中国全科医学2017，Vol.20Issue(1)：114-118,5.DOI:10.3969/j.issn.1007-9572.2017.01.023
基于来访者视角的心理治疗和咨询中的伤害性因素研究
The Harmful Factors in Psychotherapy and Psychological Counseling Based on the Perspective of Clients
摘要
Abstract
Objective To investigate the factors possibly causing harm to the clients in psychotherapy and psychological counseling. Methods Of the students visited the psychological counseling center of a university from March 2013 to December 2014,169 clients finished the psychological counseling while 46 clients prematurely terminated it. Members of this research group invited the 46 clients to attend an interview by ways of phone call,E - mail,and so on,and finally 27 of them agreed to participate in this study( dropout group). From the 169 clients,30 were selected as the control group by random number table method. Both groups completed a Counseling Efficacy Evaluation Scale for evaluating the help they obtained during the counseling. The dropout clients were interviewed intensively to explore what factors contributed to their premature dropout. Results Compared with the control group,the dropout group had lower scores of item 1,2,4,6,8,10 in the Counseling Efficacy Evaluation Scale and lower total score(P ﹤ 0. 05). The scores of item 3,5,7,9 in the scale between the two groups were not statistically significant(P ﹥ 0. 05). The results of the interview revealed that there were 2 types of common reasons caused the premature dropout,factors related to psychological counselors and caused harm to therapist - client aliance, and factors related to clients. Of the former type,the following had most times reported by the dropout group:the mismatch between the clients and counselors(9 times),the distrust of clients on the efficacy of psychological counseling(6 times),and the perceived stress related to high expectation of the counselors(5 times)and the counselors could not abide by the counselor -client confidentiality agreement(5 times). Conclusion The mismatch between the clients and counselors,the distrust of clients on the efficacy of psychological counseling,and the perceived stress related to high expectation of the counselors and other factors may cause harm to the clients. Correctly identifying the harmful factors in psychotherapy and psychological counseling is important for the competence as a counselor. Psychological counseling programs should train the trainees to recognize,describe and avoid harmful factors in psychological practice.关键词
心理治疗/心理咨询/负面后果/伤害性因素Key words
Psychotherapy/Psychological counseling/Adverse outcome/Harmful factors分类
医药卫生引用本文复制引用
杨雪岭,张培宁,任家贤,马晓欣,谷文静,张小远..基于来访者视角的心理治疗和咨询中的伤害性因素研究[J].中国全科医学,2017,20(1):114-118,5.基金项目
2014年度广东省医学科学技术研究基金项目（ A2014395）；2014年度广东省哲学社会科学“十二五”规划课题 （）
