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무엇이 상담 효과를 산출하는가?: 상담의 효과성에 관한 경험적 증거의 함의

Counseling or psychotherapy not as scientific application of experimental psychological knowledge, but as systematic applications of counselor interpersonal skills

김동민
한국상담학회 (Korean Counseling Association (KCA))|2021.10|상담학연구 (Korea Journal of Counseling)|제22권 제5호|pp. 59-75|DOI 10.15703/kjc.22.5.202110.59

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키워드

메타분석meta-analysis공통요인common factor심리서비스법안국면모델관계-기반 모델legal proposal on delivering psychological servicesphase modelrelationship-based model
주제분류교육학

초록

상담 및 심리치료 등 여러 처치의 효과에 관한 Smith와 Glass(1977)의 메타분석 이래, 상담과 심리치료는 매우 큰 효과를 갖는 처치로 인정받고 있다. 이 논의에서는 첫째, 모든 상담 및 심리치료에 공통적으로 존재하는 요인이 상담 및 심리치료의 효과를 산출한다는 관점을 제시하고, 이에 대한 경험적 증거로는 어떤 것이 있는지를 제시하였다. 둘째, 공통요인이 상담 및 심리치료의 효과를 발생하게 되는 경로를 설명하는 두 모델, 즉 국면모델 및 관계-기반 모델을 소개하였다. 셋째, ‘증거기반 실무’와 ‘실무기반 증거’라는 현재의 실무 및 연구 흐름을 소개하고, 국내의 성과 연구가 지향해야 할 방향을 제시하였다. 이 논의의 결론으로 상담 및 심리치료가 심리학 지식을 체계적으로 적용하는 성격의 활동이라기보다는 상담사의 대인관계 역량을 체계적으로 발휘하는 활동이라는 관점을 제시하였다. 이런 관점에서 한국심리학회의 심리서비스법안에서 제기되는 한 가지 쟁점 즉, 심리학 학위 소지자에게 면허 취득 자격을 ‘배타적’으로 부여하는 안의 적절성을 논의하였다.

Abstract

Since the first meta-analysis by Smith & Glass(1977) on outcome of various psychological treatments, counseling and psychotherapy have been known as remarkably efficacious and effective treatments. In this discussion, first, based on evidence from meta-analyses and individual outcome studies, it was argued that common factors(e. g., explanation on symptoms and rituals consistent with the explanation) were responsible for outcomes of counseling and psychotherapy. Second, two models, namely the phase model and the relationship-based model, explaining how counseling and psychotherapy produce it’s benefit were presented. In those models, counselor interpersonal competence in mobilizing common factors is critical in outcomes of counseling and psychotherapy, which is the most critical point of this discussion. Third, a recent movement in research and practice, i. e., evidence- based practice and practice-based evidence, was described briefly. Accordingly, suggestions for future outcome study in Korea were proposed. Finally, an implication regarding newly proposed legal regulation on delivering psychological services by Korean Psychological Association, particularly granting license-application right exclusively to the graduates of psychology department was presented.

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