복합적 외상 후 스트레스 장애 환자와의 즉흥연주 및 음악과 심상을 이용한 음악치료 사례 연구
Case Study of Music Therapy that used Improvisation and Music Imaging Methods with Complex PTSD Patient
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초록
이 연구는 최근 증가 추세에 있으나 약물치료와 정신치료 등에는 잘 반응하지 않는 복합적 외상 후 스트레스 장애(Complex PTSD) 환자를 대상으로 한 사례 연구이다. 본 연구에서는 안정화, 외상적 기억 처리, 재통합의 단계에 즉흥연주 및 음악과 심상을 이용한 음악치료를 통해 복합적 외상 후 스트레스 장애 환자의 스트레스, 우울, 불안, 사건충격, 해리경험의 변화를 보고자 하였다. 본 연구에서 사용한 척도는 SIDES-SR, BDI, BAI, IES-R, DES이고 치료효과 판정은 음악치료 시작 전, 9개월 동안의 치료 기간을 3개월씩 구분하여 3개월 후, 6개월 후, 9개월 후의 평가 자료를 비교 분석하였다. 연구 결과 SIDES-SR의 6가지 영역 모두에서 평균 심각도가 감소되었고, 치료기간이 경과함에 따라 더욱 호전되었다. 특히, 심각도가 높았던 영역 중에서 정동과 충동 조절의 변화, 신체화의 감소율이 큰 것으로 나타났다. 또한 BDI, BAI, IES-R, DES에서도 치료기간이 경과함에 따라 증상의 감소를 보여 호전이 진행된 것으로 나타났다.
Abstract
People who were exposed to chronic interpersonal traumas in their early life consistently demonstrate complex psychological disturbances and many of them meet the criteria for proposed diagnosis of complex post-traumatic stress disorder (complex PTSD). The author reports a case of the successful music therapy that sequential integrative treatment mainly composed of improvisation and music imaging in a complex PTSD patient. The patient did not respond to the previous treatment with psychotropic medications and supportive psychotherapy. Nineteen sessions of music therapy were done for the patient. Psychological assessments and behavioral measures were performed before starting the treatment, after 3 months and after 6 months and after 9 months. After the music therapy session, the patient improved on all the psychological scales and behavioral measures. This case suggests that the music therapy that sequential integrative treatment using improvisation and music imaging may be effective for complex PTSD patients.
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