）評估與建立基本的處遇計畫，（二）專業工作者之間建立合作網絡，協助兒童少年情緒適應與支持、（三）與精神疾患父母合作，支持教養與互動相關操作的練習與協助、（四）協助兒童少年因應準備與自我照顧能力的提升、（五）連結其他資源，協助解決經濟、藥酒癮等相關問題，以促進兒童與青少年發展。

Background: Children of parents with mental illness (COPMI) can experience insufficient care and support and are likely to be neglected or even abused. Purpose: Based on the needs of child and adolescent development, preventive interventions from a family-resilience perspective are suggested. In this approach, preparation is the most important concept for improving children's and family's response to risks caused by parental mental illness. Methods: A review of the literature is the method adopted in this paper to acquire an understanding of the topic. Results: In this paper, an interdisciplinary team model is used to create a framework to help COPMI and families develop coping skills. This includes the provision of services such as parenting support, education of children about mental illness, family conferences and so on. In cases of parental mental illness, a focus on prevention of future problems and family-focused practice in mental health are essential for building child and family resilience.