PLISSIT 模式應用在心智障礙者性議題之啟示

The Implication of Applying the PLISSIT Model to Sexual Issues of Individuals with Intellectual Disabilities

2007 年我國修正公布身心障礙者權益保障法，明定應提供身心障礙者婚姻及生育輔導的支持服務，開啟了身心障礙者性處遇政策法制化之門。事實上，諸多先進國家，對於身心障礙者（尤其智能障礙者）的性權，早已倡議多年，並認為不論障礙程度為何，智障者在人權理念下，本就應該擁有性，並發展有意義、互惠的親密關係或結婚的權利。 前述我國身心障礙者的婚姻生育政策，依「日升條款」的規定，將於2012 年開始施行，此一創新規定的執行方式，亟須參考他國之發展經驗。而「PLISSIT 模式」即透過允許（permission）--適量的知識（limited information）--明確的建議（specific suggestion）--密集的治療（intensive therapy）等四個層次，採取教育、輔導和諮商、治療等方式，以處遇智障者各種與性有關問題。此一模式在國外已施行多年，可適用於不同的設施、時間，能協助並澄清工作人員對性的自在感受與精熟程度；如其自在程度或專業準備不足時，亦可採取轉介方式處理，此模式的運用方式十分具體與有效。 此外，應用PLISSIT 模式，可促使相關部門由下而上、自微而鉅地考量重要相關議題，包括：智障服務領域工作人員應具備的性教育專業知能、智障者性處遇所需的相關專業範疇，以及我國智障者性政策的重點與指導方針。

People with Disabilities Rights Protection Act announced in 2007 stipulates a brand new regulation that individuals with disabilities be provided marriage and fertility counseling and support services based on the assessment of their needs. According to the “Five-year Sunrise Clause”, the new provisions will be in carried out in 2012, with a need to refer to other countries' practical experiences or approaches, such as the PLISSIT model. The PLISSIT model, developed by Annon (1976), includes four aspects of sexual treatment: Permission (P), Limited Information (LI), Specific Suggestions (SS), and Intensive Therapy (IT). The model using educational, counseling, and therapy approaches deals with individuals with intellectual disabilities on a variety of sexual issues. This model, developed for many years, is applicable to different people, facilities, and time, and can help the helping staff to clarify the degree of their comfort with and mastery on sexuality. If their professional preparation is insufficient, the staff may refer the individuals to other experts. The application of the PLISSIT model may foster all the people in helping professions to think, in both micro and macro ways, about the following important issues, including: to propose the professional knowledge of sexuality education that staff should possess, to cooperate with multi-discipline professionals to treat the sexual issues of individuals with intellectual disabilities, and to develop sexuality policies and guidelines for individuals with intellectual disabilities.