정신장애인 자기-스티그마 감소프로그램의 개발과 파일럿실행: 정체성 재구성을 위한 이야기치료의 적용
Program Development and Pilot Implementation of a Narrative Group Practice With Persons Having Psychosocial Disabilities
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초록
본 연구의 목적은 정신장애인의 자기-스티그마를 감소시키고 이들의 정체성을 재구성하는 데 초점을 둔 집단프로그램을 개발하고 효과를 검증하는 파일럿 연구를 수행하는 것이다. 이를 위해 후기구조주의 기반의 이야기치료 기법을 활용한 10개의 프로그램 모듈을 개발하였다. 이 파일럿 프로그램은 지역사회 정신재활시설을 이용하는 중증 정신장애인 7명을 대상으로 총 7회기에 걸쳐 실시되었고, 자기-스티그마 감소와 자기정체성 재구성에 주목하여 프로그램 효과성을 평가하였다. 첫째, 윌콕슨 부호순위 검정을 실시하여 프로그램 참여 전후 참여자의 자기-스티그마 점수 변화의 유의성을 검증한 결과, 자기-스티그마 총합 점수는 통계적으로 유의한 감소가 있었다. 둘째, 참여자의 대안적 정체성 발달 수준을 평가하기 위해 집단프로그램을 통해 생성된 텍스트를 분석한 결과, 이들의 내러티브가 자기정체성이 재구성되는 방향으로 발달되었음을 확인하였다. 본 연구에서 개발된 집단프로그램이 정신장애인의 자기-스티그마를 감소시킬 뿐 아니라 이들의 풍부한 정체성을 구성하는데 기여할 수 있도록 국내 적용을 위한 시사점을 도출하였다.
Abstract
Objectives: This study aimed to develop and pilot-test a group-based intervention that reduces self-stigma and reconstructs the personal identity of individuals with psychosocial disabilities (PDs). Methods: Informed by the themes derived from a previous study on the lives of persons having PDs, this study developed ten program modules that were guided by postmodern narrative therapy. The pilot program was implemented over seven sessions on seven adults with severe PDs at a mental health rehabilitation center. Program efficacy was examined. Results: The result of a Wilcoxon test showed that participants' self-stigma was reduced significantly post intervention. The analysis of the text data generated during the sessions indicated that an alternative identity of the participants had begun to be reconstructed. Conclusions: This intervention has potential for significantly reducing self-stigma of persons with PDs and facilitating the efforts of thickening their personal identity.
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