實習諮商心理師於社區機構實習經驗倫理困境及決策歷程之探討

Abstract

本研究動機除源自研究者自身的諮商心理實習經驗中，曾經歷過倫理困境的兩難，也基於文獻大多數探討學校場域的倫理困境，若能增加社區機構之諮商倫理困境的探討，將能更完整的看見實習心理師面對的倫理為難和決策歷程。本研究目的在探究實習諮商心理師於社區諮商機構實習經驗倫理困境及其決策歷程。邀請兩年內曾在社區機構進行全職諮商實習的實習心理師，共計1位前導受訪者以及6位正式研究參與者為研究對象，進行1次時長60～90分鐘的訪談，其中正式研究參與者為5位女性與1位男性，3位已完成碩士學位，3位仍是碩士在學中，平均年齡為29歲。研究方法以半結構式訪談法蒐集研究資料，進一步採取主題分析法進行編碼與分析訪談資料，以探究其在實習場域中曾遇倫理困境及其決策歷程。研究結果顯示常見之倫理困境議題有：個案資料的隱私與保密、預警與通報責任、雙（多）重關係以及個案自主權；在5種較具代表性學者所提出之理論模式中，研究參與者決策歷程則有4類，分別為：四階段倫理決策模式、倫理決策權變模式、個人與情境交互作用之倫理決策模式及整合之倫理決策模式。最後依據研究結果根據七眼模式將倫理決策歷程中的影響因素分為工作場所（社區諮商機構）及受督者（研究參與者）的視框進行討論，同時也參考本研究結果與內容提出建議與未來研究方向。The motivation of this study is not only derived from the researcher’s own practice experiences, but also based on the literature findings. Most of the discussions on the ethical dilemma were in the school field, if the discussion of the ethical dilemma in community institutions can be added more references for intern counseling psychologists, it will be able to see more completely the ethical dilemmas and decision-making process by trainee, can provide more comprehensive, ethic decision-making aspirational rules as a future reference. The purpose of this study is to explore the ethical dilemmas and decision-making process of intern counseling psychologists' experience in community counseling institutions, and invite counseling psychologists who have done full-time internships in community institutions within two years, a total of 1 pilot interviewee and 6 a formal research participant was the research object, and an interview was conducted for 60-90 minutes. Among them, the formal research participants were 5 females and 1 male, 3 of whom had completed their master's degree, and 3 of them were still studying for their master's degree, with an average age of 29. The research method uses the semi-structured interview method to collect research data, and further adopts thematic analysis method to code and analyze the interview data, so as to explore the ethical dilemmas and decision-making processes encountered in the practice field. The research results show that common ethical dilemma issues include: privacy and confidentiality of case data, responsibility for early warning and notification, dual (multiple) relationships, and client autonomy; among the five theoretical models proposed by more representative scholars, there are four types of decision-making processes model found in our study, namely: four-stage ethical decision-making model, ethical decision-making contingency model, ethical decision-making model of interaction between individuals and situations, and integrated ethical decision-making model. Finally, according to the research results, the influencing factors in the ethical decision-making process are divided into workplaces (community consultation agencies) and supervisors (research participants) ethic types, and we discuss those meaning from the seven-eyes model and the recent literatures. As the content of the interview and research results we offer further suggestions and direction of future research.