帶領緩起訴二級毒品附命戒癮治療團體經驗

Experiences in Conducting Mandated Group Therapy for Schedule II Drug Offenders under Deferred Prosecution Orders

本文旨在探討參與緩起訴處分附命二級毒品戒癮治療團體成員的改變階段變化與團體療效因素。研究採立意取樣，於北部某專科醫院進行6梯次團體，每梯次共8次課程，納入49名成員。參與者主要為男性（90%）、未婚（51%）、年齡集中於31-40歲（55.1%），多為國中學歷與勞工階層。研究工具包括羅德島大學改變階段量表（URICA）於課程前後施測，以及雅隆團體治療療效因素量表（TFI）於第8次課程後填寫。改變階段變化結果顯示，沉思期比例由57%增至67%，顯示部分成員在動機上有顯著進展；然而行動期比例略減（由10%降至8%），反應行為實踐仍具挑戰。團體療效因素方面，得分最高前三項依序為「存在性」（M=6.35）、「宣洩」（M=6.17）及「自我了解」（M=5.87），最低為「模仿」（M=3.91），顯示參與者在團體中最受益於對生命責任的體認、情感的釋放以及自我反思。整體分析顯示12項療效因素間存在顯著差異（F（11，539）=7.094，p<.01）。研究指出，即便在法律強制性介入下，團體治療仍能促進動機轉換並提供重要的心理支持歷程。然而，樣本數有限、僅進行前後測，未有後續追蹤設計，結果推論具限制。未來研究：建議擴大樣本並探討不同性別與族群之差異，以增進司法處遇與臨床介入成效。

This study examined the therapeutic processes and stage-of-change transitions among individuals mandated to attend addiction treatment groups under deferred prosecution for Schedule II drug offenses. Conducted at a psychiatric hospital in northern Taiwan, six treatment cohorts of eight sessions each were implemented, involving 49 participants. The sample was predominantly male, unmarried, aged 31-40, with junior high education and working-class backgrounds. Pre- and post-assessments using the University of Rhode Island Change Assessment (URICA) revealed an increase in contemplation (57% to 67%) and a 15% rise in preparation/decision stages, suggesting enhanced motivation for change. However, action and maintenance stages showed minimal improvement, highlighting challenges in sustaining behavioral transformation. Evaluation of Yalom’s therapeutic factors indicated existential awareness, catharsis, and self-understanding as the most impactful elements, while imitation was least endorsed. These findings suggest that even within court-mandated, non-voluntary contexts, group therapy can foster motivational readiness and facilitate reflective and emotional growth. Despite limitations such as small sample size, purposive design, and reliance on pre/post measures only, the study provides empirical support for integrating transtheoretical approaches and therapeutic factor frameworks into judicially mandated substance use interventions.