2017年04月 48-4 表達性藝術治療運用於華人文化下 乳癌婦女團體方案介入之要素探究

賴念華   張祐誠 黃傳永 龔庭溱 林葳婕
國立臺北教育
大學心理與諮
商學系 教授
國立臺灣師範
大學教育心理
與輔導學系博
士候選人
國立臺北護理
健康大學生死
與健康心理諮
商系助理教授
彰化縣學生輔
導諮商中心心
理師
中華民國乳
癌病友協會
秘書長

本研究旨在探討表達性藝術治療運用於華人文化下乳癌婦女團體方案設計之要素,包含影響團體發展之脈絡、方案介入及成效。採取質性研究的現象學觀點,透過個別與焦點團體訪談,探討乳癌婦女團體成員和帶領者在表達性藝術治療團體中之經驗。結果顯示:(1)影響團體運作脈絡有:「華人女性多重角色與犧牲奉獻的特質」、「團體成員病程相異促進交流」、「成員出席受家庭與生理因素之限制」、「疾病的不確定性促進團體動力」;(2)表達性藝術治療介入和效果有:「多元表達形式中回到當下體驗」、「圖像視覺化能再度關注自我意象」、「隱喻破除社會框架緩衝焦慮」、「非語言溝通產生共鳴」、「可控性找回自我能力感」、「再建構轉化生命態度」、「跨越時空與角色交換擴展視框」、「作品保存見證改變」;(3)華人乳癌病友團體帶領方向:「帶領者去專家化」、「團體成為訊息分享平台」、「從乳癌談及自我概念」、「重要議題為家庭、親密關係、失落、自我照顧」;(4)方案成效為促進成員「內在覺察與整合」以及「人際間表達與連結」。最後,依據研究結果提出討論,並提供後續方案設計參考。

關鍵字
表達性藝術治療、乳癌病友、華人文化、團體心理治療

參考書目
王貴霞、劉哲銘、呂志得(2005):乳癌病患的困擾及擔憂問題。北市醫學雜誌,2(9),844-
850。DOI: 10.6200/TCMJ.2005.2.9.10[Wang, K. S., Liu, C. M., & Leu, J. D. (2005). Anxiety and
Concern in Breast Cancer Patients. Taipei City Medical Journal, 2(9), 844-850. doi: 10.6200/
TCMJ.2005.2.9.10]
世 界 衛 生 組 織(2015): 癌 症 實 況 報 導。 取 自 http://www.who.int/mediacentre/factsheets/fs297/zh/
[World Health Organization. (2015). Cancer. Retrieved fromhttp://www.who.int/mediacentre/
factsheets/fs297/zh/]
朱怡儒(2009):乳癌病患的社會支持及生活品質之研究-以臺北市某跨院性乳癌病友支持團體為
例。國立臺灣師範大學健康促進與衛生教育學系碩士論文,未出版,台北。[Chu. Y. J. (2009).
A Study of the Association of Social Support and Quality of Life among Breast Cancer Patients-
A Case Study of A Supporting Group in Northern Taiwan. Unpublished master’s thesis. National
Taiwan Normal University, Taipei, Taiwan]
利翠珊(2005):婚姻關係及其調適。載於楊國樞、黃光國、楊中芳(主編),華人本土心理學(331-
362 頁)。臺北市:遠流。 [Li, T. S. (2005). Marriage relationship & adjustment. In K. S. Yang, K. K.
Hwang, & C. F. Yang (Eds.), Chinese indigenized psychology (pp. 331-362). Taipei: Tuan-Liou.]
利翠珊、陳富美(2004):配偶親職角色的支持與分工對夫妻恩情的影響。本土心理學,21,49-
83。DOI: 10.6254/2004.21.49[Li, T.S., & Chen, F. M. (2004). Effects of Coparenting Support and
Division-of-labor on Marital Enqing in Chinese Couples. Indigenous Psychological Research in
Chinese Societies, 21, 49-83. doi: 10.6254/2004.21.49]
李玉嬋、王雪蓮、梁惠君、李佩怡(2013):「親密關係團體諮商」對促進乳癌患者及配偶之夫妻親
密關係成效研究。教育心理學報,44,537-559。DOI:10.6251/BEP.20121001[Li, Y. C., Wang,
S. L., Liang, H. C., & Li, P. Y. (2013). The Effects of Group Counseling on Couples’ Intimacy
Relationship among Breast Cancer Patients and Partners. Bulletin of Educational Psychology, 44,
537-559. doi: 10.6251/BEP.20121001]
吳明富(2012):貼心照護相伴抗癌路。健康世界,316,40-43。[Wu, M. F. (2012). Giving cares and
providing company to people battling against cancer. Health World, 316, 40-43.]
