사회불안장애 아동을 위한 게임 인지행동치료 프로그램의 개발 및 효과
A study on the development and effectives of game-cognitive behavioral therapy program for social anxiety disorder in children
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본 연구의 목적은 사회불안장애 아동을 대상으로 게임 인지행동치료(CBT) 프로그램을 개발하여 그 효과를 검증하는 것이다. 연구대상 선별을 위해 초등학교 5, 6학년생에게 사회불안 척도(K-SAS-A)와 개정판 아동용 사회불안 척도(SASC-R)를 실시하고 두 척도의 상위 10%에 중복 해당하는 경우 진단면접을 진행하였다. 최종적으로 선발된 16명은 실험집단과 통제집단에 각각 8명씩 무작위로 배정되었다. 본 프로그램은 자기감찰과 인지적 재구성의 인지적 개입과 노출훈련, 사회기술훈련 및 이완훈련의 행동적 개입으로 구성되었으며, 각 치료 구성 요인을 촉진시키기 위한 다양한 게임이 사용되었다. 본 프로그램은 주 1회 90분씩 총 12회기가 진행되었으며, 프로그램의 효과 분석을 위해 사전, 사후 및 추후검사를 실시하였다. 본 연구의 주요 결과는 다음과 같다. 첫째, 프로그램 실시 후 실험집단의 인지적 특성(자동적 사고 및 비합리적 신념)은 유의미한 감소를 나타냈다. 둘째, 프로그램 실시 후 실험집단의 정서적 특성(사회불안, 주관적 불편감)은 유의한 감소를 나타냈다. 셋째, 프로그램 실시 후 실험집단의 행동적 특성 중 또래관계기술과 발표시간은 유의한 증가를 나타낸 반면, 안전행동, 수행불안행동은 유의한 감소를 나타냈다. 넷째, 프로그램 종료 2개월 추후검사에서도 실험집단의 변화는 그대로 유지되었다.
Abstract
The present study examined the effects of the G-CBT(Game-Cognitive Behavioral Therapy) program on children with social anxiety disorder. Through the diagnostic process of clinical psychologists, final patients were selected among 5th and 6th graders from an elementary school based in Paju and randomly assigned to a treatment group(N=8) and a control group with no G-CBT(N=8). For the children in the experimental group, a weekly 90-minute session was conducted for 12 weeks. At post-treatment, the treatment group showed significant improvement on indices of cognitive perspective(automatic thought, irrational beliefs of cognition), emotional perspective(social anxiety) and behavioral perspective(safety behavior, behavior checklist for performance anxiety, subjective units of discomfort). In addition, the levels of both cooperation and empathy including peer relationship skills and length of presentation significantly improved. Furthermore, the effects on the cognitive, emotional and behavioral characteristics were maintained at the 2-month follow-up.
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