| 摘要: | 本研究以質、量並行的研究取向，探討臺灣四十四所大專院校所使用的告知後同意說明書內容以及心理諮商當事人的告知後同意經驗。研究者以描述統計的方式檢視告知後同意書；整體而言，同意書皆以概略的描述方式條列呈現告知後同意內容，並沒有一張同意書的內容與格式完全相同。其中，「保密特性」、「諮商中斷的權利」、「更換諮商師的權利」等內涵是所有告知後同意書皆會納入的資訊；而「接觸檔案的權利」、「諮商之外的其他選擇」、「治療的益處與風險」的相關內容是最少被討論的。各校對「保密的特性」中資料保存的期限有明顯的差異，特別缺乏錄音（影）的資料保存說明。
研究者以立意抽樣方式募集到五位平均年齡26歲、曾經在大專院校之學生諮商中心有過至少六次個別諮商經驗的受訪者進行研究訪談，探討接受大專院校提供心理諮商服務之當事人的告知後同意經驗。受訪者普遍認為告知後同意是帶有壓迫的規範，僅具有形式上的意義，對於說明心理諮商方式及預告接下來可能發生的事情效果有限。大多數的受訪者的告知後同意經驗是充滿疑惑和壓迫的，在面臨模糊或不滿之處，受訪者多是採用順應、臆測或中斷的方式消極面對，整體來說當事人在告知後同意中的自主權是受限的。
最後，本研究透過邀請當事人分享歷程中的個人經驗，比較當下歷程與回顧，針對告知後同意書內容及專業人員提出告知後同意之建議，亦對未來的研究方向提供意見。
The researcher used both quantitative and qualitative methods to investigate the content of informed consent forms which are used in 44 student counseling centers of universities in Taiwan and clients’ experiences involved in informed consent process in psychotherapy. The investigation of 44 informed consents forms were analyzed and presented by using descriptive statistics. The elements included in informed consent forms are itemized, and the content and format of informed consent vary depending upon the schools. The limits of confidentiality, the right to request or to refuse any particular treatment technique or to withdraw from therapy at any time and the right to request a referral to another therapist are the elements which are included in every informed consent forms; however, just few of them mention about the information regarding clients’ right to examine personal records, alternative treatments or options and potential risks and benefits of treatment. Generally, the consent for audio or video recordings and the information of destruction timeframe as well as who will have access to the recordings and where they will be stored are ambiguous and scanty.
A total of 5 interviewees (3 females and 2 males) with a mean age of 26 years, who had at least 6 times of individual counseling experiences in the student counseling centers in universities were recruited by purposive sampling for in-depth interviews in this study. Interviewees described their informed consent experiences as confusing and oppressive. The signed informed consent form and a clear verbal interpretation of situation cannot ensure the clients really understand the nature of psychotherapy and what its process. While confronting dilemma, they tend to react in a passive way such as withdrawal, conformity or surmise.
Finally, basic on their personal experiences, interviewees give suggestions to therapists conducting informed consent. Recommendations and suggestions for future research are also provided. |
