支援情緒行為問題學生』研討會『「師」 + 情緒急救—

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張溢明保良局社會服務部教育心理學家 11.11.2016 ryan.cheung@poleungkuk.org.hk

『「師」+ 情緒急救—

支援情緒行為問題學生』研討會

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情緒急救研討會

1.

「情緒急救」概論

2.

情緒困擾與行為差異：



「內在化」與「外在化」問題

3.

「情緒急救」的介入與實踐

4.

從情緒急救到學生正向情緒發展

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情緒急救 (Winch, 2013)



Recognize when you’re in emotional pain.

知悉自己情緒上的痛楚



Be gentle and compassionate with yourself.

對自己溫柔憐憫



Distract yourself from rumination.

分心使不致反覆沉思



Redefine your view of failure.

重整自己對失敗的睇法



Find meaning in loss.

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緊急精神狀態



傷害自己



經歷極端壓力



行為表現極端

保良局教育心理服務張溢明

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學童壓力

(教育局，2015，頁38)

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青少年壓力

Stress 壓力



Amygdala杏仁核



Cortisol 皮質醇



Pituitary gland 腦下垂體



Adrenaline 腎上腺素

青少年期：皮質醇的高峰期 (特別是女生)

 負面情緒 (worry, anxiety, anger, etc.)

 孤獨感 (loneliness)

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青少年壓力

1.

專注力下降

2.

記憶力下降

3.

情緒困擾

“… the teen’s hippocampus appears to get smaller (not good for memory and learning), and the

amygdala appears to grow in size” (Jensen, 2015, p.

176)

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升中試壓力大易有情緒問題學童咬文具或患焦慮症

(蘋果日報 08.11.2016)



父母關係差都會影響小朋友情緒，(精神科專科醫生傅子健醫生)指，曾有小五男生由牙醫轉介精神科求診，原來男生有多年咬萬字夾習慣，

直至牙痛求診，發現牙裂及牙齒琺瑯質受損引致多處蛀牙，懷疑有情緒問題故轉介。男生確診焦慮症，相信是因為父母經常爭吵令男生感焦慮，加上學習壓力，令他咬萬字夾發洩，需接受藥物及行為治療控制病情。

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升中試壓力大易有情緒問題學童咬文具或患焦慮症

(蘋果日報 08.11.2016)



(精神科專科醫生傅子健醫生)稱，運動玩樂都是健腦活動，兒童每日最好有1小時的遊戲活動及休息時間，「落街跑吓都得」，音樂、繪畫或手工藝如紙黏土等可抒發感受，有助化解焦慮情緒。另外，兒童可玩「吹泡泡」幫助減壓，

透過學習慢慢吹一個大肥皂泡，持之以恒練習

，將緊張急促的呼吸減慢，放鬆情緒。

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Internalizing - Examples



Low or restricted activity levels



Quiet, not talking with other children



Shy, timid and or/ or unassertive



Socially avoidant or withdrawn



Preference to play or spend time alone



Acting in fearful manner



Non-participatory in games and activities



Unresponsive to social situations



Not standing up for self

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Internalizing – Non-Examples



Initiating social interactions with peers



Having conversations



Normal rates of social contacts



Positive social behaviours towards others



Participatory in games and activities



Resolving peer conflicts



Joining in with others

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Externalizing - Examples



Aggression towards objects or persons



Frequent arguing



Forcing submission of others



Defiant towards teachers



Frequent out of seat



Not complying with instructions



Frequent tantrums



Hyperactive



Disturbance and annoyance to others



Stealing



Uncompliant to rules

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Externalizing – Non-Examples



Cooperating



Sharing



Working on assigned tasks



Listening to teachers and parents



Appropriate peer interactions



Following instructions



Attending to tasks



Complying with teacher requests

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Article:



7, 9 & 11 years old

Savina, E., Coulacoglou, C., Sanyal, N., & Jhang, Z.

(2012). The study of externalizing and internalizing behaviours in Greek, Russian, Indian, and Chinese children using the Fairy Tale Test. School

Psychology International, 33, 39-53.

