表達性藝術治療運用於華人文化下乳癌婦女團體方案介入之要素探究

Essential Elements of Group Intervention for Chinese Women with Breast Cancer Using Expressive Arts Therapy

本研究旨在探討表達性藝術治療運用於華人文化下乳癌婦女團體方案設計之要素，包含影響團體發展之脈絡、方案介入及成效。採取質性研究的現象學觀點，透過個別與焦點團體訪談，探討乳癌婦女團體成員和帶領者在表達性藝術治療團體中之經驗。結果顯示：（1）影響團體運作脈絡有：「華人女性多重角色與犧牲奉獻的特質」、「團體成員病程相異促進交流」、「成員出席受家庭與生理因素之限制」、「疾病的不確定性促進團體動力」；（2）表達性藝術治療介入和效果有：「多元表達形式中回到當下體驗」、「圖像視覺化能再度關注自我意象」、「隱喻破除社會框架緩衝焦慮」、「非語言溝通產生共鳴」、「可控性找回自我能力感」、「再建構轉化生命態度」、「跨越時空與角色交換擴展視框」、「作品保存見證改變」；（3）華人乳癌病友團體帶領方向：「帶領者去專家化」、「團體成為訊息分享平台」、「從乳癌談及自我概念」、「重要議題為家庭、親密關係、失落、自我照顧」；（4）方案成效為促進成員「內在覺察與整合」以及「人際間表達與連結」。最後，依據研究結果提出討論，並提供後續方案設計參考。

This study aimed to explore the intervention plan, mediating factors, and effects of expressive arts therapy for the group work for women with breast cancer in Chinese culture. Using qualitative methods as well as individual interviews and focus groups, we tried to understand the experiences of members and leaders in an expressive arts therapy group for women with breast cancer. The results showed: (1) The factors mediating the group work are “multiple roles and the self-sacrificing and devoting trait of Chinese women,” “differences in the illness process promoting member interaction,” “member attendance restricted by family and physiological reasons.” and “the uncertainty of illness promoting group dynamics.” (2) The characteristics of the intervention plan are “turning to the present using diverse forms of expression,” “re-focusing on self-image by image visualization,” “breaking social framework and buffering anxiety using metaphors,” “creating resonance by non-verbal communication,” “finding self-efficacy in controllability,” “reconstructing lift attitude for transformation,” “expanding perspectives across time and space in role reversals,” “keeping artwork to witness changes.” (3) Suggestions for leading groups for Chinese women with breast cancer: “leader taking a non-expert stance,” “using the group as a platform for sharing information,” “using breast cancer to talk about self-concept,” “important issues including family, intimate relationships, loss, and self-care.” (4)The effects of the intervention plan are promoting members “to gain inner awareness and integration” and “to express and connect interpersonally.” Finally, discussions based on these results and intervention plans for future work were provided.