社會安全網心衛社工工作經驗初探

NHUIR > College of Humanities > Department of Life-and-Death Studies > Disserations and Theses(M. A. Program in Life-and-Death Studies) > Item 987654321/28679

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Title:	社會安全網心衛社工工作經驗初探
Other Titles:	The Preliminary Research of Mental Health Social Workers with Social Safety Nets
Authors:	陳婉君 CHEN, WAN-JUN
Contributors:	生死學系碩博士班周煌智;陳增穎 CHOU, HUANG-CHIH;CHENG, TSENG-YING
Keywords:	心衛社工;社安網計畫;工作經驗 mental health social worker;social safety nets;work experience
Date:	2021
Issue Date:	2022-08-10 10:53:47 (UTC+8)
Abstract:	因應強化社會安全網策略三而設置的心衛社工，在政策滾動式修正中對當前我國社工專業人員來說，是一種新的挑戰，其中仍存有不確定與待建置的地方。　　本研究旨在探究社會安全網政策下策略三心衛社工工作經驗之初步探究，透過深度訪談的方式初步探討心衛社工的工作經驗，瞭解不同背景的心衛社工在擔任心衛社工一職後對實務工作的內涵是否有差異；本研究採用質性研究方法，研究對象為3位來自不同工作背景的心衛社工，透過深度訪談進行資料蒐集，整理出以下結果：一、心衛社工的專業角色(一)心衛社工與關懷訪視員的專業角色極近重複，兩者專業角色待細緻區分。(二)具關懷訪視員、精神科社工工作經驗者的專業工作內涵、先備知能與心衛社工工作內涵較相近，故轉銜至心衛社工工作是專業的延伸與累積且就業動機皆具挑戰深化服務，與社安網策略三的目的及對心衛社工的期待較一致。(三)保護社工背景者轉任心衛社工，在工作歷程中需要一段自我專業的磨合，經過調整過往對加害人的刻板印象與價值觀較能順利銜接並延續心衛社工的工作。(四)心衛社工是綜融性的助人工作，除了資源連結外，也協助案主及其家庭關係調整，更是扮演社政和衛政溝通與協調的角色。(五)心衛社工服務對象不僅是精神疾病個案合併家暴或性侵害加害人身分者，這些加害人有些同時為被害人身分，或者從服務歷程中發現這些所謂的加害人其實才是系統中的被害人；但因心衛社工隸屬衛政，故在協助個案連結資源豐富性較隸屬社政的保護社工匱乏。二、心衛社工所需的專業知能(一)來自不同背景的心衛社工專業基礎的異質性大，任職心衛社工的專業知能，除了仰賴過去的專業基礎外，也靠實務工作歷程裡做中學習及透過組織內提供專業訓練來增加專業知能的厚實度。(二)心衛社工的基礎專業知能需對精神疾病的了解和辨識發病能力、因應精神疾病發作的危機處遇、家庭功能與家暴防治的概念、暴力風險的評估和處遇、資源連結的能力等專業知能；對於尚缺乏精神疾病辨識和暴力風險評估的概念的初任心衛社工者，人身安全的知能則最為重要。(三)因應拒訪個案的策略：1.轉向與其他家人工作、與網絡合作，並調整自我心態，接納個案拒訪的決定，並進行自我反思。2.尋求督導協助、邀請專家學者召開個案研討會商討處遇方式，暫緩積極介入。3.反思個案或家屬拒訪原因、想要的服務來調整服務方式、同理個案或家屬拒絕的想法、感受，並使用不同媒介(如：留紙條、透過網絡人員來與個案聯繫等)來與個案或家人連結，期間以立即性危機為優先處理。4.尋求同儕支持，並以個案和家屬的立場來理解個案罹患精神疾病的痛苦和家屬照護個案的辛苦，幫助自己轉念。(四)處遇過程，擅用個人中心學派取向的真誠一致、無條件積極接納、同理心之技巧。三、心衛社工所需的態度(一)接納精神疾病和加害人身分的友善態度。(二)具團隊合作的精神。最後，依據研究結果提出對未來實務工作、政策、研究上的建議。　　Taiwan's local governments have implemented a plan to strengthen social safety network since 2018. The third strategy is to “integrate the offenders with mental illness prevention services.”　　This study mainly explores the status of integrated services provided by mental health social workers to offenders of domestic violence. The research objects share their own experience by semi-structured interview guide and individual interview. The results of the study were that：1. Professional Role of Mental Health Social Workersa) The professional role between mental health social workers and care visitors are extremely similar. Their difference needs to be distinguished and clarified.b) The professional job's content, required qualification and skills of care visitors and psychiatric social workers are more similar to those of mental health social workers; for this reason, the transition to the job content of mental health social workers is the extension and accumulation of professional skills. In addition, the motivation is accompanied with challenging and deepening services. It is more consistent with the objective 3 of social safety net and the expectation of mental health social workers.c) When protective services social workers are transferred to mental health social workers, they need to go through an adjustment period to adapt their own professional skills during their time of work. After adjusting the stereotype and thoughts about perpetrators in the past, they can keep working as mental health social workers more smoothly. d) Mental health social workers have generic supporting services. Not only do they need to link all resources, but also to assist the adjustment of clients and family relationship. They are playing a role of communications and coordination between social politics and health policies.e) The target of mental health social workers are not only for victims suffering from psychiatric disorder problems, combining with domestic or sexual violence. Sometimes, these victims are also the perpetrators at the same time. Or, they might discover that these so-called perpetrators are actually the victims in the system from their service experience. However, the domain of mental health social workers belongs to health policies, they have relatively poor resources in assisting their clients in linking resources compared to protective services social workers subordinate to social politics. 2. Required Professional Skills and Knowledge for Mental Health Social Workersa) Mental health social workers with different background have high heterogeneity in basic professional skill. Their professional skills and knowledge shall be increased based on their past professional experience, working practices and studies, and professional training provided by the organization. b) The professional skills and knowledge of mental health social workers shall understand and identify psychiatric disorders, cope with crisis and situations for psychiatric disorders, have general concepts of family functions and domestic violence prevention, know how to estimate violence risks, and have capability of linking resources. For new mental health social workers lacking psychiatric disorder identification and violence estimation capability, the most important concept is personal safety.c) Strategies for those who refuse to have interviews:i. Cooperate with their family members and other networks instead. Adjust the mental status, accept their decision of refusing interviews, and conduct self-reflection process.ii. Ask supervisors for help. Invite specialists and scholars to have case seminars to discuss about the ways to solve problems, and stop temporarily the active intervention.iii. Rethink about the reasons why case owners or their family members refused to have interviews. Think in their shoes to adjust the provided services. Understand their refusal, feelings, and use different media (such as, leaving notes, asking network personnel to contact the case owners, etc.) to link with the case owners or their family members. Any immediate crisis shall be taken care in priority.iv. Ask support from peers. Stand in case owners and their family members' shoe to understand the pain suffering from psychiatric disorders of case owners, and the hard work of their family members for taking care of them to change the state of mind.e) Intervention process, good at using of Person-Centered Theory to be consistent, accept everything without any conditions and have empathy.3.Professional Attitude for Mental Health Social Workersa)Accept the psychiatric disorders and have friendly attitudes towards the identity of perpetrator.b)possessing team work cooperation spirit.　　Lastly, based on this study's results, the researcher proposes suggestions are provided for policies and individual practitioners, along with directions for future research.
Appears in Collections:	[Department of Life-and-Death Studies] Disserations and Theses(M. A. Program in Life-and-Death Studies)

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