本研究旨在探討一位自陳網路遊戲成癮者接受藝術活動介入之心理改變歷程，網路遊戲成癮（Internet Gaming Disorder, IGD）的問題逐漸被重視，尤其對脆弱性較高的數位原生世代之發展影響需要被關注。研究指出，成年初顯期的個體更容易有網路遊戲成癮的問題，而大學正是此時期發展的關鍵階段。回顧網路遊戲成癮的治療方式，現行較為普遍的是認知行為療法（Cognitive Behavior Therapy, CBT）。然亦有學者指出，CBT雖可以矯正在成癮行為底下的認知偏誤，但如果沒有合併使用其他療程的話，將無法有效改善可能誘發成癮行為的情緒困擾。因此，本研究探究網路遊戲成癮傾向大學生認知情緒上的樣貌及成癮機制，亦將合併藝術治療與現行研究顯示最為有效之認知行為治療，採認知行為藝術治療（Cognitive Behavior Art Therapy, CBAT）之方式介入，探究藝術活動如何促成心理上的改變、闡述其心理狀態與改變歷程，並對CBAT應用於網路成癮提出實務建議。
    本研究為探索性研究，研究者透過十週、每週一次、每次九十分鐘的治療架構，深入探究網路遊戲成癮者的心路歷程、CBAT介入對其情緒與認知的影響，並試圖找尋改善的契機。研究參與者為大學心輔系三年級學生，在DSM-5（the fifth edition of the Diagnostic and Statistical Manual of Mental Disorder）網路遊戲成癮九項診斷標準中符合四項標準，為網路遊戲成癮傾向者。資料蒐集在取得知後同意之後，以錄音檔、晤談逐字稿、參與者的作品以及非語言行為觀察做為主要分析資料；以參與者的網路使用時數及用途、每次介入後所填之問卷作為輔助的分析資料。資料的蒐集和分析過程注重保密性和避免受傷害原則，並且於計畫期間每週定期接受藝術治療的督導以確保研究品質。
    經過十次介入，參與者自評「自尊」、「自我效能」、「內控」及「網路遊戲成癮問題改善程度」程度隨著研究進行而逐漸提升，「網路遊戲成癮問題困擾程度」則顯著下降。網路遊戲時間在CBAT介入四週後開始減少，最後四週約減為一開始的三分之一。在整個過程中，能預測網路遊戲成癮之核心自我評價皆有改善，並且能清楚看見CBAT合併了CBT與藝術治療的優點：在CBT以問題導向的方式有效改善問題行為及非理性信念的同時，藝術治療的進行則有利外化問題並協助面對困擾、增加情緒調適能力，這些優點皆有助於維持改善效果。此外，創作者在作品中視角的轉換、創作中對於混亂的掌控、以及對於內心狀態的詮釋與理解亦皆有助於整合認知歷程，有利成年初顯期中自我認同的成熟。
    最後，研究者亦對於應用CBAT協助網路遊戲成癮者改善成癮問題提出建議，分別為：一、可採納CBT-IA之架構進行，且CBAT適合應用於網路遊戲成癮主題。二、此介入模式可應用於大專院校之短期個別諮商中。三、數位原生世代「熱衷於立即的回饋與滿足」之特性可能會導致多種形式的網路成癮，世代特性需要列入考量。除了協助控制網路相關的問題行為、改善心理狀態以外，亦可以協助增加有益的線上活動。

This research aimed to investigate progressive changes in the psychological aspects of a self-reported internet-game addict after receiving artistic interventions. The issue of internet gaming disorder (IGD) has been gradually valued in these years, especially for digital natives and emerging adults who are considered more vulnerable to IGD than other populations. Regarding intervention approaches, Cognitive Behavior Therapy (CBT) is considered as the most effective approach for IGD, but past research also suggested that combining other approach can further address the emotional aspect of IGD, therein improve prognosis. As is, this study investigated an IGD undergraduate’s mental state, and used Cognitive Behavior Art Therapy (CBAT) to intervene and improve her IGD problem, and to examine how artistic interventions can alleviate IGD symptoms.
This study is an exploratory research. The participant was a junior student majoring in counseling. She had video game addiction tendency and met four IGD diagnostic criteria of DSM-5 (the fifth edition of the Diagnostic and Statistical Manual of Mental Disorder). Through a ten-week project, researcher used recordings, transcripts, participant’s artwork, and researcher’s observations in sessions as main analyzing data; and collected statistics of the participant’s internet gaming hours by day as well as results from questionnaire after each session as secondary analyzing data. The researcher was under supervision throughout this project to maintain the quality of interventions. 
After ten times of interventions, the participant reported her “self-esteem”, “self-efficacy”, “internal locus of control” and “improvement of IGD problems” increased significantly, and “the negative influence of IGD” decreased during this project. Internet gaming hours started decreasing after session 4, and was maintained at 1/3 of beginning gaming hours in last four sessions. Core self-evaluation which can be used to predict IGD was improved, and the strengths of CBAT, which combines advantages of CBT and art therapy, can be discovered: CBT, a problem-oriented approach, can efficiently help the participant decrease problematic behaviors and alter irrational beliefs, while art therapy can help an individual externalize problem as well as increase the ability to regulate negative emotion, therein improve prognosis. In addition, during the art making process, creator can alter his/her perspectives, control chaos through interpreting and understanding the complexities of internal states, therein foster the integration of cognitive process. This will also be beneficial for the maturity of an emerging adult’s self-identity. 
The researcher provides suggestions regarding using CBAT on internet gaming addict as follows: a. Therapists can use the steps of CBT-IA while dealing with IGD, and CBAT is an adequate approach to use; b. This intervention model can be used in short-term counseling in college; c. Digital native is considered related to the trait, “thrive on instant gratifications and rewards”, and this can lead to multiple types of internet addiction. Thus, while working with digital native population, internet usage habit should be comprehensive understanded to figure out one’s core issue. In addition, when dealing with the internet related problematic behaviors, therapists can also help clients increase beneficial online activity.

