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    Title: 男性受戒治人之改變動機及治療投入對康復態度的影響
    The Impact of drug offender`s motivation and treatment engagement on attitude for recovery
    Authors: 顏蔚吟
    Contributors: 許文燿
    顏蔚吟
    Keywords: 男性受戒治人
    強制藥癮治療
    改變動機
    治療準備性
    治療投入
    康復態度
    drug offender
    mandated residential drug abuse treatment
    motivation for change
    treatment readiness
    treatment engagement
    attitude for recovery
    Date: 2007
    Issue Date: 2009-09-19 11:56:38 (UTC+8)
    Abstract: 動機是成癮行為改變的重要因素,但動機高者並不能保證治療成效,同時強制治療個案即使在進入治療時動機較低,治療成效卻和自願者組沒有差異,顯示強制治療下即使進入治療時其內在動機較低也不影響治療成效。同時文獻亦證實預測成效最一致的因子為停留在治療期間的長短(retention),而預測治療期間的因子為治療投入,所以在治療過程為架構的研究模式下治療投入為影響成效的關鍵因素。雖然多數研究均顯示進入治療時動機對治療投入及治療期間長短有所影響,但是亦有研究認為治療過程相關因素才是影響治療投入及治療期間的關鍵。基於上述藥癮成效與治療過程、個案動機、治療期間的關係,同時考量台灣戒治制度須有替代治療期間的變項,本研究以探討戒治醫療處遇方案為主,了解治療對受戒治人之出所時康復態度的影響,此外基於動機在改變歷程的重要性,本研究分為二個重點:一、探討動機的相關因素,著重探討認知評估對動機的影響。二、釐清個案動機、治療投入及康復態度之關係。

    本研究以台灣北區某戒治所受戒治人為研究對象,在受戒治人出所前三個月開始接受戒治醫療處遇為期六週,治療前施測:動機量表、基本資料、物質使用情形、犯罪/前科/服刑情形、康復態度等,治療結束後施測:康復態度、治療回顧、治療投入、對治療者評價等,最後以65位受試者作為本研究樣本進行分析。
    研究結果顯示:一、動機相關因素:(1)人口變項、物質使用情形無法有效預測動機變項。(2)認知評估相較於問題嚴重度更能有效預測動機變項。(3)認知評估作為人口變項、物質使用、問題嚴重度(獨變項)及動機變項(依變項)間的中介效果部分獲得支持。(4)心理問題及困擾、家庭問題能夠有效預測動機。二、個案動機、治療投入與康復態度之關係:(1)治療投入僅與康復態度後測正相關顯著,卻未與康復態度前測相關達顯著。(2) 階層迴歸中治療投入能解釋較大的變異,同時治療投入及個案動機中之治療準備性對康復態度的重要性大。(3).動機及治療投入皆能有效預測康復態度,但康復態度不具有中介效果。同時康復態度前後測差異未達統計顯著性。由上述結果來看,認知評估對動機的影響最為重要,並具有中介效果,顯示除了真實藥癮及其相關問題外,認知性內在動機須由高等認知評價歷程相關較高。儘管進入治療動機能影響康復態度,但是治療投入對於治療結束時對出所後運用社區醫療資源意願有較大的預測力。

    最後根據研究結果進行對動機及治療投入相關因素進行討論,並建議未來研究方向及矯正機構毒品犯處遇。
    Aim. This study examined the predictors of drug offender motivation and the relationship among motivation, treatment, attitude for recovery. Setting. The data were collected from long-term mandated residential treatment program located in Taiwan Rehabilitation Rehabilitation Northern Center. Participants. A total of 65clients received drug abuse treatment program were studied. Measurement. Pretreatment variables included: socio-demographic indicators, drug use history and dependence criminality, addiction severity index, TCU three –staged-of- motivation(problem recognition, desire for help, treatment readiness),and attitude for recovery. After treatment variables included: treatment process review, treatment engagement, and attitude for recovery. Results. (1)Cognitive appraisal is the most important predictor of client internal motivation for change.(2)Cognitive appraisal has mediating effect between problem severity and internal motivation.(3)Client motivation(treatment readiness) and treatment engagement are significantly related to attitude for recovery. Treatment engagement is more important than client motivation. The clinical implications and limitation was discussed.
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