慈輝班身心障礙學生的學校支持系統之個案研究

Abstract

本研究以質性研究之個案研究法，探討一名慈輝班身心障礙學生在學校中的需求與挑戰，以及慈輝班的學校支持系統之合作歷程與模式。研究過程中，透過半結構訪談、檔案資料分析蒐集資料，並佐以文獻與理論，逐漸描繪出落實專業合作全貌，並說明團隊合作模式與互動歷程。研究者發現慈輝班身心障礙學生受到家庭與障礙的「雙重不利」因素交織而成，整體適應不佳且需求是多元且複雜的。慈輝班（校）團隊可以由生態系統理論詮釋以個案為中心的學校支持系統之形成歷程，其中微觀系統包含導師與住宿輔導員，第一線協助個案，也連結著家庭、給予支持；中介系統以特教個管教師、專輔教師與生教組長組成的核心團隊，給予微觀系統支持並連結外部系統的資源；外部系統依據個案需求加入醫療系統、社政系統、警政系統與地區支援系統；鉅觀系統包含校園氛圍、相關法規等等。以個案為中心的生態系統主要是依據多層級模式建構，再依需求逐漸擴張系統，發展歷程為準備期、第一階段的初級預防與間接服務、第二階段中介系統直接服務與醫特合作、第三階段的三級處遇性介入與擴大專業支持、第四階段建構校內跨專業合作、第五階段外部資源介入並提供專業諮詢。此合作歷程顯現了專業合作的重要性與必要性，學校團隊如同一把傘逐漸撐開，成員如傘布一般支撐起個案的生態系統，逐漸形成跨專業團隊的合作模式，因個案的特教身分，特教教師透過兩個大小三角形的PBS工作架構找到連結資源和工作目標。本研究中，團隊最終形成「跨專業團隊合作模式」，其中是以個案的特教教師為個案管理者，透過角色釋放的過程達到跨越專業藩籬的合作模式。當不同專業的意見分歧時，會透過行政人員的溝通取得合作共識，同時家庭參與可視為擴大後的跨專業團隊合作。研究者發現影響跨專業合作包含八個關鍵因素與四個原則，其中八個關鍵因素分別為：「共同信念—學生最佳利益為目標」、「心態彈性調整：面對、接受與放下」、「慈輝學校教師特質相近，彼此感情深厚」、「慈輝學校設置特性：專業人力與日夜接班」、「溝通方式多元且即時」、「校園地域狹小，互動緊密」、「專業分工卻又互相補位的系統合作」、「互相支持、感謝彼此付出，共創並肩作戰的團隊氛圍」。專業合作成功的四個原則為：「循序漸進的多元介入模式、逐漸擴充支持系統」、「整合團隊共識，將點狀服務連成線、再畫成面」、「角色分工明確，給予一致性的原則」、「團隊氛圍和諧，彈性調整與接納理解」。最後，基於上述研究發現與討論，本研究對未來研究與實務工作提出相關建議。This study utilized a qualitative case study approach to explore the needs and challenges of a student with disabilities in a Tzu-huei program, as well as the processes and patterns of the collaboration among school support system in the Tzu-huei program. The data were collected through semi-structured interviews, archival data analysis, and referred from literature and theories to gradually conclude a comprehensive picture of the situation and to illustrate the patterns of teamwork and interactions.The researcher found that the student with disabilities in Tzu-huei program was affected by the"double disadvantage" from family and disability, and her overall adjustment was poor and her needs were diversified and complicated. The Tzu-huei program team gradually formed a student-centered school support system based on the ecological system theory, in which the micro-system consists of instructors and residential counselors, who provide first-line assistance to the student as well as connecting with the families and providing support; the intermediary system consists of the core team members, such as special education teacher as her care manager, counseling teacher, and discipline section chief , who provide support to the micro-system and connect with the resources of the external systems. The external system includes the medical, social welfare, the police, and the local support system according to the needs of the student; the macro system includes the campus atmosphere, relevant laws and regulations, and so on.The student-centered eco-system is constructed based on a multi-level model, and then the system is gradually expanded according to the needs. The development process includes the preparation period, the first stage is primary prevention and indirect services, the second stage is direct services from the intermediary system and cooperation between the medical and specialties, the third stage is third-tier intervention and expansion of professional support, the fourth stage is inter-professional cooperation within the school, and the fifth stage is external resource intervention and professional consultation. This collaborative process demonstrates the importance and necessity of professional collaboration, with the school team acting as an umbrella that gradually opens up, and its members acting as umbrella fabrics to support the ecosystem of the case, gradually forming a model of inter-professional teamwork.In this study, the team eventually formed an" Trans-disciplinary teamwork model", in which the special education teacher was the case manager, and through the process of role release, a model of cooperation across professional barriers was achieved. When there were differences in opinions among different team members, a consensus was reached through communication among team members, and family involvement could be regarded as an expanded model of Trans-disciplinary teamwork. The researchers found that there are eight key factors and fourprinciples that influence Trans-disciplinary. The eight key factors are:"common beliefs - the student’s maximum benefit as the goal", "flexible adjustment of mindset: face, accept and let it go", "similar characteristics of teachers in Tzu-huei program and deep relationship among them", "characteristics of Tzu-huei program 's setup: professional manpower and day and night shift work", "diversified and immediate ways of communication", "the school is small in size, but the interaction is close" ,"the systematic cooperation of professional division of labor but complement each other," and "mutual support, appreciation for each other's contribution, and the creation of a team atmosphere of working side by side". In addition, the four principles of success were: "gradual and diversified intervention model, gradually expanding the support system", "integration of team consensus, connecting point services into lines and then into surfaces", "clear division of roles, giving the principle of consistency", and "harmonious team atmosphere, flexible adjustments and acceptance of understanding". Finally, based on the findings and discussions, the researcher would like to make some suggestions for future research and practical work for reference.