第一章	緒論
第一節	研究背景......1
第二節	研究動機......3
第三節	研究目的......5
第四節	研究設計......5
第五節	研究預期......5
第二章	文獻探討
第一節	數位原生世代及其特性......6
第二節	網路成癮及網路遊戲成癮......8
壹、 網路成癮......8
貳、 網路遊戲成癮......9
參、 網路遊戲成癮之危險因子及成因......12
第三節	網路遊戲成癮對大學生發展階段之影響......14
壹、 大學生發展階段的任務及挑戰......15
貳、 遊戲成癮對大學生的發展影響......16
第四節	網路遊戲成癮的治療方法......17
壹、 現行網路遊戲成癮之治療方式......17 
貳、 藝術治療與網路遊戲成癮......18 
參、 認知行為藝術治療與網路遊戲成癮......19
第三章   研究方法
第一節	研究流程與研究設計......22
壹、 整體研究流程規劃......22
貳、 單次流程設計......23
第二節	研究參與者......24
壹、 收案過程......24
貳、 研究參與者......24
第三節	資料蒐集與分析......26
第四節	研究者的角色......27
第四章   研究結果
第一節   流程概要......28
壹、 十次藝術活動介入之概要......28
貳、 藝術活動介入後之改變......31
第二節   逐次藝術活動介入之歷程......33
壹、 第一次活動......33
貳、 第二次活動......37
參、 第三次活動......42
肆、 第四次活動......46
伍、 第五次活動......51
陸、 第六次活動......56
柒、 第七次活動......61
捌、 第八次活動......66
玖、 第九次活動......71
拾、 第十次活動......76
第三節  整體歷程分析及介入成效......82
壹、 現象層面：成癮行為及心理狀態之改變......82
貳、 分析層面：促成改變之認知因素......83
參、 技術層面：CBAT對於改變之影響......85
第四節  CBAT在網路遊戲成癮大學生之應用......90
壹、 CBAT與網路遊戲成癮......90
貳、 CBAT與網路遊戲成癮傾向大學生......92
第五章  結論、省思與建議
第一節  結論......95
第二節  省思......96
壹、 融合不同取向之挑戰......96
貳、 治療者之情緒調適......97
第三節  建議......100
參考文獻......101
附錄一：個案資料保密同意書......113
附錄二：網路徵受試者之資訊......114
附錄三：參與研究同意書......115
附錄四：每次介入後之問卷......116
附錄五：論文原創性比對結果......117
-圖次-
圖1 Awesome Face......4
圖2 2001年至2019年全球網路使用趨勢......6
圖3 2009年至2019年台灣網路使用趨勢...... 7
圖4 不同的增強方式帶來的效果......10
圖5 遊戲中的戰利品箱......10
圖6 被電玩影像激發的成癮者腦區fMRI影像......12
圖7 App使用統計......23
圖8 單次流程設計......23
圖9 家庭圖......24
圖10 個人色票......25
圖11 重要他人色票......25
圖12 第一次之回應生活創作「喜怒哀懼」......29, 33
圖13 第二次之回應生活創作「喜怒哀懼」......29, 38
圖14 第三次之回應生活創作「喜怒哀懼」......29, 42
圖15 第四次之回應生活創作「喜怒哀懼」......29, 47
圖16 第五次之回應生活創作「喜怒哀懼」......29, 52
圖17 第六次之回應生活創作「喜怒哀懼」......29, 57
圖18 第七次之回應生活創作「喜怒哀懼」......29, 62
圖19 第八次之回應生活創作「喜怒哀懼」......29, 67
圖20 第九次之回應生活創作「喜怒哀懼」......29, 71
圖21 第十次之回應生活創作「喜怒哀懼」......29, 76
圖22 第一次主題創作「玩遊戲的好」......30, 35
圖23 第一次主題創作「玩遊戲的壞」......30, 35
圖24 第一次主題創作「玩遊戲的好與壞」......30, 36
圖25 第二次主題創作「融合」......30, 40, 68, 72, 78
圖26 第三次主題創作「灰色畫面」......30, 44, 68, 72, 78
圖27 第四次主題創作「大魔王」......30, 49, 54, 58
圖28 第五次主題創作「手機視角」......30, 54, 58
圖29 第六次主題創作「好朋友」......30, 59
圖30 第六次之作品回顧 ......30, 60
圖31 第九次「情緒調適創作」......31, 73
圖32 第九次主題創作「閃電的事實」......31, 74, 78
圖33 第十次回顧創作......31, 79
圖34 研究者回應性創作......31, 79
圖35 A做的卡片......31, 80
圖36 十次之問卷統計......31
圖37 研究者之整理情緒創作......31, 98
-表次-
表1 網路遊戲成癮之危險因子......13
表2 第一週之認知行為治療之進度......37
表3 第二週之認知行為治療之進度......42
表4 第三週之認知行為治療之進度......46
表5 第四週之認知行為治療之進度......51
表6 第五週之認知行為治療之進度......56
表7 第六週之認知行為治療之進度......61
表8 第七週之認知行為治療之進度......66
表9 第八週之認知行為治療之進度......70
表10 第九週之認知行為治療之進度......76
表11 第十週之認知行為治療之進度......81
表12 Ellis之A-B-C模式......83

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