| 摘要: | 本研究主要探討專線助人者面對困難個案來電時，可能遭遇之困境、所採用之因應策略以及有效的因應策略為何。本研究採用質性研究法，以五位專線助人者及五位專線督導為研究對象，進行半結構式深度訪談及接案逐字稿評量。根據訪談逐字稿、接案逐字稿以及督導評量結果進行分析與歸納，本研究主要發現如下：
一、助人者遭遇之困境及其成因
(一)接線助人者接獲困難個案來電時，所遭遇之困境主要來自於為三大類，分別為「專業工作流程之困境」、「處遇策略之困境」以及「難以聚焦之困境」。其中因專業工作流程所造成之困境是五位受訪者遭遇最多之困境。
(二)造成上述困境的原因：最主要來自來電者因素，其次依序為系統因素，互動因素及助人者因素。
二、助人者接獲困難個案來電時採用之因應策略
(一)當助人者接獲困難個案來電時，主要採用七項因應策略，分別為促進會談進展策略、情緒介入策略、引導來電者覺察及釐清錯誤認知、豐富案情策略、結構化策略、賦能策略以及助人者自我觀照策略。其中促進會談進展策略與賦能策略是五位受訪者最常採用之因應策略。
(二)透過交叉分析助人者遭遇之困境與採用之因應策略發現，助人者遭遇困境時，最常使用同理或蒐集案情技巧。此似乎意味著當助人者面對困境時，將回歸使用最基本的技巧─同理來電者或完成專線任務以因應困境。
(三)本研究更進一步發現，同理技巧有助於助人者脫離會談中的困境，單獨使用蒐集案情技巧卻可能引發困境。然而，助人者若能同時使用蒐集案情技巧與關懷支持技巧時，卻能有助於助人者脫離困境。
三、困難個案處理之有效因應策略
(一)根據助人者自評與督導針對接案逐字稿之評量，兩者皆認為同理、蒐集案情技巧、維護安全技巧、建立會談規範以及提供認知上新的刺激有助於因應困難處理個案的來電。
(二)督導與助人者對於有效因應策略評量不同看法為：督導們重視基本會談技巧及促進雙方良好互動技巧之運用，如：聚焦當下、面質、關懷支持、提供正向回饋以及維護個人隱私；而助人者相較於督導似乎更重視目標導向技巧之運用，如：邀請來電者進入會談、確認發言權、認知處理技巧以及引導來電者釐清錯誤認知。此結果顯示：雖然機構專業訓練同時重視晤談關係建立與專線任務達成，然而專線助人者卻多將注意力放在「如何完成」以及「是否完成」專線任務；造成此落差的原因可能來自於助人者「被評價」與「績效」的擔心。
(三)本研究針對訪談與接案逐字稿進行交叉分析發現，有效因應策略可能為會談帶來四種影響：解決會談中的困境、引發來電者更深層的揭露、帶來複合式技巧的效果，或是相反地，有效因應策略可能導致後續會談進入另一種困境。
The purposes of the research are to explore the difficulties the telephone counselors experienced, the coping strategies the counselors used and effectively coping strategies the counselors and the supervisors rated when difficult clients called. By using qualitative research methods and depth–interviews, the researcher interviewed five participants who had answered a difficult phone in seven days. All the verbatim of five interviews and five telephone counseling records were analyses and induced. The results of this study are the followings:
A. The difficulties that the telephone counselors met and the factors caused the difficulties
1. The difficulties that the participants met: including the difficulties of “Standardized Procedures for Counseling,” the difficulties of “Intervention Strategies,” and the difficulties of “Hard to Focus.”
2. The factors that caused the difficulties: including the factors of clients, the factors of interaction, the factors of telephone counselors and the factors of system.
B. The coping strategies that the telephone counselors used when the difficult clients called.
1. Coping strategies: including the strategies of advance counseling progress, the strategies of emotion intervention, the strategies of guide clients to perceive and clarify their wrong cognition, the strategies of enrich the contents of case, the strategies of structured, the strategies of empower, and the strategies of telephone counselors self-care.
2. Analysis across difficulties and coping strategies: when telephone counselors experienced difficulties, the coping strategies they use most is empathy and the skills of collecting information of the case.
C. The effective coping strategies of difficult clients
1. The comparison of the views of the supervisors and the counselors. Both they agreed: empathy, the skills of collecting information of the case, the skills of maintenance of security, the skills of set up the rules of counseling, and the skills of providing the new cognition were be useful for coping with the difficult calls.
2. The difference of the supervisors and the counselors: the supervisors valued use basic counseling skills and the skills that advanced telephone counselors and clients have good interaction, for example focusing on here and now, confrontation, caring and supporting, provide positive feedback and protect privacy. The telephone counselors valued use goal-oriented skills that including the skills of invite, make sure the authority of speak in counseling, the skills of cognition process and clarify wrong cognition.
3. According to analyze across the verbatim there were four affects about effective coping strategies: including break away the difficulties, trigger the deeper disclosure, trigger another difficulties, and the effect of compound skills. |
