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신체적 학대를 받은 아동에게 점진적 노출기법을 적용한 인지행동치료에 대한 연구

The Effectiveness of an Individual Cognitive-Behavioral Treatment for Physically Abused Children

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본 연구는 신체적 학대를 받은 아동에게 점진적 노출기법을 적용한 인지행동 개인치료를 실시하여 치료 전과 후의 변화를 비교하였다. 연구 대상은 심한 신체적 학대를 받고 부모와 분리되어 아동보호기관에서 일시적으로 보호받고 있는 아동 7명이었다. 치료 결과 참여 아동들은 치료 전과 비교해서 치료 후에 외상 후 스트레스 증상, 불안 및 우울 증상, 또래와의 이질감, 타인에 대한 불신감에서 향상을 보였다. 그러나 분노감, 부정적 사건의 개인적 귀인, 타인에게 신뢰받지 못한다는 지각에서는 유의한 변화가 없었다. 이런 결과는 신체적 학대를 받은 아동의 경우, 점진적 노출에 기반한 인지행동 개인치료가 효과적일 수 있다는 가능성을 시사해 준다. 참가 아동 중 2명의 치료과정에 대한 사례연구를 통해 점진적 노출기법의 적용과정을 제시하였다. 그러나 신체적 학대를 받은 아동에 대한 인지행동 개인치료의 효과를 경험적으로 검증하기 위해서는 다른 개인 치료와 비교한 무선 할당된 통제 연구가 필요하다.

Abstract

The aim of this study was to describe a case series of physically abused children who received an individual cognitive-behavioral treatment program. Seven physically abused children took part in 14 weeks of twice weekly individual therapy. The treatment program was developed with a focus on gradual exposure and on cognitive and emotional processing. The children were assessed before and after treatment using measures of post-traumatic stress, anxiety, depression, anger, and attribution style. Significant improvements were found in depression, anxiety, post-traumatic stress, feeling different from peers and interpersonal distrust. The implications and limitations of this study were discussed with suggestions for future study.

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