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Chinese Children



“Chinese children obtained the highest score on the

measure of anxiety… associated with the pressure for high academic expectations… supported by previous research indicating that anxiety and fear of failure are common mental health problems experienced by

Chinese students (p. 48)”



Strong control over (impulsive) aggressive behaviours

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執行功能 executive functions

行為抑制 (behavioural inhibition/ inhibitory control)



忍耐表現，按規則行事



克制衝動

工作記憶 (working memory)



按步驟工作



按班規守禮

靈活認知 (cognitive flexibility)



集中精神，忽視干擾



維持工作，按工作形式轉變

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緊急精神狀態



傷害自己



經歷極端壓力



行為表現極端

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情緒急救

(Hromek, 2007)

身體生理徵狀認知行為徵狀

• 面紅耳熱

• 頭臉冒汗

• 呼吸短促

• 眼寬皺眉

• 焦慮躁動

• 大叫大嚷

• 粗言

• 不理性想法

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A: Approach, assess and assist



接近受關注人物



合適時間、地點



展開說話



「我是 XXX，我可以坐在你身邊和你談談嗎？」



尊重私隱

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L: Listen non-judgementally



不批判的聆聽



容許對方多講

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G: Give support and information



給予情緒支援



同理心



關注感受

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E: Encourage for professional help



鼓勵進一步尋求專業支援



醫生



輔導



心理治療



升學就業



朋輩交友

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E: Encourage other supports



家人



朋友



個人能力

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情緒崩潰

Emotionally overwhelmed



眼神空洞，欠缺焦點，或充滿憂慮



對提問和指示無回應



情緒表現極端



不能自主地哭



氣促、氣喘，過度換氣



身體顫抖、顫動



瘋狂般搜尋物品



進行危險行為

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T: Thought V: Verbal

B: Behavioral

情緒急救 T.V.B.

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Stabilization穩定



尋求別人協助



減少刺激



寧靜的環境



柔和的聲線



查詢當時當刻的感受



事情持續？



閃回 Flashbacks?



回應關注



不止「冷靜」、「安全」



預告：下一步

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Stabilization穩定



「望住我」、「聽住我」



「你知唔知呢度邊度？」「我地宜家係禮堂」

「我地上緊早會」



「你宜家見/聽到咩？」「你知唔知係呢度做咩

？」



Grounding

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Grounding



舒適安坐



呼吸：紓緩



5 種看到而不讓你苦惱的物品



5 種聽到而不讓你苦惱的聲音



5 種感受到而不讓你苦惱的事物



5 種顏色

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「我見到……」

中性、不苦惱、不帶動感受的事物

1.

地板

2.

鞋

3.

……

4.

……

5.

……

慢而深地呼吸

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「我聽到……」

中性、不苦惱、不帶動感受的事物

1.

有個男人的聲音

2.

支筆跌落地

3.

……

4.

……

5.

……



慢而深地呼吸

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「我感覺到……」

中性、不苦惱、不帶動感受的事物

1.

冷冰冰的椅

2.

大腿上的手袋

3.

……

4.

……

5.

……



慢而深地呼吸

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行為小改變

1.

緩緩深呼吸

2.

暫時離開

3.

飲杯水

4.

找其他事做

1.

輕鬆事

5.

……

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呼吸法

等留

吸

• 吸、留、呼、等：各 3 秒

• 「一千零一、一千零二、一千零三」

• 重覆 5 次

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情緒急救

(Hromek, 2007)



釋放：流程



需時：約20分鐘



時間與空間：自我冷靜 (self-calming)

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情緒急救：前提

(Hromek, 2007)



溫和、冷靜、「對事」的聲線



減少言語的直接命令



時間換取空間



留意自己的情緒反應



留心是否捲入權力爭鬥

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「我訊息」的步驟：

1.

把困擾你的行為描述出來，不要責怪「當我看到你表現激動……」

2.

說出你對這件行為有什麼感受「……我覺得很擔心……」

3.

然後把這行為所可能導致的後果說出來「……因為這樣做可能會弄傷自己。」

「我訊息」簡單格式：

「當……的時候，我覺得……，因為……。」

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Article:



Dorsal Executive System (ColdEx)

- ‘Cool’ Cognition - Goal-relevant

information processing - Future-oriented



Ventral Affective System (HotEmo)

- ‘Hot’ Emotion

- Basic drives and emotions - Here & now

Metcalfe, J., & Mischel, W. (1999). A hot/cool-system analysis of delay of gratification: Dynamics of

willpower. Psychological Review, 106, 3-19.

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有冇幫助的想法？



以事實或實際資料為基礎



合符情理



沒誇張、不輕視



讓情緒平和下來



使人有能力(正面)面對



沒有事實根據



誇大負面後果



令焦慮不安升級



使人逃避

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Article:

1. 相信情緒可轉變，特別是自己的情緒可變

 「成長心態」

De Castella, K., Goldin, P., Jazaieri, H., Ziv, M., Dweck, D.S., & Gross, J.J. (2013). Beliefs about emotions: Link to emotion regulation, well-being, and psychological distress.

Basic and Applied Social Psychology, 35, 497-505.

