目的: 探讨整合诗歌疗法在综合医院心理科门诊混合性焦虑和抑郁障碍患者中的应用疗效。
方法: 在综合医院心理科门诊招募8名混合性焦虑和抑郁障碍患者,开展为期3周的整合诗歌疗法团体治疗。在治疗前和治疗结束后分别评估团体成员的焦虑、抑郁、自我和谐、自尊及个人意义感,并通过威尔科克森符号秩检验对收集的数据进行分析。治疗结束后,对患者进行焦点小组访谈,依据Colaizzi七步分析法对访谈资料进行质性分析。
结果: 量化评估表明在整合诗歌疗法团体治疗前后,团体成员焦虑、抑郁、自我和谐、自尊、个人意义感等评分差异均无统计学意义。在质性研究中,发现在混合性焦虑和抑郁障碍患者中开展整合诗歌疗法的应用效果包括3个一级主题：激活感受、认知改变、症状改善。整合诗歌疗法起效的潜在疗效因子包括4个一级主题：诗歌内容、团体带领者言行、团体成员连接以及团体中的技能练习。
结论: 虽然团体成员在整合诗歌疗法前后各维度量化评估中数据未表现出显著差异,但质性研究表明整合诗歌疗法在混合性焦虑和抑郁障碍患者中具有潜在效果。
Objective: To explore the effectiveness of integrated poetry therapy in treating patients with mixed anxiety-depressive disorder in the Department of Psychology of a general hospital.
Methods: Eight patients with mixed anxiety-depressive disorder were recruited from the outpatient Department of Psychology of a general hospital and participated in a 3-week integrated poetry therapy group therapy. Assessments of anxiety, depression, self-consistency and congruence, self-esteem, and sense of personal meaning were conducted before and after the treatment. Quantitative data were analyzed by the Wilcoxon signed-rank test. After the intervention, a focus group interview was used to conduct qualitative research, and Colaizzi's seven-step analysis was used to analyze the interview data.
Results: There was no significant difference in the scores of anxiety, depression, self-consistency and congruence, self-esteem, and sense of personal meaning before and after the integrated poetry therapy. However, the qualitative study found that the effects of integrated poetry therapy in patients with mixed anxiety-depressive disorder included the following three primary themes: activation of feelings, cognitive changes, and symptom improvement. The potential therapeutic factors contributing to the efficacy of integrated poetry therapy included the following four first-level themes: the content of the poems themselves, the words and deeds of the group leaders, group members' connection, and the practice of therapeutic skills within the group.
Conclusion: Although there was no significant difference in the measured data among group members in the quantitative assessment of each dimension after integrated poetry therapy, qualitative findings indicated the potential utility of integrated poetry therapy in patients with mixed anxiety-depressive disorder.
[1] 梁群君, 徐瑾, 杨薇薇, 姜思仪, 郑雪. (2018). 个人意义清单简版中文修订版在大学生群体中的适用性. 中国心理卫生杂志, 32(7), 607-614. doi: 10.3969/j.issn.1000-6729.2018.07.013
[2] 尼古拉斯・玛札. (2013). 诗歌疗法理论与实践 (沈亚丹, 帅慧芳译). 南京: 东南大学出版社.
[3] 彭勇文. (2017). 节奏训练应用于身心健康促进的实践与文化传承. 健康教育与健康促进, 12(5), 4. doi: CNKI:SUN:JYCJ.0.2017-05-011
[4] 彭勇文, 卞茜, 陈春梅, 顾俊杰. (2020). 整合性团体诗歌疗法改善青少年抑郁症的有效性和可行性探索. 健康教育与健康促进, 15(4), 359-363. doi: 10.16117/j.cnki.31-1974/r.202004006
[5] 田兆耀. (2018). 当代欧美诗歌疗法管窥: 以尼古拉斯·玛札的理论为主. 语文学刊, 38(2), 58-65. doi: CNKI:SUN:YWWY.0.2018-02-010
[6] 王登峰. (1994). 自我和谐量表的编制. 中国临床心理学杂志, 2(1), 19-22. doi: CNKI:SUN:ZLCY.0.1994-01-004
[7] 王军. (2023). 基于知识图谱的国内外阅读疗法研究可视化分析. 图书馆理论与实践, (2), 90-98. doi: 10.14064/j.cnki.issn1005-8214.2023.02.009
[8] 汪向东, 王希林, 马弘. (1999). 心理卫生评定量表手册 (增订版). 北京: 中国心理卫生杂志社.
