國民小學諮商心理師面臨保密議題倫理判斷歷程之敘說研究

A Narrative Research on Ethical Judgment Process of Counseling Psychologists at Elementary Schools When Facing Confidentiality Issues

本研究之目的旨在探討諮商心理師在國民小學場域中面對保密議題時的倫理衝突經驗，瞭解其在面對未成年個案的保密議題時之倫理判斷，以及在經歷保密議題的倫理衝突後，此經驗對其造成之影響。經深度訪談三位在國小場域服務，經歷保密議題之倫理衝突事件，且具深刻影響與感受之諮商心理師，以敘說其倫理保密議題衝突經驗，再以訪談內容為文本，使用敘說研究之「類別－內容」進行分析，結果發現：諮商心理師經驗保密議題的倫理衝突事件時，首須瞭解事件狀況與思考可行方式，以做出較佳決定，再根據決定以採取行動，行動後產生事件結果，結果造成之影響則會使諮商心理師在想法、感受或下次遭遇倫理衝突事件時有不同的因應方式，同時，諮商心理師經驗上述衝突事件後，需經歷調適過程，以協助自己調整狀態，並準備好面對下次挑戰。整體而言，倫理的衝突與因應具備三階段之歷程：一、倫理衝突階段；二、倫理判斷階段；三、倫理影響階段。本研究亦針對研究結果提出倫理判斷歷程模式、研究貢獻、限制與建議。

The purpose of this study aimed to investigate the experiences of counseling psychologists in elementary schools with ethical dilemmas of confidentiality issues as well as understand their ethical judgement when facing confidentiality issues of minor clients and the impacts of the encountered dilemmas. In depth interviews were conducted to three counseling psychologists working in elementary schools with such experiences. The interview transcripts were analyzed and interpreted using narrative approach which included holistic-content and categorical-content analysis. Results indicated that when facing ethical dilemmas, counselors must first learn about the situation and consider attainable options to make a better decision and then take actions based on the decision. The results of their actions will affect the counselor's thoughts and feelings or they handle next ethical dilemma. In addition, after the incident, counselors need to adjust themselves in order to deal with next challenges. Generally speaking, there are three stages in the ethical conflict and coping process: the ethical conflict stage, the ethical judgment stage, and the impacts and adjustments stage. Based on the findings, an ethical judgment process model, contributions, limitations, and recommendations are proposed.