團體認知行為治療對門診憂鬱症青少年之成效初探
The Effectiveness of Group Cognitive Behavioral Therapy for Outpatient Adolescents With Depression: A Pilot Study
中文摘要
論文摘要
論文名稱：團體認知行為治療對門診憂鬱症青少年之成效初探 研究所名稱：臺北醫學大學護理學研究所
研究生姓名：謝玉萍
畢業時間：九十六學年度 第二學期
指導教授：張秀如 臺北醫學大學護理學院 助理教授
本研究目的為探討短期團體認知行為治療對門診憂鬱症青少年之成效。採單組前、後測之類實驗 性研究設計，研究對象為北部某教學醫院門診憂鬱症青少年共四人，參與經設計的團體認知治療 模式共八次，每週進行一次，每次 60-70 分鐘。研究工具包括：「貝克憂鬱量表」、「認知三元素 量表」、「自殺危險程度量表」、「自我傷害行為量表」、「團體成效量表」，統計方式包括描述性統 計、無母數 paired samples t-test；結果顯示個案的憂鬱分數，由前測之 11(SD＝6.7)降低 至後測之 5.8(SD＝5.4)，認知三元素分數也由前測之 40.5(SD＝14.3)進步為後測之
51.5(SD＝12.3)，自殺危險程度量表分數由前測之 6.8(SD＝9.2)降低至後測之 2.5 (SD＝
3)，自我傷害行為量表分數由前測之 22.3(SD＝15)降低至後測之 10.3(SD ＝10.70，但前 後測分數差異皆未達到統計上顯著差異。以內容分析法分析團體歷程，發現成員的生病歷程為檢 視致病起源、檢視憂鬱之負向認知、檢視負向認知的多方影響；團體歷程轉變包括情緒辨認、情 緒控制、檢視想法、想法轉個彎，透過團體歷程分析內在轉變的歷程，結果呈現從生病看法、認 知及對日常生活影響，到團體中開始察覺情緒、挑戰非理性想法、情緒控制到與外界互動的轉變。
研究結果可提供未來相關研究及護理實務介入措施的依據及參考。
關鍵字：認知行為治療團體、憂鬱症青少年
英文摘要
The purpose of this study was to study the effectiveness of short-term group cognitive-behavioral therapy for the outpatient adolescents with depression . The research design was to adopt the one-group pretest-
posttest of experimental method. This study was on four outpatient adolescents at a teaching hospital at northern Taiwan. They participated the tailor-made cognitive group therapy with once weekly for eight times, and each session lasted for 60-70 minutes. The research instruments consisted of the Beck Depression Inventory (BDI-II), Cognitive Triad Inventory for Children (CTI-C), Scale of Suicidal Risk, Self-harm Behaviors Scale, and Group Effectiveness Scale. The data were analyzed using descriptive statistics and nonparametric paired sample t-test used to analyze for different between pre-tests and post-tests.
The results of this study showed that patients'' pre-test 11±6.7 (mean±SD)to post-test of 5.8±5.4, the score of Cognitive Traid was improved from pre-test 40.5±14.3 to post-test 51.7±12.3, the Scale of Suicidal Risk was reduced from pretest 6.8±9.2 to post-test 2.5±3, and the score of Slf-harm Bhaviors Sale was decreased from pretest 22.3±15 to post-test
10.3±10.7 But those improvements did not reach any significant differences from pre-test to post-tests. We used the content analysis method to analyze group process, and we found that illness process of the members began with the examination of the origin of illness-cause, inspection of negative cognition of depression, and inspection of diversified impacts of negative cognition. To further analyze the group processes with content analysis method, we needed to include emotion recognition, emotion control, inspection of thought, and shift of thoughts as we resorted to the process of internal transformation of group process analysis.
The results further included thought, cognition, and impact of daily life from illness to emotion discovery of the group, challenge of irrational thoughts, emotion control and change of interaction with the external world.These finding of this pilot study may provide as the preliminary
reference to the related research and the nursing practice of group cognitive behavioral therapy in the future.
keyword：cognitive behavioral group therapy 、adolescents with depression
