本文選題：情緒障礙 + 兒童　； 參考：《南京中醫(yī)藥大學(xué)》2013年博士論文

【摘要】：當(dāng)前,兒童情緒障礙對青少年身心健康成長的負面影響已日益受到教師和心理治療師的重視。本研究將敘事療法作為干預(yù)手段,以兒童情緒障礙患者及其父母為研究對象,探索敘事治療對兒童情緒障礙家庭的影響及其療效,并為兒童情緒障礙的綜合干預(yù)以及敘事治療的本土化提供理論和實驗的參考。 作為家庭治療的后現(xiàn)代流派,敘事治療從社會文化的廣闊視角,關(guān)注主流文化價值觀如何影響家庭成員的互動,從而導(dǎo)致心理問題的產(chǎn)生。敘事治療幫助個體解構(gòu)問題故事和價值觀,發(fā)展偏好故事和價值觀,探索解決問題的知識和技能,并建構(gòu)積極的身份認同。 本研究以有效樣本30例兒童情緒障礙患者及其父母為研究對象,采用系統(tǒng)家庭動力學(xué)量表(SSFD)、父母養(yǎng)育方式量表(EMBU)和家庭環(huán)境量表(FES-CV)比較治療前后家庭動力學(xué)、父母養(yǎng)育方式和家庭環(huán)境的變化。采用訪談法對4例兒童情緒障礙患者進行訪談,了解他們對敘事治療的體驗、治療的獲益和治療不足之處,以促進治療方法的改進。采用個案研究探索具體個案的轉(zhuǎn)變過程和療效。研究結(jié)論如下： 1.治療后兒童情緒障礙患者家庭動力學(xué)的家庭氣氛和個性化維度有顯著改善,治療后兒童情緒障礙患者的母親家庭動力學(xué)的家庭氣氛、個性化和系統(tǒng)邏輯等維度有顯著改善,治療后兒童情緒障礙患者的父親家庭動力學(xué)各維度無顯著變化。 2.治療后兒童情緒障礙患者的家庭環(huán)境在親密度、矛盾性、知識性、娛樂性和組織性等因子上有顯著改善。 3.治療后兒童情緒障礙患者的父母養(yǎng)育方式中的父親情感溫暖理解、母親情感溫暖理解、懲罰嚴厲、拒絕否認等因子有顯著改善。 4.兒童情緒障礙患者的父母養(yǎng)育方式治療轉(zhuǎn)變同家庭動力學(xué)的治療轉(zhuǎn)變具有相關(guān)性。父親情感溫暖理解、母親情感溫暖理解差值同家庭氣氛差值呈負相關(guān),父親懲罰嚴厲、父親拒絕否認、母親懲罰嚴厲、母親拒絕否認同家庭氣氛差值呈正相關(guān)。母親情感溫暖理解差值同個性化差值呈負相關(guān),母親懲罰嚴厲差值同個性化差值呈正相關(guān)。 5.兒童情緒障礙患者的父母養(yǎng)育方式治療前后變化同家庭環(huán)境治療前后變化具有相關(guān)性。父親情感溫暖理解、母親情感溫暖理解差值同親密度、知識性、娛樂性差值呈正相關(guān)；父親情感溫暖理解、母親情感溫暖理解差值同矛盾性差值呈負相關(guān)；母親拒絕否認、母親懲罰嚴厲差值同矛盾性差值呈正相關(guān)；父親拒絕否認、母親拒絕否認差值同娛樂性差值呈負相關(guān)；母親懲罰嚴厲差值同組織性差值呈負相關(guān)。 6.兒童情緒障礙患者不同年齡、治療次數(shù)、性別在療效上沒有顯著差異。 7.兒童情緒障礙患者及其父母的問題價值觀在治療前后有顯著轉(zhuǎn)變。 8.質(zhì)的研究表明敘事治療對兒童情緒障礙患者的情緒改善,家庭及人際關(guān)系改善、偏好價值觀、個人主權(quán)、閃光事件或替代故事等方面有較好療效,治療存在提問不夠清晰、治療時間不夠長、部分個案起效慢等不足。 9.敘事治療在本土化過程中,需要考慮本土隱喻和傳統(tǒng)文化,治療實踐應(yīng)做出相應(yīng)的調(diào)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.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2013
【分類號】：R749.94

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