老年抑郁症患者的个案工作介入

发布时间：2018-07-14 16:24

【摘要】：自我国进入老龄化社会以来,老年人的精神健康日益成为社会关注的热点。抑郁症是老年人疾病中最常见的精神疾病之一。我国社区老年人抑郁症患病率6%～29.4%①。抑郁症造成的各种社会功能失调严重影响着老年人的健康,特别对于那些有慢性疾病的老人,抑郁症会导致他们卧床时间的延长,疾病导致残疾的机率提高,并且因抑郁而导致自杀几率的增加。抑郁症不仅使患者忍受着折磨,对于家庭和社会来说也是沉重的负担。因此老年抑郁症患者的康复存在研究的必要性。通过阅读大量文献,大多数专家学者从老年抑郁症诊断、老年抑郁症的致病因素、影响康复的心理因素以及抑郁症的治疗方法等角度出发,得到了相应的研究成果。这些研究大多从宏观的定量角度出发,利用真实有效的数据肯定了心理服务对老年抑郁症康复的作用。但是专家学者们对社会工作如何介入抑郁症康复的研究比较少。老年人不是独立的,他是社会大群体中的一员。因而恢复社会功能,回归正常社会生活是老年抑郁症患者康复的最终目的。本研究中,笔者以抑郁症患者ZQX为案主,从微观层面出发,详细研究为老年抑郁症患者提供社会工作服务时应如何操作,运用怎样的社会工作技巧. 在研究的初期,笔者利用破冰技巧与案主建立信任关系,确定案主与社工的专业关系。接着笔者通过搜集资料和深入的访谈,对案主的个人信息有了基本了解。初步评估确定案主面临的主要问题之后,笔者制订了从个人、家庭、社会支持网络三个层次恢复案主社会功能的服务方案。最后对个案工作介入老年抑郁症患者康复作出总结与反思。本研究以危机介入理论、增权理论、社会支持理论为理论基础,以个案工作为手段,帮助老年抑郁症患者消除因抑郁情绪造成的危机,并且发现自我优势,肯定自我价值。笔者运用社工专业技巧努力引导案主澄清心里想法,促成家庭成员形成良好的沟通,为患者的康复营造良好的家庭氛围。同时良好的朋辈网络也是患者康复的重要因素,因此笔者尽力为案主挖掘可利用的社区资源,扩大人际交流网络。笔者通过参与观察、个案访谈,并结合社会工作服务的经验制定出相应的服务计划。然后以建立关系、直接服务和结案评估三部分展现老年抑郁症患者康复的社会工作介入,形成了危机介入模式、家庭治疗模式和社会支持模式三种服务提供的方式。以此为老年精神康复工作者提供一些借鉴和参考。
[Abstract]:Since China entered the aging society, the mental health of the elderly has become the focus of attention. Depression is one of the most common mental disorders in the elderly. The prevalence rate of depression among the elderly in Chinese community is 29.41. All kinds of social disorders caused by depression seriously affect the health of the elderly. Especially for those with chronic diseases, depression can lead to prolonged bed-rest hours and an increased chance of disability caused by illness. And depression leads to an increase in suicide rates. Depression is a heavy burden not only for the patient, but also for the family and society. Therefore, it is necessary to study the rehabilitation of elderly patients with depression. Through reading a large number of literature, most experts and scholars from the diagnosis of depression in the elderly, the pathogenic factors of depression in the elderly, psychological factors affecting rehabilitation and the treatment of depression, and so on, obtained the corresponding research results. Most of these studies confirm the effect of psychological service on the rehabilitation of senile depression by using real and effective data from macroscopic quantitative point of view. But experts and scholars have done little research on how social work can intervene in the rehabilitation of depression. The old man is not independent. He is a member of a large group of society. Therefore, to restore social function and return to normal social life is the ultimate goal of rehabilitation of elderly patients with depression. In this study, the author takes the depression patient ZQX as the victim, from the microscopic level, studies in detail how to operate and how to use the social work skills when providing social work service for the elderly depression patients. At the beginning of the study, the author established the professional relationship between the victim and the social worker by using the ice-breaking technique to establish the trust relationship with the victim. Then the author through the collection of information and in-depth interviews, the owner of personal information has a basic understanding. After preliminary evaluation and identification of the main problems faced by the victim, the author worked out a service plan to restore the social function of the victim from three levels: individual, family and social support network. Finally, the rehabilitation of elderly depression patients involved in case work is summarized and reflected. Based on crisis intervention theory, empowerment theory, social support theory and case work, this study aims to help elderly patients with depression to eliminate the crisis caused by depression, and to find out their own advantages and to affirm their self-worth. The author used professional skills of social work to guide the victim to clarify his thoughts, promote the family members to form good communication, and create a good family atmosphere for the rehabilitation of patients. At the same time, a good peer network is also an important factor in patients' rehabilitation, so I try my best to tap the community resources available to the victim and expand the interpersonal communication network. The author made the corresponding service plan through the participation observation, the case interview, and the social work service experience. Then the three parts of relationship, direct service and closed evaluation show the rehabilitation of elderly depression patients social work intervention, forming a crisis intervention model, family treatment model and social support mode of three modes of service provision. In order to provide some reference for the elderly mental rehabilitation workers.
【学位授予单位】：南京农业大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：C916;C913.6

【参考文献】