家屬團體模式及臨床運用

The Application of Psychiatric Family Group Models

傳統上，對精神疾病患者的服務都集中於病人本身，從各種團隊成員的工作對象，多以患者為主，可見一斑。身為患者的家屬並沒有獲得同等的服務機會，除非這些家屬也被視為案主（Ferries & Marshall, 1987）。他們的需要既沒有被重視，也沒有機會得到滿足，甚至於常被視為對病患的一個負面影響因素，因此，以正向的角度來看家屬，並善用家屬為治療的聯盟（Hatfield, 1986; Johnson, 1987），是本文的意圖，更重要是提倡以「家屬團體」的工作方式，作為協助家屬面對照顧困境的具體可行之方案。

Social Service Department Taipei City Psychiatric Center Traditionally, the interventions to mental disorders are always focus on patients, only if the families are treated as clients. In the past, most common was the mistake of blaming families for either causing mental illness or for perpetuating it in a vulnerable relative. Families were thus treated as patients rather than partners in treatment. Fortunally, the professionals have positive attitudes and working relationship with families in these two decades. Sometimes in the clinical setting, such statments by subjective interpretations as ''the family is overprotective'', ''it is a high EE family'' .... are frequently heared. Families are easily hurt by these interpretations from the professionals. In fact, families who suffering the caring burden need to be supported not to be judged. Family groups or family support programs come into helping families in this circumstance. They are useful and important for two reasons. First, family therapy. Second, there is an evidence that these approaches result in significantly improved families'difficulties. There are four general categories in family group approaches: (1) informational approaches (2) skill-training approaches (3) supportive approaches (4) comprehensive approaches. Each approach provides a clear goal of the intervetion、strengthes and limitations . In different clinical settings, there are different implements and points for attention. It will be discribed in detail. Finally,some guidelines and suggestions will be mentioned for enhancing the professionals to operate family groups.