從多重迷走神經理論的觀點理解兒童中心遊戲治療之治

Understanding the ACT Limit Setting of Child-Centered Play Therapy Through the Lens of the Polyvagal Theory

當今，神經科學與遊戲治療的相關研究與理論概念的整合正持續蓬勃發展中。神經科學的研究發現不僅有助於解釋遊戲治療如何滿足兒童的發展需求，同時也協助遊戲治療師更加理解遊戲治療歷程中所運用的方法和基本原理。兒童中心遊戲治療的治療性設限，是遊戲治療師在臨床實務中一個重要但具挑戰性的促進性回應。進行治療性設限的過程，需要遊戲治療師對自身和兒童當下的情感狀態有所覺察，以進行共同調節。因此，充實神經生理系統運作機制的知識，如多重迷走神經理論，有益遊戲治療師增強自我覺察，並理解兒童的經驗和表達。雖然不同的諮商取向都將治療性設限作為治療的一部分，本文關注如何透過多重迷走神經理論的概念，來理解兒童中心遊戲治療取向的治療性設限。同時，本文聚焦於從多重迷走神經理論的觀點來闡述兒童中心治療性設限的基本原理，並透過案例範例深化討論。展望未來，筆者鼓勵遊戲治療研究學者與實務工作者，持續深化多重迷走神經理論對遊戲治療歷程與效能影響的探究，進而豐厚神經科學與遊戲治療領域的實徵研究。

The integration of neuroscience into play therapy research and literature continues to grow. Neuroscience research not only supports how play therapy meets the developmental needs of children but also provides explanations for the approaches used by play therapists and their rationales in the process of play therapy. The ACT limit setting of child-centered play therapy (CCPT) is an important yet challenging facilitative response for play therapists to implement in clinical practice. The ACT process requires play therapists’attunement to the emotional state of the child and of the therapists themselves. Having knowledge of polyvagal theory, a model that depicts how neurophysiological systems work, may aid play therapists in gaining self-awareness and understanding child clients’experiences and expressions. While different disciplines have utilized limit-setting as a part of their treatments, this article focuses on applying polyvagal theory to ACT limit-setting within the CCPT approach. In this article, we will discuss the process of using limit setting of CCPT in play therapy based on some of the organizational principles of polyvagal theory. We will use a case example to illustrate the fundamental rationale for the ACT limit setting procedure from the lens of polyvagal theory.