自杀意念的叙事疗法干预个案报告

A case study of effects of narrative therapy onsuicidal ideation

目的:采用叙事疗法对1例大学生进行自杀意念干预并评价效果。方法:个案共接受7次叙事干预,采用患者健康问卷抑郁症状群量表(PHQ-9)的条目9评估自杀意念出现频率,使用PHQ-9、自我认同问卷(SIS)、生活满意度量表(SWLS)和青少年心理韧性量表(RSCA)评估心理状况,采用治疗效果评定量表(ORS)评估干预进展效果,并收集个案的主观报告。结果:7次叙事干预后,个案自杀意念的出现频率从“少数几天”减少为“完全不会”;抑郁程度从“轻度”变为“正常”,SIS得分从46升至50,SWLS得分从18升至20,RSCA得分从88升至101,ORS总分从29.15升至33.60;自我报告咨询帮助很大,咨询目标基本达成,已远离自杀意念。结论:叙事疗法可有效减少大学生的自杀意念。

Objectives:To evaluate the effect of narrative therapy on a college student with suicidal ideation.Methods:Seven sessions of narrative therapy was conducted.The frequency of suicidal ideation was assessed with the 9th item of the Patient Health Questionnaire 9-Item depression module(PHQ-9).The PHQ-9,Self-identity Scale(SIS),Satisfaction with Life Scale(SWLS)and the Resilience Scale for Chinese Adolescents(RSCA)were used to evaluate the mental health status.The effect of intervention progress was evaluated with the Outcome Rating Scale(ORS)and the subjective reports of case X were collected.Results:After the narrative counseling,the frequency of suicidal ideation decreased from“few days”to“never”.Depression levels changed from“mild”to“normal”,the score of SIS increased from 46 to 50,the score of SWLS increased from 18 to 20,the score of RSCA increased from 88 to 101,and the score of ORS increased from 29.15 to 33.60.Meanwhile,the client thought that the intervention was helpful,the goals were basically achieved and had been far away from suicidal ideation.Conclusion:Narrative therapy is effective in reducing suicidal ideation in college students.