目的：分析強迫症患者在團體認知行為治療過程中出現的療效因子，包括Yalom的團體療效因子和認知行為治療技術的療效因子。方法：本研究經「人體試驗委員會」（IRB）審核通過後，邀請北部某醫院精神科強迫症門診中，藥物治療穩定、強迫症狀嚴重度接近、無嚴重共病診斷的11位患者為研究對象。參加為期11週，每週1次120分鐘的團體認知行為治療，團體治療過程中逐次觀察團體歷程及結束後每位研究對象接受1次的半結構式訪談，以找出強迫症團體認知行為治療過程中的療效因子。使用工具包括：團體歷程觀察記錄表、團體療效訪談指引。結果：研究發現團體主要出現：宣洩、普同感、灌輸希望、傳達訊息、團體凝聚力、利他主義和人際學習等7個團體療效因子；認知行為治療技術的療效因子則出現：相信認知行為治療有效、暴露練習的成功經驗、能完成指定作業、對治療師的遵從性高、能改變自己的認知及其他等6個認知行為治療技術的療效因子。結論：找出強迫症團體認知行為治療之療效因子，能對強迫症臨床治療人員提供具體之治療建議，及未來相關研究之參考。
Objectives: This study was to analyze the therapeutic factors in cognitive-behavioral group therapy (CBGT) for obsessive compulsive outpatients, based on Yalom's theories and cognitive-behavioral therapy (CBT). Methods: With approval from the institutional review board (IRB), this study recruited 11 outpatients as research subjects from a hospital in northern Taiwan. The research subjects met the following criteria: steady medication, same level of OCD (moderate and severe) and without serious comorbidity. They attended CBGP 2 hours a week for 11 weeks. The study methods included process observations of each session and a semi-structured interview for each subject after group therapy, and the study tools comprised observation forms and interview guidelines. Results: Seven major group therapeutic factors were found: catharsis, universality, instillation of hope, imparting of information, group cohesiveness, altruism, and interpersonal learning. For CBT, the following therapeutic factors were discovered: subjects' trust in CBT, successful experience of executing ＂exposure and response prevention＂ technique, accomplishment of homework, compliance with leader's instruction, change in the rigid recognition and other. Conclusions: Based on the results, the research further proposed several suggestions for clinical practice and future studies.
