中西醫整合之短期結構式心理治療應用於精神科門診輕型精神疾患之前驅研究

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Title:	中西醫整合之短期結構式心理治療應用於精神科門診輕型精神疾患之前驅研究
Other Titles:	A Pilot Study on the Feasibility of a Short-Term Integrated Traditional Chinese Psychotherapy among Minor Mental Disorders of Outpatient Psychiatric Clinic
Authors:	施春華 SHIH, CHUN-HUA
Contributors:	生死學系碩博士班陳增穎;楊明仁 CHENG, TSENG-YING;YANG, MING-JEN
Keywords:	心理針灸;中醫心理治療;低阻抗意念導入;精神疾病 Psychological acupuncture;Chinese medicine psychotherapy;Low resistance thought imprint therapy;Mental disorders
Date:	2021
Issue Date:	2022-08-10 10:47:50 (UTC+8)
Abstract:	研究目的：本研究目的在以中西醫整合的心理治療應用於精神科門診中的輕型精神疾患的治療，並以深度訪談瞭解其治療改變歷程，以作為其未來心理治療可行性之評估。　　研究方法：研究者採質性研究取向，以立意取樣來選取4位符合ICD-10診斷準則，神經性憂鬱症或焦慮狀態診斷之患者為研究對象，進行中西醫整合之短期結構式心理治療，並於心理治療結束後針對歷次諮商之經驗與感受進行深度訪談，並以歷次治療內容及訪談之逐字稿加以分析，以瞭解治療改變歷程，症狀改善之主觀感受。中西醫整合之短期結構式心理治療結構分為三個階段六次治療，（1）初始階段：辯證情志建立信任安全的醫病關係；（2）治療階段：低阻抗意念導入的操作；（3）鞏固階段：以心理針灸方式化解過去的創傷圖示建立新的神經迴路。　　研究結果：本研究結果發現，經過三階段六次治療後，研究參與者的身心症狀困擾嚴重緩解程度，平均下降達7分（總分十分），症狀有很明顯的改善，且也產生新的認知行為模式。中西醫整合之短期結構式心理治療介入前研究參與者都經過身心症狀糾纏著與茫然無助的求醫之路。求醫之路中也會因為社會文化對於精神疾病的詮釋，擔心被污名化，而延誤就醫。治療初始階段中治療關係的建立是治療成功與否的關鍵，而關鍵就是諮訪雙方都要能夠在當下形成「我們」。治療者在過程中藉由研究參與者的名字搭起治療關係的橋樑，除此之外，內在真實的連結，交叉體驗更是拉近諮訪關係，且也是治療改變的開始。另，治療中「低阻抗意念導入」與「心理針灸」技術除了具有治療作用外，也算是一種重要儀式，研究參與者可以感覺到治療者似乎要將研究參與者的困擾拍打掉，並將美好的感覺鞏固在身體中。　　研究結論：為提高精神疾病的防治回歸本土化的精神醫療是當前迫切且必要的課題。治療上該以全人整體的觀點來介入；以西方治療模式，加入原本有效的本土文化的治療因素應是值得被參考的。除此之外，世界醫學心理學需要中醫心理學的加入，立足於中國傳統文化的背景和基礎，在心理治療工作中大力推展，搭配各種技術，在共情的基礎下「損有餘而補不足」，針對不調和的心理衝突之處進行工作，中西醫整合之短期結構式心理治療是一種具有特色、有效且符合現代人需求的現代心理治療，達到治療的效益。　　Purpose: The purpose of this study is to apply integrated Chinese and Western psychotherapy to the treatment of psychiatric patients with mild mental disorders, and to understand how the treatment process changes through in-depth interviews. This research will help to evaluate the feasibility of psychotherapy in the future. 　　Methodology: The researcher adopted a qualitative approach and selected four patients who met the ICD-10 diagnostic criteria for depression or anxiety as research subjects. The subjects were then treated with short-term structured psychotherapy based on integrated Chinese and Western medicine. After performing psychotherapy, in-depth interviews were conducted on the subjects' experiences and feelings during their consultations. Researchers then analyzed the treatment course and the interview transcript in order to understand how the course of treatment changed over time as well as the patients' subjective feelings towards the improvement of their symptoms. The short-term structured psychotherapy was divided into three stages and took place over six sessions: (1) Initial stage: using dialectics to establish trust and a safe patient-doctor relationship; (2) Treatment stage: the introduction of low-resistance thought imprint therapy (TIP); (3) Consolidation stage: psychological acupuncture is used to resolve past trauma and establish new neural circuits. 　　Results: The results of the study revealed that after completing three stages and six sessions of treatment, participants found there was on average a 7 point (out of 10) decrease in the severity of their psychological disorders. Furthermore, there was a significant improvement of their symptoms and new cognitive-behavioral patterns were established. Study participants had endured the torment of psychological symptoms and fruitlessly seeked treatment before the intervention of integrated Chinese and Western short-term structural psychotherapy. Their road to recovery was further delayed due to social and cultural stigmas towards mental disorders. In the initial stage, the key to treatment success was determined by whether or not a therapeutic relationship could be established. It was also key that both parties be able to form an “us” in the present. The therapist was able to build a bridge by using the participant's name. In addition, creating a real connection and exchanging experiences was what began to create a therapeutic change. During the course of treatment, “low resistance TIP” and “psychological acupuncture” were not only therapeutic tools, but also important psychotherapy rituals. The participants felt it was as if the therapist was swatting away their troubles and helping them consolidate good feelings within themselves. 　　Conclusion: Returning to the localization of mental healthcare is both urgent and necessary if doctors wish to prevent and treat mental disorders. Treatment should take a more holistic approach. While using the Western model of treatment, it should be worth considering adding effective elements from local Chinese medicine. Furthermore, global psychiatric care needs the addition of Chinese psychotherapy, which has a traditional Chinese background and foundation. Doctors should vigorously promote psychotherapy and utilize various treatment methods. With empathy as the foundation for treatment, doctors should work to “reduce surplus to relieve deficits” and treat a patient’s yin/yang imbalance. “No blockage, no pain” is an interesting and effective concept that fulfills the needs of modern people when it comes to psychiatric care and treatment.
Appears in Collections:	[Department of Life-and-Death Studies] Disserations and Theses(M. A. Program in Life-and-Death Studies)

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