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[ 摘要 ] 

本研究係以佈局─策略家族醫治的觀點,對某市立病院家族醫治門診中一個睡眠障礙、酗酒大學生家庭的家族治療歷程進行調查及詮釋翻譯研究者以詮釋性研究的微觀剖析法對二十次的醫治進程錄影帶與醫治者、裁判員配合進行闡明,獲得以下幾方面的主要發現。


1、 構造─策略家庭醫治者對〝問題〞的建構:

家庭對問題的觀念是找出〝病因〞的「癥狀」架構,醫治者則是提出互動、多元因果的「系統」架構翻譯

2、 醫治者的介入

包括「適應家庭結構」、「挑戰家庭構造」、「挑戰家庭的問題架構」、「醫治關係的參與」、「策略性的參與」、「挑戰小我內涵」、「其他」等七大部門的介入。醫治者最常常呈現的為「挑戰家庭佈局」,另外一面又同時在「適應家庭構造」的醫治參與。


三 、家庭互動構造的成長歷程

家庭的互動佈局隨著IP癥狀的轉變,歷經以下六個階段的改變歷程:(A)家庭為IP癥狀求助(B)IP癥狀改良而家庭關係的衝突顯現(A’)IP癥狀發生發火與家庭佈局被挑戰(B’)IP癥狀改良與家庭構造回穩的抗衡 (A”)IP癥狀再復發與家庭構造改變(B”)癥狀消逝與家庭構造的改變。家庭的互動佈局跟著癥狀的「復發─改善」的螺旋曲線而輪回進展。

4、 醫治參與發展階段的歷程

陪伴家庭構造的改變歷程,治療參與也構成六個階段的成長歷程如下:(A)使家庭參與醫治 (B)設立建設信任與合作的關係(A’)適應癥狀發生發火對家庭佈局挑戰(B’)醫治第二階段的系統架構(A”)對夫妻佈局的挑戰(B”)改變與結束翻譯本研究發現癥狀除了對家庭系統有癥狀功能之外,對醫治參與的成長也一樣具有正面功能。
5、醫治者介入遇見的阻抗

醫治者在進行家族醫治參與時會遇到的阻抗包羅:(一)醫治過程呈現的阻抗(二)醫治手藝參與的阻抗(三)醫治者的系統架構面臨家庭癥狀架構的阻抗(四)來自家庭內部的權力衝突的阻抗。醫治者對阻抗的轉化的參與包括:從頭框架家庭的問題觀; 尊敬父親的癥狀架構;決心疏忽或淡化家庭呈現的阻抗的訊息;順應家庭的權力與階層來進行挑戰。

研究者進一步就這個家族醫治進程所反映的社會意義,包括:(一)家庭對問題「病」的建構所反映的社會意義(二)家庭結構反應的社會文化(三)醫治介入反應的社會文化進行討論,進而對進行一個詮釋性研究的歷程提出結論與建議,作為將來家庭治療理論、實務及研究的參考。 

[ 論文目錄 ] 
封面
誌謝詞
中文摘要
英文摘要
目錄
表次
圖次
第一章 緒論
第一節 緣起
第二節 研究念頭與目標
第三節 名詞诠釋
第二章 文獻切磋
第一節 系統思惟的家族醫治建構
第二節 佈局與策略的家族醫治
第三節 家族醫治改變歷程的成長
第四節 詮釋性研究的精微闡明
第三章 研究方式
第一節 研究場合
第二節 研究介入者
第三節 研究對象
第四節 究法式
第五節 資料剖析
第四章 結果
第一節 結構─策略家族治療對問題的建構
第二節 構造─策略家族醫治介入的內在
第三節 家庭互動結構的改變歷程
第四節 佈局─策略家族醫治參與的成長歷程
第五節 佈局─策略家族醫治參與碰見的阻抗
第五章 計議
第一節 構造─策略家族治療對問題的建構
第二節 構造─策略家族治療參與的內涵
第三節 家庭互動佈局改變歷程的接頭
第四節 佈局─策略家族治療參與發展歷程的接洽
第五節 構造-策略家族醫治介入碰見的阻抗
第六節 家族治療過程回響反映的社會文化意義
第六章 結論


參考文獻
附錄
附錄一 田野窺察表
附錄二 家庭治療進程構觀察表
附錄三 訪交心得筆記
附錄四 二次家族醫治進程的轉接點闡明
附錄五 第二次家族醫治的家庭互動構造闡發
附錄六 第二次家族治療的醫治參與闡明
附錄七 二十次家族醫治的家庭互動構造歷程闡明
附錄八 二十次家族醫治的治療參與歷程分析 



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【家族醫治】《以構造─策略學派的觀點建構一個家族醫治的改變歷程》







【家族醫治】

【家族醫治】



《以佈局─策略學派的概念建構一個家族醫治的改變歷程》
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