李敏龍、楊國樞(1998):中國人的忍:概念分析與實徵研究。本土心理學研究,10,3-68。[Li, M.
L., & Yang, K. S. (1998). The Chinese “Ren”: an empirical study on the analysis of the concept of
“ren”. Indigenous Psychological Research in Chinese Societies, 10, 3-36.]
林玉淨、胡淑貞(2001):乳癌婦女延遲就醫、診斷與治療之相關因子研究:以南部某醫學中心為
例。公共衛生,27(4),287-299。[Lin, Y. C., & Hu, S. C. (2001). Factors associated with medical-
seeking delay, diagnostic delay, and therapeutic delay of women with breast cancer: in a medical
cencer in southern Taiwan. Public Health Quarterly, 27(4), 287-299.]
林慈玥(2008):心理劇運用於乳癌病友。中華團體心理治療,14(2),1-8。[Lin, T. Y. (2008).
Implementing Psychodrama with Breast Cancer Patients. Chinese Group Psychotherapy, 14(2), 1-8.]
林耀盛、胡至家(2010):內在與外緣間異質身體:詮釋乳癌第一、二期存活者之心理經驗現象。
中華心理衛生學刊,23(2),305-335。[Lin, Y. S., & Hu, C. C. (2010). Body multiplicity of the
Breast Cancer Survivor: Exploring the Psychological Experiences of the Illness Adaptation Process.
Formosa Journal of Mental Health, 23(2), 305-335.]
洪久茹(2006):乳癌婦女的心理社會適應狀態探討:以中年(35 至 64  歲)女性為例。臺灣大學
社會工作學研究所碩士論文,未出版,台北。[Hung, C. J. (2006). Psychosocial Adjustment of
Breast Cancer Women in middle age from 35 to 64. Unpublished master’s thesis. National Taiwan
University. Taipei, Taiwan.]
唐先梅(1999):從家務工作的本質談雙薪家庭夫妻家事分工。應用心理學研究,4,131-173。
[Tang, S. M. (1999). Division of Domestic Labor in Dual-Earner Families: A Perspective of the
Nature of Housework. Research in Applied Psychology, 4, 131-173.]
陳書玲(2010):乳癌倖存者及其家人之逆境因應與家庭韌力研究。國立新竹教育大學教育心理
與諮商研究所碩士論文,未出版,新竹市。[Chen, S. L. (2010). A Study of Adversity Coping
and Family Resilience of Breast Cancer Survivor and Her Families. Unpublished master’s thesis.
National Hsinchu University of Education, Hsinchu, Taiwan.]
陳惠美、馬鳳歧、郭英調、石宜銘(1999):乳癌術後婦女身心社會調適之探討-以羅氏適應模式
為基礎。護理研究,7(4),321-332。[Chen, H. M., Ma, F. C., Kuo, I. T., & Shyr, Y. M. (1999).
Physical and Psychological Adjustment in Women with Mastectomy: Based on Roy’s Adaptation
Model. The Journal of Nursing Research,7(4), 321-332.]
陸洛(2003):人我關係之界定-「折衷自我」的現身。本土心理學,20,139-207。[Lu, L. (2003).
Defining the Self-other Relation: The Emergence of Composite Self. Indigenous Psychological
Research in Chinese Societies, 20, 321-332.]
陸洛、楊國樞(2005):社會取向與個人取向的自我實現觀:概念分析與實徵初探。本土心理學研究,
23,3-69。[Lu, L., & Yang, K. S. (2005). Social- and Individual-oriented Views of Self-actualization:
Conceptual Analysis and Preliminary Empirical Exploration. Indigenous Psychological Research in
Chinese Societies, 23, 3-69.]
