門診精神官能症患者團體心理治療早退因素探討

FACTORS ASSOCIATED WITH DROPOUT FROM GROUP PSYCHOTHERAPY WITH NEUROTIC OUTPATIENTS

目的：透過回溯性資料分析，進行門診精神官能症患者團體心理治療早退因素之探討。 方法：依Gilbert M（1994）之定義，出席次數少於療程三分之二者為早退者，並以89年10月25日至91年9月11日參加門診團體心理治療精神官能症之病患為研究對象，共72名個案（第一年38名，第二年34名）針對評估變項進行描述性統計、卡方檢定、t-檢定及對數回歸分析。 結果：比較31名早退（dropout）組及41名非早退（non-dropout）組後發現，兩組在性別、年齡、教育程度、婚姻狀態及診斷別，使用藥物與否，用藥種類，參加團體型態方面均無統計差異，但早退組有較高之比例參加治療時有職業（p=0.016），非早退組多為自助團體志工轉介支持者（p=0.000）。 結論：自助團體志工之轉介支持或夜間假日開辦團體治療門診，有助於成員持續參加團體，減少早退現象。

Objectives: Attempts to determine the characteristics of those individuals who drop out from outpatient group psychotherapy by retrospective data analysis. Methods: In this two-year study, the first year group was non-structured and open; the secondary year was semi-structured and semi-open. Clinically depressed or anxious patients who completed a course of brief group psychotherapy(10-12 sessions) in outpatient settings were compared with those who failed to complete treatment. For the purpose of our research, dropouts were considered to be those individuals who attended fewer than two-thirds of the therapy sessions. On this basis, 41 subjects completed therapy and 31 were dropouts. Results: The two groups were examined on demographic and clinical variables. Analyses of variance indicated that there were no differences between the dropouts and completers on age, gender, educational level, marital status, diagnostic category, medication condition and types of group. But the dropouts were significantly more likely to be on job on group psychotherapy session (p=0.016), and less referred and support by volunteers of self-group (P=0.000). Conclusion: Providing outpatient group psychotherapy at night or on holidays or encouraging active participation of volunteers of self-help group in group psychotherapy would be important factors to prevent or reduce early dropout.