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)

保良局 教育心理服務 張溢明

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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。

保良局 教育心理服務 張溢明

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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Socially avoidant or withdrawn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

保良局 教育心理服務 張溢明

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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

保良局 教育心理服務 張溢明

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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

保良局 教育心理服務 張溢明

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

保良局 教育心理服務 張溢明

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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

保良局 教育心理服務 張溢明

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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

保良局 教育心理服務 張溢明

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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

保良局 教育心理服務 張溢明

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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

保良局 教育心理服務 張溢明

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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

保良局 教育心理服務 張溢明

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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

保良局 教育心理服務 張溢明

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「我見到……」

中性、不苦惱、不帶動感受的事物

1.

地板

2.

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

保良局 教育心理服務 張溢明

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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.

……

保良局 教育心理服務 張溢明

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呼吸法

等 留

• 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)

保良局 教育心理服務 張溢明

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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……。」

保良局 教育心理服務 張溢明

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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

保良局 教育心理服務 張溢明

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」

保良局 教育心理服務 張溢明

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

保良局 教育心理服務 張溢明

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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)

保良局 教育心理服務 張溢明

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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

保良局 教育心理服務 張溢明

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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

保良局 教育心理服務 張溢明

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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

保良局 教育心理服務 張溢明

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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

保良局 教育心理服務 張溢明

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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

保良局 教育心理服務 張溢明

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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

Beaudoin, M.-N. (2014). Boosting All Children’s Social and Emotional Brain Power: Life Transforming Activities. Thousand Oaks, California: Corwin.

Brock, L.L., Rimm-Kaufman, S.E., Nathanson, L., & Grimm, K.J. (2009). The contributions of

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Carson, J.L., Parke, R.D. (1996). Reciprocal negative affect in parent-child interactions and children’s peer competency. Child Development, 67, 2217–2226.

Cole, P. M., Dennis, T. A., Smith-Simon, K. E., Cohen, L. H. (2008). Preschoolers’ emotion regulation strategy understanding: relations with emotion socialization and child self- regulation. Social Development, 18, 324-352.

Davis, E.L., & Levine, L.J. (2013). Emotion regulation strategies that promote learning:

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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.

保良局 教育心理服務 張溢明

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References

Denham, S.A. (2007). Dealing with feelings: How children negotiate the worlds of emotions and social relationships. Cognition, Brain, Behavior, XI(1), 1-48.

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New York: Kluwer Academic.

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empowerment: The application of positive psychology.

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London: Paul Chapman Publishing.

Iordan, A. D., Dolcos, S., & Dolcos, F. (2013). Neural signatures of the response to emotional distraction: A review of evidence from brain imaging investigations. Frontiers in Human,

Neuroscience, 7, 1-21.

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References

Jensen, F.E. (2015). The Teenage Brain: A Neuroscientist’s Survival Guide to Raising Adolescents and Young Adults. London: Thorsons.

Kauffman, J.M. (2005). Characteristics of Emotional and Behavioral Disorders of Children and

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

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

Reilly, N. (2015). Anxiety and Depression in the Classroom. New York: W.W. Norton & Company.

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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.

Rydell, A., Berlin, L., & Bohlin, G. (2003). Emotionality, emotion regulation, and adaptation among 5- to 8-year-old children. Emotion, 3, 30–47.

Sallquist, J.V., Eisenberg, N., Spinrad, T.L., Reiser, M., Hofer, C., Liew, J., & Zhou, Q., et al. (2009). Positive and negative emotionality: Trajectories across six years and relations with social competence. Emotion, 9, 15-28.

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.

Seligman, M.E.P., Ernst, R.M., Gillham, J., Reivich, K., & Linkins, M. (2009). Positive education: Positive psychology and classroom interventions. Oxford Review of Education, 35, 293-311.

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Winch, G. (2013). Emotional First Aid: Healing Rejection, Guilt, Failure and Other Everyday Hurts. New York: Plume – Penguin Group.

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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