基于来访者视角的心理治疗和咨询中的伤害性因素研究

发布时间：2018-06-06 12:29

本文选题：心理治疗 + 心理咨询　；参考：《中国全科医学》2017年01期

【摘要】：目的探索心理治疗和咨询过程中对来访者可能造成伤害的因素。方法 2013年3月—2014年12月某高校心理咨询中心来访的学生中,有提前终止咨询的来访者46例和未提前终止咨询的来访者169例。课题组成员通过电话、邮件等方式联系提前终止咨询的来访者,提出访谈的请求,共有27例接受了该请求并同意参加本研究作为脱落组;在未提前终止咨询的来访者中,采用随机数字表法选取30例作为对照组。两组均填写《咨询疗效评估表》,以评估在咨询中获得的帮助程度;并对脱落组进行深入的质性访谈,了解可能导致心理咨询提前终止的原因。结果脱落组咨询疗效评估表条目1、2、4、6、8、10得分及总分均低于对照组,差异有统计学意义(P0.05);两组咨询疗效评估表条目3、5、7、9得分间差异无统计学意义(P0.05)。访谈结果显示,导致提前结束咨询的常见原因可以分为两大类:与咨询师相关、损害咨访联盟的因素,以及来访者个人方面的因素。其中,在与咨询师相关、损害咨访联盟的因素中,来访者提到次数最多的因素为:咨询师和来访者的不匹配(9次)、难以信任咨询师会真的给自己带来帮助(6次)、知觉到咨询师的过高期望带来的压力(5次)、咨询师不能为来访者有效保守秘密(5次)。结论心理治疗和咨询中存在咨询师和来访者的不匹配、难以信任咨询师会真的给自己带来帮助、知觉到咨询师的过高期望带来的压力等伤害性因素,准确识别伤害性因素是心理治疗/咨询师是否胜任的重要指标,培训项目需要训练心理治疗/咨询师学会识别、描述和防止伤害性因素的发生。
[Abstract]:Objective to explore the possible injury factors during psychotherapy and counseling. Methods from March 2013 to December 2014, there were 46 early termination of counseling and 169 unterminated counseling in a college psychological counseling center. The members of the research group contacted the visitors who had terminated the consultation in advance by telephone, mail and other means, and made requests for interviews. A total of 27 cases accepted the request and agreed to participate in the study as the shedding group; among the visitors who did not terminate the consultation in advance, 30 cases were selected as control group by random digital table method. In order to evaluate the degree of help obtained in counseling, the two groups filled in the form of evaluation of the efficacy of counseling, and conducted in-depth qualitative interviews with the shedding group to understand the reasons that might lead to the early termination of psychological counseling. Results the scores and the total scores of the items in the evaluation table of counseling efficacy in the exfoliated group were lower than those in the control group (P 0.05), but there was no significant difference between the two groups in the scores of 3 / 5 / 7 / 9 in the form of consultation and evaluation of the therapeutic effect of the two groups (P < 0. 05). The results show that the common reasons leading to the early termination of counseling can be divided into two categories: the relationship between consultants, the factors that damage the consultation alliance, and the personal factors of the visitors. Among them, among the factors related to consultants and damaging the advisory alliance, The factors most frequently mentioned by the visitors are: the mismatch between the consultant and the visitor is 9 times, it is difficult to trust that the consultant will really bring help to himself 6 times, the pressure caused by the high expectations of the consultant is perceived 5 times, and the consultant is not able to trust the consultant. You can't keep a secret for a visitor five times. Conclusion there is a mismatch between counselors and visitors in psychotherapy and counseling. It is difficult to believe that counselors can really help themselves, and they are aware of the harmful factors, such as the pressure brought by the high expectations of counsellors, etc. Accurate identification of harmful factors is an important indicator of the competence of psychotherapy / counselors. Training programs need to train psychotherapy / counselors to identify, describe and prevent the occurrence of harmful factors.
【作者单位】：南方医科大学公共卫生学院心理学系;
【基金】：2014年度广东省医学科学技术研究基金项目(A2014395) 2014年度广东省哲学社会科学“十二五”规划课题(GD14CXL02)
【分类号】：B849

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