住院康复精神病人日常生活实践中的充权 一个广州的个案研究

Empowerment Through Everyday Life Practices:A Case Study of a Hospitalized Patient with a Mental Disorder in Rehabilitation in Guangzhou

本文源于社会工作者在广州某精神病院介入一位强迫症患者的实务反思。首先,本文描述精神病院这一专家权力掌控的"全控机构",凸显全控机构下日常生活实践的碎片化特点。而这既是住院康复精神病人主体性展现的空间,也是社会工作者同理与接纳个案的理想平台,为探讨日常生活实践充权的可能性创造了条件。其次,本文反思与个案建立专业关系的过程,重新理解个案日常生活与外界环境的互动行为的意涵,不仅认识到个案本身的主体性力量和其中存在的充权可能性,也认识到日常生活实践对实现社会工作者同理与接纳的重要意义。这提醒社会工作者在实务过程中要时刻反思如何激发个案主体性,帮助其实现自我认同与接纳。

This paper is based on a social-work intervention with an Obsessive Compulsive Disorder （OCD） case in a mental hospital in Guangzhou. With the method of ＂alternative lens＂ developed in drama and theater research, the readers will be guided to observe the space and power construction in a mental hospital, to see the hospital as the ＂total institution＂ under the experts＇ power control, and to get the basics of the characteristics and importance of the daily life practices in such a total institution. The fragmented daily life that has survived the total control is not only the space for the hospitalized patients with mental disorders in rehabilitation to display their identity but also an ideal space for social workers to display theirs and to accept cases. Furthermore, this also makes it possible to explore the possibility of empowering the clients in daily life practices. Through reflecting upon the challenges and resistance encountered during the initial establishment of a professional relationship with the patient in the case, the authors recognized the meaningfulness of the clienls resistance, the power of the identity itself, the possibility of potential empowerment, and the significance of daily life practices to social workers＇ acceptance of the client. There are two insightful points. First, there is tension between the identity in daily life practices and the power, which may lead to the individual challenging or defying the existing regulations and restrictions. Second, Social workers, when having gotten the first point, should be good at stimulating the individuaV s identity in order to get his or her self-identification and self-acceptance. The authors＇ concept of empowerment through daily life practices summarizes the individual actions illustrated in the first point and also is the expectation and demand of the roles taken on by social workers.