不同治療取向慢性精神病患團體治療性和反治療性因素之探討研究

本研究之目的在探討不同治療取向團體的團體治療性和反治療性，並進一步瞭解各個因素在不同治療取向團體和不同時間點的變化情形。本研究係以國內某精神醫療機構內罹患慢性精神分裂病的女性病人為研究對象，病人皆為自願參加病房心理師帶領的不同治療取向團體之成員，其中「服藥訓練團體」有六人進行八次團體，「藝術治療團體」有八人亦進行八次團體。兩組成員在年齡和住院環境上並沒有明顯差異。本研究用來評估治療性和反治療性因素的評估工具為林美珠、王麗華（民87）所編訂的「團體治療性因素量表」和「團體反治療性因素量表」。為了解兩個團體在不同時間點團體治療性和反治療性因素上的變化情形，本研究分別選定在第三（初期）、第六（中期）和第八次（末期）團體結束時，進行兩個量表的評估。本研究的結果顯示：1）「認知教育性團體」較「情緒表達性團體」提供較多治療性因素，但也容易產生較多反治療性因素。2） 「認知教育性團體」與「情緒表達性團體」在不同的時間點呈現的治療性因素與反治療性因素的改變情形並不相同。最後研究者依據本研究的結果提出建議。

Objective: This study attempted to explore the therapeutic and anti-therapeutic factors from different group approaches and to explore further their changing figures via different group approaches and different time. Methods: All subjects were chronic schizophrenics and come from the same chronic psychiatric hospital in Taiwan. There were six patients participated in the ''drug-compliance training group'' and eight participated in the ''art-therapy group.'' Each group had 8 sessions. There were no differences in age and residential environment between these two groups. The therapeutic and anti-therapeutic factors were assessed by two scales developed by Meei-Ju Lin & Li-fei Wang (1998) at the third, the sixth and the eighth session accordingly. The Group Therapeutic Factor Scale includes 57 items to assess 8 therapeutic factors and The Group Anti-therapeutic Factor Scale includes 63 items to assess 6 anti-therapeutic factors. Results: There were two main findings in this study. Firstly, the ''cognitive-educational approach'' showed more therapeutic and anti-therapeutic factors than the ''emotional-expressive approach'' did. Secondly, the changing figures of therapeutic and anti-therapeutic factors at different time from the ''cognitive-educational approach'' and ''emotional-expressive approach'' groups were not alike. Conclusions: For chronic schizophrenics, the ''cognitive-educational approach'' and ''emotional-expressive approach'' groups each had their own strengths and weaknesses from the perspective of therapeutic and anti-therapeutic factor.