叙事治疗在儿童情绪障碍中的应用研究

发布时间：2018-05-17 09:54

本文选题：情绪障碍 + 儿童　；参考：《南京中医药大学》2013年博士论文

【摘要】：当前,儿童情绪障碍对青少年身心健康成长的负面影响已日益受到教师和心理治疗师的重视。本研究将叙事疗法作为干预手段,以儿童情绪障碍患者及其父母为研究对象,探索叙事治疗对儿童情绪障碍家庭的影响及其疗效,并为儿童情绪障碍的综合干预以及叙事治疗的本土化提供理论和实验的参考。作为家庭治疗的后现代流派,叙事治疗从社会文化的广阔视角,关注主流文化价值观如何影响家庭成员的互动,从而导致心理问题的产生。叙事治疗帮助个体解构问题故事和价值观,发展偏好故事和价值观,探索解决问题的知识和技能,并建构积极的身份认同。本研究以有效样本30例儿童情绪障碍患者及其父母为研究对象,采用系统家庭动力学量表(SSFD)、父母养育方式量表(EMBU)和家庭环境量表(FES-CV)比较治疗前后家庭动力学、父母养育方式和家庭环境的变化。采用访谈法对4例儿童情绪障碍患者进行访谈,了解他们对叙事治疗的体验、治疗的获益和治疗不足之处,以促进治疗方法的改进。采用个案研究探索具体个案的转变过程和疗效。研究结论如下： 1.治疗后儿童情绪障碍患者家庭动力学的家庭气氛和个性化维度有显著改善,治疗后儿童情绪障碍患者的母亲家庭动力学的家庭气氛、个性化和系统逻辑等维度有显著改善,治疗后儿童情绪障碍患者的父亲家庭动力学各维度无显著变化。 2.治疗后儿童情绪障碍患者的家庭环境在亲密度、矛盾性、知识性、娱乐性和组织性等因子上有显著改善。 3.治疗后儿童情绪障碍患者的父母养育方式中的父亲情感温暖理解、母亲情感温暖理解、惩罚严厉、拒绝否认等因子有显著改善。 4.儿童情绪障碍患者的父母养育方式治疗转变同家庭动力学的治疗转变具有相关性。父亲情感温暖理解、母亲情感温暖理解差值同家庭气氛差值呈负相关,父亲惩罚严厉、父亲拒绝否认、母亲惩罚严厉、母亲拒绝否认同家庭气氛差值呈正相关。母亲情感温暖理解差值同个性化差值呈负相关,母亲惩罚严厉差值同个性化差值呈正相关。 5.儿童情绪障碍患者的父母养育方式治疗前后变化同家庭环境治疗前后变化具有相关性。父亲情感温暖理解、母亲情感温暖理解差值同亲密度、知识性、娱乐性差值呈正相关；父亲情感温暖理解、母亲情感温暖理解差值同矛盾性差值呈负相关；母亲拒绝否认、母亲惩罚严厉差值同矛盾性差值呈正相关；父亲拒绝否认、母亲拒绝否认差值同娱乐性差值呈负相关；母亲惩罚严厉差值同组织性差值呈负相关。 6.儿童情绪障碍患者不同年龄、治疗次数、性别在疗效上没有显著差异。 7.儿童情绪障碍患者及其父母的问题价值观在治疗前后有显著转变。 8.质的研究表明叙事治疗对儿童情绪障碍患者的情绪改善,家庭及人际关系改善、偏好价值观、个人主权、闪光事件或替代故事等方面有较好疗效,治疗存在提问不够清晰、治疗时间不够长、部分个案起效慢等不足。 9.叙事治疗在本土化过程中,需要考虑本土隐喻和传统文化,治疗实践应做出相应的调整。
[Abstract]:At present, the negative impact of children's emotional disorders on the physical and mental health of adolescents has been paid more and more attention by teachers and psychotherapists. This study uses narrative therapy as a means of intervention, taking children with emotional disorders and their parents as the research object, to explore the effect and effect of narrative therapy on the families of children with disorder disorder, and for children's feelings. It provides theoretical and experimental reference for the comprehensive intervention of disorder of the mind and the localization of narrative therapy.
As a post modern school of family treatment, narrative therapy, from a broad perspective of social culture, pays attention to how mainstream cultural values affect the interaction of family members and lead to the emergence of psychological problems. Narrative therapy helps individuals deconstruct problems and values, develop preferences and values, and explore knowledge and skills to solve problems. And build a positive identity.
In this study, 30 cases of children with emotional disorders and their parents were studied in this study. Family dynamics scale (SSFD), parental rearing pattern scale (EMBU) and family environment scale (FES-CV) were used to compare family dynamics, parental rearing patterns and family environment changes before and after treatment. 4 children's emotional disorders were treated with interview method. The patients were interviewed to understand their experience in narrative therapy, the benefits of treatment and the deficiency of treatment to promote the improvement of the treatment.
1. after treatment, the family atmosphere and individualized dimension of family dynamics were significantly improved. The family atmosphere of the mother's family dynamics, individualization and system logic were significantly improved after treatment. There was no significant change in each dimension of father family dynamics in children with emotional disorders after treatment. Change.
2. after treatment, family environment of children with emotional disorder improved significantly in terms of intimacy, ambivalence, knowledge, entertainment and organization.
3. the parents' parental rearing patterns in children's emotional disorders after treatment were warm understanding, mother's emotional warmth understanding, severe punishment, refusing denial and other factors were significantly improved.
4. the transformation of parental rearing style treatment in children with emotional disorders was related to the transformation of family dynamics. Father's emotional warmth understanding, mother's emotional warmth understanding is negatively related to family atmosphere difference, father's punishment is severe, father refuses to deny, mother's punishment is severe, mother refuses to deny the difference between family atmosphere and family atmosphere. There was a negative correlation between the difference of mother's emotional warmth and the difference of personality. The difference between mother's punishment and severity was positively related to the difference of personality.
5. the changes of parental rearing patterns before and after the treatment of children's emotional disorders were related to the changes before and after the family environment treatment. Father's emotional warmth understanding, mother's emotional warmth understanding, the difference of the difference of the same relative density, the knowledge and the entertainment difference are positively related, the father's emotional warmth understanding, the mother's emotional warmth understanding difference and the contradictory difference show Negative correlation; mother refused to deny that mother's severe difference was positively correlated with the contradiction difference; father refused to deny that mother refused to deny the difference and had negative correlation with the entertainment difference; mother's severe difference was negatively related to the organizational difference.
6. there was no significant difference in curative effect between children with emotional disorder in different ages, times of treatment and gender.
7. the problem values of children with emotional disorders and their parents changed significantly before and after treatment.
The 8. qualitative study showed that narrative therapy had better effects on emotional disorders in children, improvement in family and interpersonal relationships, preference values, personal sovereignty, flash events or alternative stories. There were insufficient questions in the treatment, the time of treatment was not long enough, and the results of the division were slow, and so on.
9. in the process of localization, the local metaphor and traditional culture should be considered in the process of narrative therapy, and the corresponding adjustment should be made in the practice of treatment.
【学位授予单位】：南京中医药大学
【学位级别】：博士
【学位授予年份】：2013
【分类号】：R749.94

【参考文献】