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一、反覆沉思 (rumination)

二、保持距離 (distancing)

三、隨遇而安 (acceptance)

四、正面重估

Article:

Rood, L., Roelofs, J., Bögels, S. M., &

Arntz, A. (2012). The effects of

experimentally induced rumination, positive reappraisal, acceptance, and distancing when thinking about a

stressful event on affect states in

adolescents. Journal of Abnormal Child

Psychology, 40, 73-84.

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情緒調控

1.

離開休息

2.

冷靜思想

3.

安全釋放

4.

解決問題

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Education for Emotional competence

1.

Emotion understanding

2.

Emotion expression

3.

Emotion regulation

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自我情緒的察覺

1.

我很清楚自己情緒的好壞。

2.

心情變差時，我能馬上感覺到。

3.

我通常知道自己心情不好的原因是什麼。

4.

我常傾聽自己內心的感受，並藉此了解自己的情緒。

5.

我能從生理狀況、身體反應來了解自己的情緒。

6.

我的表情很豐富。

7.

我能坦然接受自己的情緒。

8.

我喜歡和別人分享彼此的情緒感受。

(楊俐容、孫德齡，2015)

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Skills 技巧

點出情境

提出問題

肯定情緒

解決

方法

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S.H.I.N.E. model (Ho, Mak, Ching & Lo, in press)



S: Strength-based habit



Recognition & development of unique character strengths



Cautiousness



Interpersonal



Vitality

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個性優勢



“Character strengths are ways of thinking, feeling, and behaving that come naturally and easily to a person and that enable high functioning and performance.”

(Linley, Joseph, Harrington, & Wood, 2006)



“Character strengths are the psychological ingredients for displaying human goodness and they serve as

pathways for developing a life of greater virtue. While

personality is the summary of our entire psychological

makeup, character strengths are the positive components

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S.H.I.N.E. model (Ho, Mak, Ching & Lo, in press)



H: Hope



Future-oriented thinking style



Thinking about one’s goal



Viable pathways to goals



Sustaining will in goal pursuit



Growth mindset 成長心態

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S.H.I.N.E. model (Ho, Mak, Ching & Lo, in press)



I: Interpersonal relationship



Positive and nourishing interactions



Active positive responses



Positivity ratio



Active Constructive Responses

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School Climate

1.

Being Seen 被關注

2.

Being Recognized 被認同

3.

Being Wanted 被需要

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P.R.I.S.M.

Being Seen

Being

Recognized

Being Wanted Perceive

• What?

Recognize

• How?

Interpret

• Benefits

Sustain

• Self

regulation

Motivate

• Intrinsic/

Extrinsic motivation

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P.R.I.S.M.



P: Perceive



個性優勢：Creativity, Love of Learning, Zest, Humour



R: Recognize



對數學科日常上課及學習的觀察



日常與學生的相處、交流



I: Interpret



Good for: 幫助同學學習牢記



S: Sustain、M: Motivate



親身經歷，投入製作



製作成片段



禮堂表演機會



眾人同參與

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S.H.I.N.E. model (Ho, Mak, Ching & Lo, in press)



N: Noticing both positives and negatives



S.H.A.R.E.



Selective attention test

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S.H.I.N.E. model (Ho, Mak, Ching & Lo, in press)



S.H.A.R.E.



Slow down and direct attention to positives



Have the attention in details from senses



Amplify and prolong the positive feelings



R emember current and anticipate future positives



Express thankfulness

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S.H.I.N.E. model (Ho, Mak, Ching & Lo, in press)



E: Empowerment as outcome

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References

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De Castella, K., Goldin, P., Jazaieri, H., Ziv, M., Dweck, D.S., & Gross, J.J. (2013). Beliefs about emotions: Link to emotion regulation, well-being, and psychological distress. Basic and Applied Social Psychology, 35, 497-505.

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Dynamics of willpower. Psychological Review, 106, 3-19.

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References

Rood, L., Roelofs, J., Bögels, S. M., & Arntz, A. (2012). The effects of experimentally induced rumination, positive reappraisal, acceptance, and distancing when thinking about a stressful event on affect states in adolescents. Journal of abnormal child psychology, 40, 73-84.

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Savina, E., Coulacoglou, C., Sanyal, N., & Jhang, Z. (2012). The study of externalizing and internalizing behaviours in Greek, Russian, Indian, and Chinese children using the Fairy Tale Test. School Psychology International, 33, 39-53.

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楊俐容、孫德齡 (2015)，《給中學生的情緒管理術》，台北：親子天下。

教育局 (2015)，《學校處理學生自殺問題電子書：及早識別、介入及善後》，下載於

2016.09.01 自：http://www.edb.gov.hk/attachment/tc/student-parents/crisis-management/about-

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