A Study of the Process and Experience of An Intern Psychologist Applying Four-Step Model in Family Counseling in the Hospital

• Main Authors: Tseng, Ling-Chen, 曾昤媜
• Other Authors: Lin, Chi-Yun
• Format: Others
• Language: zh-TW
• Published: 2015
• Online Access: http://ndltd.ncl.edu.tw/handle/43982215165241906087

碩士 === 國立臺北護理健康大學 === 生死與健康心理諮商系 === 103 === This study aimed to explore the application of the four-step model family counseling theory in an intern psychologist’s (ie the researcher’s) counseling experience with four families with adolescent school refusal; and reflect upon the predicaments of the practical application of the theory. This study uses quality hermeneutic phenomenological approach. Subjects were referred by the physicians when the researcher was working as a full-time intern psychologist at a psychiatric hospital. The counseling strategy was to apply the four-step model family counseling theory. This study used a total of fourteen counseling sessions. Four-step family counseling approach was applied. The researcher found the following: During step one (opening up the presenting complaint), the clients’ school refusal symptoms were linked to family interaction patterns. Family relationship boundaries tend to be unclear and family members show inconsistent views towards school refusal. In step two (highlighting problem-maintaining interactions), clients’ school refusal persisted because families tend to be over-protective. Mothers were over-sheltering and failed to issue appropriate responsibility to the client. Other family members also rationalized the clients’ school refusal behaviors and make the clients felt they can stay at home. However, the researcher failed to facilitate motivation to change, resulting in the inability of the counseling process to move forward. During step three (a structurally focused exploration of the past), by reviewing mothers’ own native family experience, the researcher discovered the client’s interaction patterns were similar to the interactions between the mother and her father. Exploring the past experiences, the researcher found clues of the current mother-daughter interaction, and triggered changes in awareness. And lastly in step four (an exploration of alternative ways of relating), due to the sudden termination of counseling sessions from the family, the researcher failed to discuss alternative ways of relating with the family. Overall, this is an unfinished family counseling case, as well as a good example worth reflected upon. This research integrated and reflected upon the four-step model of family counseling theory, including the researcher’s lack of flexible and creative thinking abilities to make use of metaphorical skills. Finally, discussion and recommendations were made for future research based on current findings and limitations.