[[alternative]]Working Flow of the Solution-Focused Brief Therapy for Adolescent with Depressive Symptoms in Family Medicine

[[abstract]]本研究目的為透過焦點解決短期諮商，協助家庭醫學科青少年憂鬱症狀之降低，並解決心情困擾的原因，且藉由任務分析法來了解具有憂鬱症狀的青少年經歷何種改變要件和轉變歷程，達到憂鬱症狀之改變，最後建構出焦點解決短期諮商運用於家庭醫學科青少年憂鬱症狀之工作流程。 本研究使用流行病學研究中心憂鬱量表中文版（CES-D量表）做為諮商前後之評估工具，共邀請六位具有憂鬱症狀的青少年做為研究對象進入諮商，其中女生四名，男生二名，國中生四名，高中職二名，以焦點解決短期諮商進行每週一次每次50-60分鐘共三次的諮商，諮商歷程結束後，其中三位量表分數降低至標準分數內，另三位量表分數則是有明顯之降低。在諮商歷程中六位研究對象所產生的改變要件為：要件一：透過量表分數發現憂鬱狀態，描述至家醫科就診動機、要件二：敘述內在之期待、要件三：發現自己成功達到期待的經驗、要件四：想像困擾問題消失時，自我的心情和所採取之行動、要件五：為自己的困擾情緒狀態、行動能力的信心評分、要件六：選定一個回家作業，付出行動、要件七：知覺自己本身所擁有之能量與資源、要件八：發生新改變、要件九：發掘自己之進步及要件十：發現自我照顧情緒的方式。 以焦點解決短期諮商運用於家庭醫學科青少年憂鬱症狀之工作流程分為五個階段，第一個階段為建立關係，瞭解至門診就診動機和憂鬱狀態、第二個階段為設定目標、第三個階段為建構解決、第四個階段為正向回饋和第五個階段為結束階段。 最後，根據本研究結果提出建議作為焦點解決短期諮商運用於醫療場域和青少年憂鬱症狀諮商工作上及未來研究的參考依據。[[abstract]]This study is to assist and reduce the adolescent with depressive symptoms through solution-focused brief therapy, and to finalize the reason of emotion problem. Through task analysis, this study also helps to realize what the changing components and the process the adolescent with depressive symptoms would experience, to change the depressive symptoms, and to construct a workflow of solution-focused brief therapy for the adolescent with depressive symptoms. This research is applied with Center for Epidemiologic Studies Depression Scale, CES-D Chinese version to compare the before and after the counseling. Six adolescents with depressive symptoms including four females and two males (four junior high students and two senior high students) were invited, who were counseled for 50 to 60 minutes once a week for total three times. After the counseling, the result shows the scores decrease to standard rating among three of them, and it also shows obvious decrease among the other three. The changing components found in these six research subjects are as below. Component 1: Find out the depressive status and describe the motive to come to general practice for counseling. Component 2: Describe their inner expectation. Component 3: Find out the achievement experience for success. Component 4: Imagine how they feel and what action they would take while the problems disappear. Component 5: To evaluate their own emotion status and the confidence for action. Component 6: Select homework and put it into action. Component 7: To realize the power and source they are possessed of. Component 8: New changes occur.Component 9: Explore their own progress. Component 10: Find out the self-care approaches to their own emotions. The workflow of solution-focused brief therapy applied to the adolescent with depressive symptoms in general practice is divided into five stages. The first stage is to build up the relationship, and to understand the motives for counseling and their depressive status. The second stage is to set up a goal. The third stage is to construct the solution. The fourth stage is positive feedback. The fifth stage is the ending period. Finally, the results of this study provide the suggestions for the reference basis of future study for the solution-focused brief therapy which is applied in medical field and adolescent with depressive symptoms counseling as well