陸雅青(2005):藝術治療-繪畫詮釋:從美術進入孩子的心靈世界(第三版)。臺北市:心理。[Lu,
Liona. (2005). Art therapy - Painting interpretation: into the child’s mind from art (3rd.). Taipei,
Taiwan: Psychological Publishing.]
陸雅青等譯(2008):藝術治療:心理專業者實務手冊。臺北市:學富。Malchiodi, C. A. (2003).
Handbook of Art Therapy. New York, USA: Guilford Pubn.
曾文星(2002):華人的心理治療。載於曾文星(主編),文化與心理治療(231-270 頁)。香港:香
港中文大學。[Tseng, W. S. (2002). Psychotherapy for the Chinese. In Tseng, W. S. (Eds.), Culture
and Psychotherapy (pp. 231-270). Hong Kong: Chinese University of Hong Kong]
黃玉賢(2007):探討乳癌婦女於手術及化學治療期間的身心社會功能、貫徹健康行為與生活
品  質之關係。國立成功大學護理學系碩士論文,未出版,台南。[Hung, Y. H. (2007). The
Relationship of the Biopsychosocial Function, Adherence to Health Behavior and Quality of Life in
Women with Breast Cancer During Mastectomy and Chemotherapy. Unpublished master’s thesis.
National Cheng Kung University, Tainan, Taiwan.]
黃光國(2009):<人情與面子>理論的建構。載於黃光國(主編),儒家關係主義哲學反思、
理 論 建 構 與 實 徵 研 究, 臺 北 市: 心 理。[Hwang, K. K. (2009). “Renqing and face” Theory
Construction. In Hwang, K. K. (Eds.), Reflection of Confucian Relationalism, Theory Construction
And Empirical research. Taipei, Taiwan: Psychological Publishing]
黃禎慧(2013):表達性藝術治療團體對乳癌患者之治療效果。國立台北教育大學心理與諮商學系
碩士論文,未出版,台北。[Huang, J. H. (2013). The Effect of Expressive Arts Group Therapy on
Women with Breast Cancer. National Taipei Education University, Taipei, Taiwan.]
楊中芳(1993):試論如何研究中國人的性格:從西方社會/性格心理學及文化/性格研究中吸取經
驗與啟發。載於楊國樞、余安邦(主編),中國人的心理與行為。臺北市:桂冠。[Yang, C. F.
(1993). How to study Chinese character: lessons and inspiration from Western society / personality
psychology and culture / personality study. In Yang, K. S., & Yu, A. B. (Eds.), Chinese people’s
psychology and behavior. Taipei, Taiwan: laureate Publishing]
楊國樞(1993):中國人的社會取向:社會互動的觀點。載於楊國樞、余安邦(主編),中國人
的心理與社會:理念及方法篇。臺北市:桂冠。[Yang, K. S. (1993). Chinese people’s social
orientation: social interaction perspective. In Yang, K. S., & Yu, A. B. (Eds.), Chinese people’s
psychological and social: Ideas and Methods. Taipei, Taiwan: laureate Publishing]
楊國樞(2004):華人自我的理論分析與實徵研究:社會取向與個人取向的觀點。本土心理學研究,
22,11-80。[Yang, K. S. (2004). A Theoretical and Empirical Analysis of the Chinese Self from
the Perspective of Social and Individual Orientation. Indigenous Psychological Research in Chinese
Societies,22, 11-80. ]
廖美南、陳品玲(2006):婦女於乳癌診斷期間之經驗。腫瘤護理雜誌,6(2),19-29。[Liao, M.N.,
& Chen, P. L. (2006). Women’s Experience during the Diagnostic Periods of Breast Cancer. The
Journal of Oncology Nursing, 6(2), 19-29.]
劉純如(2006):身心靈賦能團體對乳癌成效之探討。國立台灣大學護理學研究所碩士論文,未出
版, 台 北。[Liu, J. L. (2006). Study on Efficacy of a Body-Mind-Spirit Empowerment Group for
the Women with Breast Cancer. Unpublished master’s thesis. National Taiwan University, Taipei,
Taiwan.]
蔡盈盈、張巍鐘、陸汝斌、曹朝榮(2007):乳癌患者主要照顧者之因應、社會支持與生活品質。臺
灣精神醫學,21(1),43-52。[Tsai, Y. Y., Chang, W. C., Lu, R. B., & Tsao, C. J. (2007). Coping,
Social Support, and Quality of Life among Primary Caregivers of Patients with Breast Cancer.
