破曉現黎明-焦點解決短期諮商在高中注意力缺陷過動症學生之個案研究

Abstract

本研究希冀透過焦點解決諮商（Solution-Focused Brief Therapy，簡稱SFBT）對於注意力缺陷過動症（Attention Deficit Hyperactivity Disorder，簡稱ADHD）青少年在諮商中所呈現的歷程階段、所運用的焦點解決短期諮商技術與分析其執行功能(Executive Function)上所呈現的交互影響，以一位注意力缺陷過動症高中學生為研究對象，進行12次的焦點解決短期諮商的個別晤談，採質性個案研究取向，分別以諮商過程逐字稿、個案諮商後訪談及回饋問卷、家長、導師及朋友訪談資料、研究者觀察記錄等不同觀點加以分析探討，以深入了解個案的內心世界及與ADHD共處的心理歷程，研究結果呈現如下: 注意力缺陷過動症學生的焦點解決諮商歷程經驗:諮商目標的設定來自於重要他人對於阿祥的優勢觀察，目標有三(1)人際相處:察覺人我差異與克制行為衝動；(2)自我悅納:看見優勢能力、重新檢視與注意力缺陷過動症共處經驗；(3)生涯規劃:統整資訊以進行生涯決策、充實自我以進行生涯準備。 諮商歷程為建立關係=>擴大正向經驗=>轉化階段=>結束階段，透過四階段歷程的諮商，帶領個案重新檢視過去賦予正向意義與開始展望未來期許正向經驗。 焦點解決諮商技術對應ADHD核心症狀、執行功能的對應比較:「因應問句V.S自我控制」、「一般化&讚美技術V.S自我激勵」、「例外問句V.S注意力分散」、「重新建構技術V.S社交孤立」、「假設問句V.S自我對話」、「評量問句V.S自立參照」、「關係問句V.S自我指導」、「社交技巧練習制V.S衝動控」、「探問與隱喻技術V.S自我監督」 最終根據研究結果發現，提供未來實務工作與相關研究建議。This study was to explore the application of Solution-Focused Brief Therapy (SFBT) on the consultation with a adolescent with Attention Deficit Hyperactivity Disorder (ADHD). The impact of its executive function is also the focus of the research. The participant, a high-school student with ADHD attended twelve SFBT sessions individually. The qualitative case study method is adopted in the data collection, including the consultation transcripts, post-consultation interviews and feedback questionnaires, the interview data from the parent, the homeroom teacher and the friend, and the researcher’s observation records, all of which are analyzed to understand the inner world of the participant and the psychological experience of coexistence with ADHD, The research results are as follows: The experience of the adolescent with ADHD adolescent under the SFBT consultation: The consultation goals are established based on the observation of the advantages from the close related people. There are three goals. (1) Interpersonal relationship: perceiving the differences between each other and restraining behavior impulses. (2) Self-acceptance: acknowledging impulses and re-examining the experience with ADHD; (3) Career planning: integrating information to make career decisions and enriching himself for career preparation. The consultation process is to build counseling relationship; to expand positive experience ; to experience conversion stage ; to end the consultation. Through the four-stage process, the participant is led to re-examine the positive meanings in the past and start looking forward to future positive outlook.

The application of SFBT compared to the core symptoms of ADHD, and executive function: " response question compared to self-control", " generalization& praise compared to self-motivation", " exception questions compared to attention distraction", " re-construction compared to social isolation" " hypothesis questions compared to self-dialogue ", " assessment questions compared to self-reliance", " relationship questions compared to self-guidance", " social skills practices compared to impression control "and " inquiry and metaphor compared to self-supervision " Based on the research findings, implications and suggestions for future practical work and related research are proposed.