遊戲治療方案在88水災與921地震災後兒童心理復健——一所大學介入之研究

The Play Therapy Programs Conducted by a University for Psychological Recovery of Children Following the August 8 Floods and September 21 Earthquake

這是一篇評估研究，探討國立台中教育大學（前身是國立台中師範學院）學生輔導中心發揮專業，積極參與台灣兩大天然災害後的兒童心理復健工作，其一是2009年8月8日發生的中南部與東南部大雨水災與山區土石流災害，認養災區一所國民小學兒童心理復健，筆者是團員；其二是1999年9月21日發生於中部的集集大地震災害，筆者擔任學生輔導中心主任，規劃兒童心理復健。本文要旨為分析兩大災後兒童心理復健方案，探討遊戲治療實施問題，評估與建議，提供未來面對頻繁的天然災害後兒童心理復健工作參考。 研究發現，八八水災發生後，實施五個月期間的班級團體輔導每二週一次共八次、家長衛教文宣共八次單張、連續三天的寒令營活動一次、實施心理量表篩檢出18名兒童接受個別諮商服務，每次50分鐘，每位兒童實施八次，共144次，其中僅有3名兒童由筆者實施遊戲治療。針對應接受後續諮商的10名兒童，建議採行遊戲治療方案。 研究發現，九二一大地震發生後，國立台中教育大學擔負兒童心理復健的兩項作法，其一是實施班級團體輔導方案，由學務處召集各個教育學系師生擔任，由班級認養小學實施多元團體輔導方案；其二是由學生輔導中心規劃實施兒童遊戲治療服務。學生輔導中心選擇與財團法人中師文教基金會合作，向社會各界募款，專款推展遊戲治療（實務上名稱為遊戲諮商）實施災區兒童心理復健，是很好的決定。迄2002年共達成1.製作四至六坪面積空間的遊戲諮商室設備80間，捐助小學與兒童輔導單位。2.主辦與協助災區縣市政府辦理遊戲治療教師增能研習，辦理每梯次16至20小時的遊戲治療小團體工作坊研習共計24梯次。3.實施實習臨床督導。4.提供1000人次兒童遊戲治療服務。5.辦理個案研討會一次。成效研究發現以上各項活動方案，均受到參與學校及教師們的肯定：國民小學輔導室主任的角色認知與負責特質，是影響學校實施遊戲治療的重要因素。建議政府資助幼兒園與國民中小學設置遊戲諮商室，審慎聘用輔導室主任，辦理遊戲治療教師增能研習，培育學校遊戲治療之諮商心理師代理者，接受諮商心理師督導，建立督導體制。

This assessment study investigated the participation ofthe student counseling center at National Taichung University (formerly National Taichung Teachers College) in children's psychological recovery work following two major natural disasters in Taiwan. After severe flooding and mountain mudslides occurred in south-central and south-eastern Taiwan on August 8, 2009, the counseling center was responsible for providing psychological recovery for one elementary school children from the affected area. The author was one of the participants. The other natural disaster was the Jiji earthquake of September 21 , 1999. As director of the counseling center at that time, the author planned and implemented a psychological recovery program for children. This paper analyzes the child psychological recovery programs conducted after these two natural disasters, investigates and assesses problems encountered during the implementation of play therapy, and provides recommendations concerning future child psychological recovery programs following natural disasters.
The study discovered that the five-month program conducted in the wake ofthe Aug. 8 floods provided counseling to children once every two weeks, and met a total of eight times. This program also provided eight health education handouts to parents, and conducted one three-day 'winter camp' activity. A psychological screening tool was used to select 18 children for individual counseling service; the counseling sessions lasted 50 minutes and were provided eight times to each child, for a total of 144 times. The author conducted play therapy sessions with three of the group of children. It was recommended that 10 children in need of further counseling participate in a play therapy program.
The study further discovered that two methods were used at National Taichung University to provide psychological recovery of children in the wake of the 921 earthquake. One method consisted of the group guidance and counseling program for class, which was taught by students and teachers from several education departments overseen by the office of student affairs. The class of students from some 'adopted' elementary schools took part in the group guidance and counseling program with varied activities. The second method consisted of the child play therapy session implemented by the university's student counseling center. The student counseling center cooperated wìth the Chung-shih Culture and Education Foundation in conducting this activity. The Foundation's decision to raise and provide funds for play therapy (which is often termed 'play counseling' in practice) for the purpose ofpsychological recovery of children from disaster-stricken areas proved to be a good choice. As of 2002, this program achieved the following: (l) Eighty 13-20 m play counseling rooms with equipment had been established as a donation to elementary schools and children's counseling units. (2) The program sponsored and helped city and county governments in stricken areas to hold skills strengthening workshops for play therapy teachers; 16-20 hour small group workshops were held during each of the psychological sessions. (3) Implementation ofpractical clinical supervision. (4) Provision ofplay therapy service to children 1, 000 person-times. (5) Holding of one case seminar. It was found that the foregoing action programs all received the support of participating schools and teachers, and the role perceptions and level of responsibility of elementary school counseling office directors were major factors affecting schools' implementation of play therapy. We recommend that the government provide funding for the establishment of play counseling rooms at kindergarteens, elementary schools, and junior high schools, prudently hire counseling room directors, conduct skills strengthening workshops for play therapy teachers, train school play therapy counseling psychologist agents under the oversight of counseling psychologists, and establish an oversight system.