Taiwanese Journal of Psychiatry, 21(1), 43-52.]
蔡惠貞、袁千邑(2010):運用藝術治療照護一位乳癌婦女之護理經驗。腫瘤護理雜誌,10(1),
53-6。[Tsai, H. C., & Yuan, C. Y. (2010). Providing Art Therapy to a Breast Cancer Woman: A
Nurse’s Experience. The Journal of Oncology Nursing, 10(1), 53-64.]
衛生福利部(2015):有關今日國民健康署公布 101 年新發生癌症人數及排名說明。取自 http://www.
mohw.gov.tw/CHT/Ministry/DM2_P.aspx?f_list_no=7&fod_list_no=5311&doc_no=49007[Ministry
of Health and Welfare. (2015). About the Health Promotion Administration announced a new
number of cancer occurred 101 years and ranks today. Retrieved from http://www.mohw.gov.tw/
CHT/Ministry/DM2_P.aspx?f_list_no=7&fod_list_no=5311&doc_no=49007]
賴念華(2010):乳癌病友之心理介入需求、實務要素與療癒因子之質性研究:以表達性藝術治療
模式為基礎。國立臺北教育大學研究發展處教師專題研究計畫。[Lai, N. H. (2010). Qualitative
research of the psychological interventions needs, clinical practice, and healing elements for breast
cancer patients: based on the expressive arts therapy model. National Taipei Education University
Professor Research.]
賴念華、王文欽、林葳婕(2011):表達性藝術治療伴侶親密工作坊在乳癌婦女之有效性初探。台
灣藝術治療學刊,3(1),23-44。[Lai, N. H., Wang, W. C., & Lin, W. C. (2011).Expressive Arts
Therapy Workshop for Couples: The overall satisfaction on Breast Cancer Patients and Partner.
Journal of Taiwan Art Therapy, 3(1), 23-44.]
賴念華、王承蘭(2011):女性罹患乳癌對家庭產生的影響。諮商與輔導,305,30-35。[Lai, N. H.,
& Wang, C. L. (2011). Breast Cancer Women’s Impact on families. Counseling & Guidance, 305,
30-35.]
賴淑華(2007):一位乳癌末期患者心路歷程改變之護理經驗。志為護理,6(2),107-116。[Lai, S.
H. (2007). Nursing Experience with a Patient Suffering Psychological Changes during the Terminal
Phase of Breast Cancer. Tzu Chi Nursing Journal, 6(2),107-116.]
簡淑娟、黃珊、韓彤珍、郭美玲、余芳娥(2005):乳癌患者之不確定感及其相關因素之探討。腫
瘤護理雜誌,5(2),1-13。[Chien, S. C., Huang, C., Han, T. C., Kuo. M. L., & Yu, F. O. (2005).
Exploring the Uncertainty and Its Related Factors in Patients with Cancer. The Journal of Oncology
Nursing, 5(2), 1-13]
蘇美雅(2008):身心靈賦能暨衛教團體對乳癌患者成效之初探。國立台灣大學護理學研究所碩士
論文,未出版,台北。[Su, M. Y. (2008). A Study on Efficacy of Body-Mind-Spirit Empowerment
and Education Group for Women with Breast Cancer:A Pilot Study. Unpublished master’s thesis.
National Taiwan University, Taipei, Taiwan .]
龔庭溱(2013):華人文化視框下台灣乳癌病友表達性藝術治療團體方案設計原則之探究。國立台
北教育大學心理與諮商學系碩士論文,未出版,台北。[Kung, T. C. (2013). A Exploration on
Expressive Arts Therapy: The Principles for Program Design of Group for Taiwan Breast Cancer
Patients in Chinese Culture. Unpublished master’s thesis. National Taipei Education University,
Taipei, Taiwan.]
Baucom, D. H., Porter, L. S., Kirby, J. S., Gremore, T. M., Wiesenthal, N., Aldridge, W., & Keefe, F. J.
