會所模式下精障者邁向獨立生活的歷程─以伊甸活泉之家為例

Abstract

國外推行了數十年的「會所模式」，近幾年來在台灣紮根。本研究跳脫病理觀點，企圖回歸精神障礙者個人主體，以實踐會所模式的「伊甸活泉之家」作為研究場域，瞭解精障者邁向獨立生活的歷程，包含會所具備哪些元素與行動策略、過程中精障者遭遇哪些困難，以及工作者如何與他們共同克服。 本研究進行為期半年的田野參與觀察，了解會所模式以社群經營的運作方式，透過自願性、肩並肩、平權等元素，讓精神障礙者逐漸尋回身為人的本質。並且以深度訪談的方式，共訪問七位精障者與五位工作者，繪出精神障礙者獨立生活的圖像。研究結果發現，精神障礙者來到伊甸活泉之家後，透過會所模式參與互動的過程，建立信心以及對人的信任，亦藉由戲劇展演、公民記者、社會宣廣等專案、就業方案等，融入社會展開多元的社會角色。此外，工作者透過關係建立的過程，協助精神障礙者跳脫疾病框架在身上的種種壓迫與束縛，進而成為自己生活的主人，自主決定與安排生活，並為每個決定負責。 會所模式不同於傳統的服務模式，工作者經常面臨關係與角色的掙扎，研究建議應健全會所模式的督導制度，協助工作者於實務過程中深度地覺察與反思，以穩固會所的發展與實踐。建議未來發展精神障礙獨立生活之服務時，應考量臺灣社會文化脈絡的差異，以貼近其生活需求，促進精神障礙者的福祉。Recently, Clubhouse Model, which has already practiced for decades overseas, has sprouted in Taiwan. In this study, the researcher takes the individual subject as the main point of view, instead of treating the people with psychiatric disability as patients, and chooses Clubhouse-Model-practiced “Eden Fountain House” as the research field, to realize the process towards independent living of the people with psychiatric disability, including what elements and strategies the clubhouse has, what difficulties the people with psychiatric disability will meet during the process, and how the workers overcome the difficulties with them. In this study, the researcher understands the operation in the Clubhouse Model Community-run during the field participant observation for half year through voluntary, side by side , equal rights and other elements, people with psychiatric disability could gradually recovered as human nature. By depth interview method for seven people with psychiatric disability and five workers, then images of independent living for the people with psychiatric disability. Through the study, the researchers found that people with psychiatric disability come to Eden Fountain House, they gradually build up their confidence and trust of the people through participation and interaction. People with psychiatric disability fit into the society and play kinds of social roles through theatre performance, citizen journalist, social advocacy, employment programs. In addiction, the workers assisted people with psychiatric disability to escape the oppression and bondage of disease framework in the body, and thus become masters of their own lives, and they autonomously make decisions and living arrangements, and are responsible for each decision. Clubhouse Model is different from the traditional model of service; workers usually have to face the struggle between the relationships and the roles. This study suggests that the supervision of Clubhouse Model should be well-systematized to assist workers to have deep awareness and reflection during the process of practice, to stabilize the development of Clubhouse Model and practice. Recommended that the future development of psychiatric disability in independent living services should be considered in the context of Taiwan's social and cultural differences, to close to their needs, and promote the well-being of people with psychiatric disability.