九二一地震災區學童心理復健工作模式——以集集地區為例

本文整理九二一地震後，一心理復健工作團隊於集集鎮進行為期一年的國小學童心理復健工作。從實務中，整理出「篩檢－會報－衡鑑－處置－追蹤」的工作模式。本文針對此五階段，分述其工作內容、參與人員與使用工具、實施的結果與討論。對地災害發生之始與週年之際學童在創傷壓力反應上與生活適應上的改變情形做初探性瞭解，結果顯示地震滿月後有49.7%，而滿週年時有11%學童的創傷壓力反應需進一步評估瞭解。女生、有親人受傷者呈顯著較多症狀反應；創傷反應與憂鬱、焦慮情緖有顯著相關。地震後一學年結束時，有39.9%學童列於生活適應不良狀態。輔佐資料亦含教師評估及回饋。最後針對實施經驗，歸納結論，及試探性評估此模式。並對未來實務工作與研究方向提出建議。

A mental rehabilitation team intervened and conducted a one year multiple-scale-survey on pupils in Chi-Chi after the 921 earthquake. From the clinical experience, a five-stage model ''screen-debrief-assessment-treatment-follow up'' is developed. This study aims to explore the earthquake posttraumatic stress reactions among pupils and the effectiveness of the five-stage intervention model. Different work, participants, instruments and results were described for each of these five stages. The symptoms related to PTSD were reported by 49.70% of 457 pupils, whom had the necessity of further evaluation after one month of the earthquake. Pupils with PTSD symptoms decreased number after one year (11%). Girls and injury of relatives were more vulnerable in presenting the PTSD symptoms. Damage of house and death of family members were not significant predictors of their PTSD features. One year later, children with PTSD symptoms had significant correlation with depressed and anxious mood. Although few students fulfill the diagnosi criteria of PTSD, 39.9% percentage of pupils was assumed in maladjustment status. Teachers' reports and feedbacks were included in analyzing. The applicability and effectiveness of this five-stage model were evaluated. Positive and negative factors were analyzed. Recommendations for further clinical work and study were discussed.