(2009). A couple-based intervention for female breast cancer. Psycho-oncology, 18, 276-83. doi:
10.1002/pon.1395
Borgmann, E. (2002). Art therapy with three women diagnosed with cancer. The Arts in Psychotherapy,
29, 246-251. doi: 10.1016/S0197-4556(02)00172-7
Chan, C. L. W., Law. M. Y. Y., & Leung, P. P.Y. (2000). An empowerment group for Chinese cancer
patients  in Hong Kong.  In R. Fielding & C. L. W. Chan. (Eds., pp. 167-187), Psychosocial
Oncology & Palliative Care in Hong Kong. Hong Kong: University press.
Chen,  P.  H.  (2009).  A  counseling  model  for  self-relation  coordination  for  Chinese  clients  with
interpersonal conflicts. The Counseling Psychologist, 37, 987-1009. doi: 10.1177/0011000009339975
Collie K., Bottorff, J., & Long, B. (2006). A narrative view of art therapy and art making by women with
breast cancer. Journal of Health Psychology, 11(5), 761-775. doi: 10.1177/1359105306066632
Cunningham, A. J., Edmonds, C. V. I., Jenkins, G. P., Pollack, H., Lockwood, G. A., & Warr, D.
(1998). A randomized controlled trial of the effects of group psychological therapy on survival
in women with metastatic breast cancer. Psycho-Oncology, 7, 508-517. doi: 10.1002/(SICI)1099-
1611(199811/12)7:6<508::AID-PON376>3.0.CO;2-7
Edelman, S., Lemon, J., Bell, D. R., & Kidman, A. D. (1999). Effects of group CBT on the survival time
of patients with metastatic breast cancer. Psycho-Oncology, 8, 474-481. doi: 10.1002/(SICI)1099-
1611(199911/12)8:6<474::AID-PON427>3.0.CO;2-A
Edmonds, C. V. I., Lockwood, G. A., & Cunningham, A. J. (1999). Psychological response to long term
group therapy: A randomized trial with metastatic breast cancer patients. Psycho-Oncology, 8, 74-
91. doi: 10.1002/(SICI)1099-1611(199901/02)8:1<74::AID-PON339>3.3.CO;2-B
Helgeson, V., & Cohen, S. (1996). Social support and adjustment to cancer: Reconciling descriptive,
correlational, and intervention research. Health Psychology, 15, 135-148. doi: 10.1037/0278-
6133.15.2.135
Hwang,  K.  K.  (2009).  The  development  of  indigenous  counseling  in  contemporary  Confucian
communities. The Counseling Psychologist, 37, 930-943. doi: 10.1177/0011000009336241
Lam, W. W., & Fielding, R. (2003). The evolving experience of illness for Chinese women with breast
cancer: A qualitative study. Psycho-Oncology, 12, 127-140. doi: 10.1002/pon.621
Mak, W. M. (2002). Psychological predictors of marital adjustment in breast cancer patients. Psychology,
Health & Medicine, 7(1), 37-51. doi: 10.1080/13548500120101540
Manicom,  H.,  &  Boronska,  T.  (2003).  Co-creating  change  within  a  child  protection  system:
integrating art therapy with family therapy practice. Journal of family therapy, 25, 217-232. doi:  
10.1111/1467-6427.00245
Serlin, I. A., Classen, C., Frances, B., & Angell, K. (2000). Symposium: Support groups for women with
breast cancer: Traditional and alternative expressive approaches. The Arts in Psychotherapy, 7(2),
123-138. doi: 10.1016/S0197-4556(99)00035-0
Spiegel, D., Morrow, G. R., Classen, C., Raubertas, R., Stott, P. B., Mudaliar, N., Pierce, H. I., Flynn,
P. J., Heard, L., & Riggs, G. (1999). Group psychotherapy for recently diagnosed breast cancer
patients: a multicenter feasibility study. Psycho-Oncology, 8(6), 482-493. doi: 10.1002/(SICI)1099-
1611(199911/12)8:6<482::AID-PON402>3.3.CO;2-N
Walsh, S. R., Manuel, J. C., & Avis, N. E. (2005). The impact of breast cancer on younger women’s
relationships with their partner and children.  Families Systems & Health, 23(1), 80-93. doi:  
10.1037/1091-7527.23.1.80
Wilmoth, M. C. (2001). The aftermath of breast cancer: An altered sexual self. Cancer Nursing, 24(4),
278-286. doi: 10.1097/00002820-200108000-00006

全文下載
全文下載