輕度自閉症者人際模式理解及自我烙印歷程初探:個案研究,ERICDATA高等教育知識庫
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篇名
輕度自閉症者人際模式理解及自我烙印歷程初探:個案研究
並列篇名
Exploring Interpersonal Patterns and Self-Stigma Process of a Young Adult with Autism Spectrum Disorder
作者 梁瑞珊田秀蘭
中文摘要

高教普及與自閉症類群盛行率提高,如何協助輕度自閉症者於校園之融合適應,值得關切,本實務研究以支持表達性療法為基礎,協助參與者瞭解人際模式,從經驗探索開展內在資源。本研究屬個案研究,參與者為男大生,過程蒐集量及質性資料:先採貝克焦慮、憂鬱量表,瞭解諮商前、後情緒變化;於正式諮商的衡鑑期,收集成長史等以利概念化;於主要諮商期,從人際事件理解互動時之需求、對他人反應知覺及自我反應,並以Barber等人(1998)核心衝突關係主題(CCRT)分類,整理人際模式;最後,以訪談蒐集諮商過程變化,以對研究及自我進行回饋。研究發現:首先,量表顯示相較於諮商前,諮商後情緒有緩解傾向。其次,以核心衝突關係主題模式分析,主要諮商初、中、後期的人際需求、他人反應知覺雖未見明顯改變,但後期之自我反應,正向自我肯定反應有提升傾向。再則,從訪談回饋反映了諮商有助理解人際模式,且引發認知及行為調整。最後本研究綜整上述發現,從診斷與脈絡交織,討論自我價值與自我烙印等形塑歷程。建議對輕度自閉的協助宜跳脫診斷框架,鼓勵特教與諮商領域合作;另本案協助參與者進行深度探索相關結果如上,惟屬個案研究宜累積相關資料利後續參究。

英文摘要

Motivation and Purpose <p> With the increasing prevalence of autism spectrum disorders and higher education accessibility, it became crucial to address the adjustment issues of high-functioning individuals with autism spectrum disorders in inclusive college environments. This counseling practice study had three main objectives: (a) to understand the effects of expressive supportive therapy on alleviating anxiety and depressive symptoms in male college students with mild autism; (b) to enhance participants’ understanding of themselves and their interpersonal behavior patterns through the counseling process, thereby promoting a more flexible perspective on social interactions; and (C) to integrate the research findings and accumulate richer data on the inner psychological experiences of male college students with mild autism. <p> Method <p> This research adopted a case study approach, utilizing both quantitative and qualitative methods to collect, analyze, and explain the results related to the research questions. The study aimed to examine the changes in the participant’s interpersonal pattern during the counseling process through the mutual examination of quantitative and qualitative data. The research process included pre- and post-counseling assessments using the Beck Anxiety and Depression Inventories, 20 counseling sessions (each lasting approximately 50 minutes), and one feedback interview session lasting about 100 minutes. The first four counseling sessions constituted the assessment period, where a growth history was collected to facilitate conceptualization. The subsequent 16 counseling sessions constituted the primary counseling period. In this stage, the focus was on understanding the participant’s interpersonal wishes (W), responses of others (RO), and responses of self (RS) during interpersonal events (or relationship episodes). The data were analyzed and organized using Barber et al.’s (1998) Core Conflictual Relationship Theme (CCRT) classification. The 21st session involved obtaining participant feedback on the counseling process, which was then subjected to summarization, analysis, and synthesis. <p> Results <p> During the assessment period, the participant’s early interpersonal failures, due to the effects of the condition, had a significant impact. When facing challenges in a new environment, the participant experienced anxiety and uncertainty, feared others’ judgment and rejection, and felt frustrated by a sense of personal inadequacy. During the 16 primary counseling sessions, the participant’s wishes (W), perceptions of others’ responses (RO), and self-responses (RS) during interpersonal interactions displayed changes across three stages, according to BooK’s (1998) Core Conflictual Relationship Themes theory. While the primary expectation remained consistent across these stages, namely the desire to be “cared for and understood,” the responses from others were mostly characterized by “rejection or opposition,” leading the participant to feel “disappointment, depression,” and “helplessness.” Although negative responses still outnumbered positive ones, there were also some relatively more positive perceptions of others’ responses (RO) and self-responses (RS) showing improvement. Feedback from the interview revealed significant changes in the participant, including the restructuring of past interpersonal interaction patterns, learning to express personal feelings through actions, recognizing how previous negative experiences had affected their perception of information, and gaining a clearer understanding of the differences between themselves and others. The Beck Anxiety Inventory showed a reduction in anxiety levels from severe (28 points) before counseling to mild (10 points) after counseling. The Beck Depression Inventory showed a decrease in depression levels from mild (16 points) before counseling to within the normal range (9 points) after counseling. <p> Discussion & Recommendations <p> The results indicated a considerable reduction in emotional symptoms in the participant before and after counseling. This change in emotional symptoms could be correlated to the enhanced understanding of self and interpersonal patterns during counseling, which, in turn, influenced adaptation. For the participant, the primary counseling period had three stages, with the responses involving interpersonal wish (W), perceptions and responses of others (RO), and responses of self (RS) showing some variations but m aintaining a common theme of desiring to be “cared for and understood.” Nevertheless, responses from others largely entailed “rejection or opposition.” During the third stage, more adaptive responses of self that included “confidence and self-control” became part of the secondary response pattern. This indicated the impact of counseling on the participant, even though the enhancement of adaptive responses of self was slight. The feedback interview revealed that the participant learned to connect past experiences and current behavioral patterns, promoting understanding and insight. This represented a positive outcome of counseling. Finally, the study integrated the participant’s experiences throughout the counseling process and highlighted the impact of a medical diagnosis on personal growth. This impact extended beyond societal stigma and overall functioning, including the severity of symptoms, and included a significant aspect called “self-stigma.” The study explored self-stigma formation through aspects like “others’ recognition, acceptance, and interactive feedback,” “self-recognition and acceptance of the condition,” and “perception and internalization of interactive feedback.” According to the participant’s experience, although parents had a considerable understanding of the condition, their understanding was mostly used to explain behavior. Without proper application, this understanding offered limited help to personal development and might even reinforce stereotypes and prejudices against the individual. Additionally, early negative feedback from others continuously reinforced the presence of the symptoms, causing distress to the patient. However, even though the individual might have been unwilling to accept this reality, it did not change the fact of the illness. As a result, the condition gradually became accepted as part of the individual’s self-concept. This study suggested that counseling or consultation for people with mild autism not only assisted through learning approaches such as behavioral modeling. Another way to help them was by helping them understand themselves (e.g., interpersonal interaction pattern). It was hoped that a deeper self-understanding would help them integrate into society more effectively. While this research held practical exploratory value, its limitations lay in the single-case design. It was advisable for future research to accumulate more data, involving a larger number of participants for broader applications. In practical terms, interdisciplinary collaboration was recommended to offer more comprehensive assistance to individuals. Additionally, it was suggested that counseling and psychotherapy should not be limited by diagnostic boundaries, but instead, focus on individual needs. Based on the participant’s experiences, it was crucial to provide individualized needs during educational and counseling efforts for individuals with the condition and their families.

起訖頁 033-067
關鍵詞 輕度自閉症人際模式個案研究自我烙印mild autisminterpersonal patternscase studyhself-stigma
刊名 特殊教育學報  
期數 202506 (61期)
出版單位 國立彰化師範大學特殊教育學系
DOI 10.53106/207455832025060061002   複製DOI
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