多軸向自我傷害危機處理能力評量之工具建構

Development of the Multi-dimensional Self-injury Crisis Intervention Competencies Scale

研究目的：鑑於近年國內自殺通報量居高不下，自我傷害的危機介入成為專業助人者必備能力。本研究旨在建立一套可供助人專業實務工作者使用之危機處理能力自我檢核量表，期望透過自我檢核結果，促進工作者危機處理專業知能的成長。研究方法：透過危機介入理論的文獻回顧，以及採納危機處理及測驗編製領域專家的建議，我們建構出此量表的題項。量表初稿共90題。透過網路問卷調查，蒐集心理、諮商輔導、社會工作相關科系畢業，並在三年內曾進行過自我傷害個案危機處理實務經驗之助人工作者的回覆。我們首先使用120名受試者的資料進行項目分析和探索性因素分析後，形成50題之版本。在第二階段，我們採用127份資料進行驗證性因素分析以及模式修正後，共保留25題，據以建構量表信效度。研究結果：本量表的七個分量表Cronbach’sα係數介於.78至.91之間，全量表Cronbach’sα係數為.95。全量表的折半信度為.89，七個分量表的折半信度介於.81至.90之間，組成信度則介於.81至.91之間。研究結論：正式版本危機處理能力量表包含七個軸向：（1）建立關係、（2）危機評估與脈絡探詢、（3）情緒支持與處理、（4）具體行動計畫探討、（5）資源連結與系統諮詢、（6）追蹤與評估，以及（7）自我調適與專業成長。最後，研究針對量表之實務應用與未來研究等進行相關討論與建議。

Purpose: Suicide attempts have been increasing in Taiwan. Self-injury crisis intervention has become a necessary competency for professional practitioners. We develop a scale for professionals to use during crisis intervention. Methods: The items comprising the scale were developed through a literature review of crisis intervention theories, and input from experts in crisis intervention and scale development. The first draft of the scale included 90 items. We collected online responses from practitioners who had graduated from departments of psychology, counselling, or social work with experience in self-injury crisis intervention in the past 3 years. We first conducted item analysis and exploratory factor analysis with data from 120 participants. Fifty items were retained. In the second stage, we used data from 127 participants to conduct confirmatory factor analysis and model modification. A total of 25 items were retained. We tested reliability and validity. Results: The Cronbach’s α of the 7 subscales ranged from .78 to .91. The Cronbach’s α of the overall scale was .95. The split-half reliability of the overall scale was .89. The split-half reliability of the 7 subscales ranged from .81 to .90, and the composite reliability of the 7 subscales ranged from .81 to .91. Conclusions: The formal scale (MD-SCIS) consists of 7 subscales: (1) building a relationship, (2) crisis assessment and context inquiry, (3) emotional support, (4) specific action plan, (5) resource linkage and systematic consultation, (6) follow-up and estimation, and (7) self-regulation and professional development. Based on the results, we recommend practical applications and research implications.