Bowen家庭系統理論運用於酒精使用障礙者心理教育團體之成效初探

Abstract

本研究旨在探討Bowen家庭系統理論運用於酒精使用障礙者之心理教育團體的成效初探。本研究混合研究之嵌入式設計，主要以量化研究探討本團體對於酒精使用障礙者於降低焦慮、提升其自我分化程度及減酒態度之成效，並輔以質性研究探討本團體對酒精使用障礙者之幫助和其團體經驗。本研究團體以Bowen家庭系統理論自我分化等概念為基礎，設計為八次，每次二小時，共計十六小時之心理教育團體方案。本研究之研究參與者為9位酒精使用障礙成年男性，其年齡介於20歲至50歲之間，平均年齡為40歲，且其在酒精使用疾患確認檢測量表（The Alcohol Use Disorders Identification Test, AUDIT）之分數皆大於8分。本研究於團體前後進行研究量表施測，以情境特質焦慮量表、中文版自我區分量表及羅德島大學行為改變評估量表蒐集研究參與者量化資料，並於團體結束後一週進行個別訪談。本研究量化研究資料以單一樣本相依t檢定進行分析，質性資料則以現象學研究取向的反思性主題分析進行研究分析。本研究量化分析結果顯示，該研究團體於降低酒精使用障礙者之焦慮程度、提升其自我分化程度及減酒態度無顯著之立即性效果。本研究質性資料主題分析結果則顯示，本團體對成員之幫助和其團體經驗包括：看見飲酒行為的複雜成因、看見焦慮的系統、飲酒在系統的功能性，以及思考改變計劃等主題。本研究結果發現，Bowen家庭系統理論運用於酒精使用障礙者之心理教育團體的成效和幫助在於成員能以系統觀點看待飲酒行為，並了解到飲酒行為的複雜成因進而觸發思考改變計畫。最後，本研究綜合討論量化與質性研究結果與發現，並對未來相關團體研究和減酒治療實務工作提出若干建議。This preliminary study aimed to explore the effects of a psychoeducational group based on Bowen family systems theory for individuals with harmful use of alcohol. The study used a mixed method embedded design, in which the quantitative approach served as the primary approach, complemented with the qualitative approach to enrich the understanding of participants' experiences. Quantitative data were collected and used to examine the effectiveness of the group on reducing participants’anxiety, enhancing their levels of differentiation of self, and improving their attitudes toward alcohol reduction. Qualitative data were also collected and used to explore participants’subjective experiences and perceived benefits of the group. The psychoeducational group was designed based on the main concepts of Bowen family systems theory such as the concept of differentiation of self. It consisted of eight 2-hour sessions with a total of sixteen hours. Participants in this study were nine male adults with harmful use of alcohol, and their ages ranged from 20 to 50 years old with a mean age of 40 years. All of them scored above 8 on the Alcohol Use Disorders Identification Test (AUDIT). Quantitative measures included the State Trait Anxiety Inventory (STAI), the Chinese Version of the Differentiation of Self Inventory (C-DSI), and the University of Rhode Island Change Assessment (URICA) were administered before and after the group intervention, and individual interviews were conducted one week after the group ended. Paired sample t-tests were used to analyze the quantitative data of the study, and a reflective thematic analysis based on a phenomenological approach was used to analyze the qualitative data of the study.Quantitative results of the study indicated no statistically significant immediate effects of the group intervention on reducing participants’anxiety, enhancing their differentiation of self, and improving attitudes toward alcohol reduction. However, qualitative results of the study revealed several main themes including participants’ understanding the complex causes of their drinking behaviors, gaining insight into the systemic anxiety, recognizing the functional role of alcohol within the systems, and contemplating change. Findings of the study suggested that the psychoeducational group based on Bowen family systems theory might benefit participants with a systemic perspective on their drinking behaviors, help them recognize the complexity of their alcohol use, and facilitate their thinking of change.Finally, the implications of findings from the study and the group intervention based on Bowen family systems theory for individuals with harmful use of alcohol as well as suggestions for future research were further discussed.