淡江大學覺生紀念圖書館 (TKU Library)

系統識別號 U0002-0907202009020900
中文論文名稱 過動兒童在系統中的哀礙愛-實習心理師的關係介入與系統整合經驗
英文論文名稱 The Sadness, Difficulties, and Care for a child with ADHD in the System-An Intern Psychologist’s Experience in Relationship Intervention and System Integration
校院名稱 淡江大學
系所名稱(中) 教育心理與諮商研究所碩士班
系所名稱(英) Graduate Institute of Educational Psychology and Counseling
學年度 108
學期 2
出版年 109
研究生中文姓名 梁綺芬
研究生英文姓名 Chi-Fen LIANG
學號 605690063
學位類別 碩士
語文別 中文
口試日期 2020-06-19
論文頁數 202頁
口試委員 指導教授-宋鴻燕
中文關鍵字 ADHD  過動兒童  系統合作  生態系統  人際歷程  合作對話 
英文關鍵字 ADHD  Children with ADHD  Systematic Cooperation  Ecological System  Interpersonal Process  Collaborative Dialogue 
學科別分類 學科別社會科學教育學
中文摘要 本研究旨在研究小學三年級經確診為ADHD過動症兒童的個案(代稱為大雄),經過一學期的諮商晤談與系統合作(主要對象為導師與案母),探討個案以系統合作的工作模式下,探討在諮商晤談前、後,包括個案與系統重要成員的影響與變化。研究方法是個案研究,採用關係介入,其內容有兩大部分,包括研究者對整個歷程的再建構與反思,以及事後與系統重要他人(導師與案母)的半結構訪談,試圖探討在這個過程中的有效與有限因子分別為何,包括像諮商師、導師、案母等各自的效能與限制各為何,各自會面對的挑戰與困難,試圖從各自的拼圖,勾勒出如何促進系統合作的藍圖。研究發現有以下幾點:
英文摘要 The purpose of this research was to study a single case of a child with ADHD in the third year of elementary school who was designated as David. The counseling sessions and interviews within the system (mainly focusing on the class teacher and the mother of David) has cooperated lasted for a semester in order to observe the influence and change, before and after the interviews in important members of the system and David under a model of systemic cooperation. Case study was adopted as the research method with the relationship intervention was offered by the intern psychologist as well. Two main parts of this study included the researcher’s reconstitution and introspection of the entire process as well as the semi-structured interview of post-event with important members (the class teacher and the mother of David). The research was intended to discover the effective factors and limited factors during the entire process, including the performance and restrictions of consultant, the teacher and the mother of David. Each role has faced its own challenges and difficulties, with the information, the blueprint of systemic cooperation will be developed. The findings of this study were listed as follows. A. Case Work: Regarding the interpersonal aspect, the establishment of a trustful relationship and the correct understanding were both the key effective factors for the individuals in the system to make a change and adaptation to the situation. About the learning aspect, the flexible approach should be used to satisfy the needs of each individual. B. Work of Parents and Teachers: Only being more empathetic and skilful could possibly make people feel that they were able to participate, reducing the contradictions and resistance brought by guilt or insufficiency and increasing the effective factors for cooperation. The main skill found here was called interpersonal process feedback. By asking more questions and having more conversation, the stress and resistance from different reasons can thus be decreased. C. School Work: Parent groups and parenthood consultation were extremely important. The former would bring hope and universality to the parents, and the latter would improve to adjust the parental generativity. D. Intern Psychologists: As an intern psychologist, I had played a role as a medium and translator to understand each other that was the effective factor for interviews and cooperative work. It could rely upon the empathy for others, which means putting oneself in someone else’s shoes, as well as having a certain degree of observation about the interpersonal process and proper boundaries between people and myself. E. Work of Systematic Cooperation: It was challenging and difficult to work within a system with individuals with different perspectives of the case. The key was to discover each individual’s needs and difficulties and built the relationship based on the principles of equality, reciprocity, and respect. F. Vision in the Future: As suggested from the abovementioned findings, a mobile alliance can be formed in the school with the teachers, parents and counsellors gather together regularly for meetings and sessions of discussion. In this way, the needs of children will be possible to be adjusted instantly to achieve the goal of nipping in the bud, and to form the volunteering groups in order to establish a cycle of human friendly resources for protecting the children with ADHD in the future.
論文目次 第一章 緒論 1
第一節、 研究緣起與動機 1
第二節、 研究目的與問題 9
第三節、 名詞釋義 10

第二章 文獻探討 13
第一節、 注意力不足過動症ADHD之基本概念和相關研究 13
第二節、 人際歷程治療取向的基本概念與相關研究 25
第三節、 生態系統合作之基本概念和相關研究 31
第四節、 ADHD過動症國小學童在系統合作的相關研究 39

第三章 研究方法 46
第一節、 前導研究 46
第二節、 研究設計 51
第三節、 研究流程 54
第四節、 研究參與對象 58
第五節、 研究資料的整理與分析 61
第六節、 研究工具 67
第七節、 研究的信度與效度 69
第八節、 研究倫理 72

