與精神障礙者攜手並進-一位就業服務員的專業成長與反思

Abstract

本論文旨在探討精神障礙者就業服務員的專業型塑歷程。精神障礙者就業服務員嘗試回顧與精神障礙者相處的片刻，並省思自身原生家庭的經驗，及機構變動的歷程中，哪些因素影響著就業服務員與精神障礙者的互動與抉擇意識。 另外，從一個基層工作者的角度，在建構自己成為一位專業工作者的同時，又因身處公立醫療機構，受到多方制度的擠壓，以及歷經政策不斷變動，因應、折衝的過程裡，精神障礙者就業服務員如何學習自我反思與充權。 最後，精神障礙者就業服務員建構自我的認同與信心，並且對於精神障礙者的就業服務有了新的啟發與洞見：專業知識的應用有多重盲點、不對等的權力關係阻礙了人我的交流、制度的建構應更加彈性以免形成服務上的阻礙，因而提出「助人美學」的深切呼籲，其中包括： 一、不強調理性知識，而是以精神障礙者的生命為主體，產生共鳴。 二、關係不是「控制」，助人者與受助者是平等、雙向互通的生命。 三、彼此承諾(commitment)，不放棄與盡力的情況下，一起前進。 再者，從「框架內的規訓」，看到「框架外的文明」，進一步辨識與回答： 一、醫院執行勞政服務是配合政策？不！是必要的跨界服務。 二、服務障礙者的政策？不！是服務制度的政策，應加以調整。 三、專業養成課程足夠否？不！需多強調生命教育與實務學習 最後，則對於精神障礙者就業服務員如何充實專業素養則提出懇切的建議。

This research is set out to explore the journey towards professionalization of a job coach. By recalling the moments in service with people with psychiatric disabilities, the author reflected on her own experiences and family upbringings, aiming to decide which of the factors determines the interaction and self-determination between the job coach and a person with psychiatric disability.

From the perspective of a basic level worker in the health service system, challenges of professionalization of a psychiatric job coach may come in multiple situations, such as when facing with complicated and sometimes contradicting policies and inconsistence of policies throughout time. This article aims to illustrate how a professional coped with these challenges, learned from the process, and endeavored to self-empower herself.

The development of self recognition and self confidence of a psychiatric job coach led to new inspirations and visions into employment service with people with psychiatric disabilities. The reflections are as follows: professional knowledge’s blind spot in practice, imbalance of the power structure that hindered interpersonal exchange, and significance of developing a more elastic system to prevent contradiction in practice.

After reflection on the practice, I propose the following values of a professional helper to facilitate professional growth: 1.Trying to perceive the service from the person (with psychiatric disability)’s point of view, in the effort to resonate with her, not from the intellectual analytic standpoint. 2.Standing on equal ground with the person receiving support, building the relationship between each other with mutual respect, not ‘attempting to control’. 3.Giving commitment from both sides to facilitate growth.

In addition, I further elaborate on the importance of professionalization of job coaches by debating the concept of ‘from discipline inside the frame to humanity outside the frame,’ in the hope to offer some sincere suggestions into this realm: 1.Should the labor administration service provided by the hospital go along with the policy? No! It ought to be a multidisciplinary collaboration in nature. 2.Is the policy adequate to serve the people with special needs? No! It is far from adequate. It should be adjusted continuously. 3.Is the professional training for a job coach sufficient? No! Further life education and practice courses should be implemented.