第四章 研究結果與討論 74
第一節、 過動兒在系統中的「哀」憤-宛如憤怒鳥的大雄故事 75
第二節、 過動兒在系統中的障礙與挑戰-「礙」在過動蔓延時 91
第三節、 過動兒在系統合作的介入與處遇-如何在挑戰中通行無「礙」 108
第四節、 過動兒在系統轉角遇見「愛」-過動帶來感動,理解帶來禮物 132
第五節、 研究結果與討論 156

第五章 研究建議限制與反思 170
第一節、 研究建議 170
第二節、 研究限制 176
第三節、 研究反思 178

參考文獻 188

附錄-1 研究參與同意書(家長版) 199
附錄-2 研究參與同意書(導師版) 200
附錄-3 研究訪談大綱(導師版) 201
附錄-4 研究訪談大綱(家長版) 202

表 2-1-1 注意力過動缺陷症ADHD的介入、處遇與限制 20
表 2-1-2 國內碩博士研究文獻之ADHD過動症整理 22
表 3-1-1 前導研究之輔導諮商與系統合作歷程表 47
表 3-4-1 研究參與者 60
表 3-5-1 研究編碼範例 62
表 3-5-2 研究檔案資料編碼範例 64
表 3-5-3 編碼主題與範例 65
表 5-1-1 研究結果與研究目的問題之對照表 164

圖 2-2- 1 以學生為本的輔導人力資源生態圖 34
圖 2-2- 2 本過動症案生的系統合作(微觀與中介)示意圖 35
圖 3-2-1 研究架構圖 52
圖 3-3-1 研究流程圖 54
圖 3-5-1 研究程序圖 63
圖 5-1 -1 大雄的人際歷程發展與系統模式圖 162
圖 5-1 -2 個案晤談與系統合作圖 166

參考文獻 中文文獻
王亦玲、蔡曉雯、陳昭伶、柳心琪、蘇倫慧、危芷芬(譯)(2008)。兒童諮商(原作者:C. L. Thompson and D. A. Henderson)。臺北:禾楓。
王麗斐、杜淑芬、羅明華、楊國如、卓瑛、謝曜任(2013)。生態合作取向的學校三級輔導體制:WISER 模式介紹。輔導季刊,49(2),4-11。
王麗斐、杜淑芬、趙曉美(2008)。國小駐校諮商心理師有效諮商策略之探索性研究。教育心理學報,39(3), 413-434。
王麗斐、謝佩玲(2007)。心理治療師反移情經驗之歷程研究。教育心理學報,38(4),461 ─ 480。
王櫻芬、連廷嘉(2012)。青少年社交能力在其人際依附與心理健康間的中介角色探討分 析研究。高雄師範大學輔導與諮商研究所諮商輔導學報高師輔導所刊,24,67-94。
吳昆壽(1999)。資優殘障學生教育現況與問題調查研究。特殊教育與復健學報,7, 1-32。
吳芝儀、李奉儒(譯)(2008)。質性研究與評鑑(原作者:Q. P. Michael)。嘉義:濤石。(原著出版年:1995)
何善欣(譯)(2002)。過動兒父母完全指導手冊。(原作者:R. A. Barkley)臺北市:遠流。(原著出版年:1995)
李嘉玲、翁士恆(2017)。注意力不足/過動症的ICF核心分類:ICF Core Set for ADHD。取自https://ndhulovekids.blogspot.com/2017/01/icf-icf-core-set-foradhd-adhd-icf-dsm.html
周海濤、李永賢、張蘅(譯)(2009)。個案研究:設計與方法 (原作者:Yin, R. K)。台北市:五南。
林秀慧、林明雄(譯)(2001)。客體關係治療:關係的運用(原作者:Sheldon Cashdan)。台北市:心理。(原著出版年:1988)
林慧雯(譯)(2018)。圖解適齡教養ADHD、亞斯伯格、自閉症(原作者:司馬理英子, 黃雅芬。台北市:新手父母。
修慧蘭、鄭玄藏、余振民、王淳弘(譯)(2013)。諮商與心理治療:理論與實務(三版)(原作者:Gerald Corey)。臺北市:雙葉。
徐宗國(譯)(1997)。質性研究概論 (原作者:A.Strauss and J. Corbin)。台北市:巨流。(原著出版年:1990)
唐子俊、唐慧芳、黃詩殷、戴谷霖(譯)(2006)。憂鬱症最新療法-人際心理治療的理論與實(原作者:S. Stuart & M.Robertson)。台北市:心理出版社。(原著出版年:2003)
教育部 (2013)。 特殊教育法施行細則。取自http://gazette.nat.gov.tw/EG_FileManager/eguploadpub/eg018043/ ch05/type3/gov40/num21/Eg.htm
陳登義(譯)(2006)。客體關係入門-基本理論與應用(原作者:Livinia Gomez)。台北市:五南。(原著出版年:1997)
楊文麗、葉靜月(譯)(2003)。兒童注意力訓練手冊(原作者:G. W. Lauth and P. F. Schlottke)。臺北: 張老師文化。
楊添圍、周仁宇(譯)(2013)。人我之間-客體關係理論與實務(原作者:N. Gregory Hamilton)。台北市:心靈工坊文化。(原著出版年:2004)
潘淑滿 (2003)。質性研究理論與應用。台北:心理。

Akman, B., Gülay, H., & Kargi, E. (2011). Social skills of first-grade primary school students and preschool education. Education, 131(3), 663-679.
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorder-V (5th ed). Washington, DC: Book Promotion & Service LTD.
Bowlby, J. (1980).Attachment and loss. Vol. III. Loss, sadness and depression.London: The Hogarth Press and the Institute of Psycho-Analysis.

Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. New York: Basic Books.

Barkley, R. A. (1995). Taking charge of ADHD: The complete authoritative guide for parents. New York: Guilford Press.
Barkley, R. A., & Murphy, K. (1998). Attention deficit hyperactivity disorder: A clinical workbook (2nd ed.). New York: Guilford.
Barkley, R. A. (1997).ADHD and the nature of self control. New York: Guilford Press.
Barkley, R. A. (2010)Attention deficit hyperactivity disorder in adults: The latest assessment and treatment strategies. Sudbury, MA: Jones and Bartlett.
Barkley, R. A. (2010) Taking charge of adult ADHD. New York: Guilford Press
Barkley, R. A. (2013). Taking charge of ADHD: The Complete, authoritative guide for parents (3rd ed). New York: The Guilford Press.
Bronfenbrenner, U (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.
Bronfenbrenner, U (1989). Ecological systems theory. In R. Vasts (Ed.) Annals of Child Development. (pp.187-251). Greenwich, CT: Jai Press.
Bronfenbrenner, U. (2010). Making human beings human: bioecological perspectives on human development. Thousand Oaks, CA: Sage.
Corey, G.(2016).Theory and Practice of Counseling and Psychotherapy(9th ed.). Practice Grove, CA: Books/Cole.

Culter, R. I. (1958). Countertransference effects in psychotherapy. Journal of Consulting Psychology, 22, 349-356.
Damon, W., & Lerner,R.M.(2006).Handbook of child psychology: Theoretical models of human development (6th ed.). New York: Wiley.
Dodge,K.A(1986). A social information processing model of social competence in children. In M. Perlmutter (Ed), Cognitive perspective on children's social and behavioral development. NJ: Erlbaum.
Freeman,A., & Dattilio,F.M.(Eds.).(1992). Comprehensive casebook of cognitive therapy. New York:Plenum Press.

Kobak, R.R., & Sceery, A.(1988). Attachment in late adolescence: working models, affect regulation, and representations of self and others. Child Development, 59, 135-146.
Lauth, G. W., & Schlottke, P. F. (2002/2003). Training mit aufmerksamkeitsgestorten Kindern. Weinheim: Psychologie Verlags Union.
Ligiero, D. P., & Gelso, C. J. (2002). Countertransference, attachment, and the working alliance: The therapist's contributions. Psychotherapy: Theory, Research, Practice, Training. 39, 3-11.
Michael,Q.P (2008). Qualitative research & evaluation methods. (3rd ed.). New York: Oxford University Press.
Murphy, K. R., Barkley, R. A., & Bush, T. (2001). Executive functioning and olfactory identification in young adults with attention deficit hyperactivity disorder, Neuropsychology, 15, 211-220.
Murphy, K., & Barkley, R. A. (1996). Prevalence of DSM-IV ADHD symptoms in adult licensed drivers. Journal of Attention Disorders, 1, 147-161.
McClure, B. A., & Hodge, R. W. (1987). Measuring countertransference and attitude in therapeutic relationships. Psychotherapy, 24, 325-335.
Rosenberger, E. W., & Hayes, J. A. (2002). Origins, consequences, and management of countertransference: A case study. Journal of Counseling Psychology. 49, 221-232.
Tarver, J., Daley, D., & Sayal, K. (2014). Beyond symptom control for attention‐deficit hyperactivity disorder (ADHD): What can parents do to improve outcomes?. Child: Care, Health and Development, 41(1), 1-14.
Thompson,C.L and Henderson,D.A(2008). Counseling children (7th ed.). Belmont, CA: Wadsworth.
Teyber E. & McClure F. H.(2016).Interpersonal Process in Therapy: An Intergrative Model( 6thed.). Practice Grove, CA: Books/Cole.
Whitmore, J. R., & Maker, C. J. (1985). Intellectual giftedness in disabled persons. Rockville, MD: Aspen.
Yin, R. K. (2009). Case study research: Design and methods (4th Ed.). Thousand Oaks, CA: Sage.
  • 同意紙本無償授權給館內讀者為學術之目的重製使用,於2020-07-14公開。
  • 同意授權瀏覽/列印電子全文服務,於2020-07-14起公開。

  • 若您有任何疑問,請與我們聯絡!
    圖書館: 請來電 (02)2621-5656 轉 2486 或 來信