[9] 杨芳, 吕冰玉. (2021). 国外阅读疗法研究知识图谱分析. 新世纪图书馆, (6), 89-96. doi: 10.16810/j.cnki.1672-514X.2021.06.016
[10] 于志涛, 牟晓青. (2019). 国际阅读疗法领域研究演变. 图书馆论坛, 39(8), 124-137. doi: 10.3969/j.issn.1002-1167.2019.08.014
[11] Canty, N. (2017). Bibliotherapy: Its processes and benefits and application in clinical and developmental settings.J World Book Community, 28(3), 32-40. doi: 10.1163/1878-4712-11112133
[12] Cuijpers P., Miguel C., Ciharova M., Ebert D., Harrer M., & Karyotaki E. (2023). Transdiagnostic treatment of depression and anxiety: A meta-analysis.Psychol Med, 53(14), 6535-6546. doi: 10.1017/S0033291722003841
[13] Czernianin W., Czernianin H., & Chatzipentidis K. (2019). Bibliotherapy: A review and perspective from Poland. J Poet Ther, 32(2), 78-94. doi: 10.1080/08893675.2019.1583413
[14] Freeman, M. (2022). The world mental health report: Transforming mental health for all.World Psychiatry, 21(3), 391-392. doi: 10.1002/wps.21018
[15] Gold, J. (1988). The value of fiction as therapeutic recreation and developmental mediator: A theoretical framework.J Poet Ther, 1(3), 135-148. doi: 10.1007/bf03391288
[16] Hazlett-Stevens, H., & Oren, Y. (2017). Effectiveness of mindfulness-based stress reduction bibliotherapy: A preliminary randomized controlled trial.J Clin Psychol, 73(6), 626-637. doi: 10.1002/jclp.22370
[17] Huang Y., Wang Y., Wang H., Liu Z., Yu X., Yan J., ... Wu Y. (2019). Prevalence of mental disorders in China: A cross-sectional epidemiological study. Lancet Psychiatry, 6(3), 211-224. doi: 10.1016/S2215-0366(18)30511-X
[18] Ihanus, J. (1998). Dancing with words: Transference and countertransference in biblio/poetry therapy.J Poet Ther, 12(2), 85-93. doi: 10.1023/A:1021490216139
[19] Kessler R. C., Ormel J., Petukhova M., McLaughlin K. A., Green J. G., Russo L. J., ... Bedirhan Ustün T. (2011). Development of lifetime comorbidity in the World Health Organization world mental health surveys.Arch Gen Psychiatry, 68(1), 90-100. doi: 10.1001/archgenpsychiatry.2010.180
[20] Kessler R. C., Sampson N. A., Berglund P., Gruber M. J., Al-Hamzawi A., Andrade L., ... Wilcox M. A. (2015). Anxious and non-anxious major depressive disorder in the World Health Organization World Mental Health Surveys.Epidemiol Psychiatr Sci, 24(3), 210-226. doi: 10.1017/S2045796015000189
[21] Landi G., Simoni E., Landi I., Galeazzi G. M., Moscara M., Pighi M., ... Di Lorenzo R. (2021). Therapeutic factors in a psychiatric group therapy: A preliminary validation of therapeutic factors inventory-8, Italian version.Psychiatr Q, 92(2), 523-536. doi: 10.1007/s11126-020-09834-2
[22] Park J. H., Kim J. Y., & Kim H. O. (2022). Effects of a group poetry therapy program on stress, anxiety, ego-resilience, and psychological well-being of nursing students.Arch Psychiat Nurs, 41, 144-152. doi: 10.1016/j.apnu.2022.07.027
[23] Pehrsson, D., & Mcmillen, P. S. (2007). Bibliotherapy: Overview and implications for counselors (ACAPCD-02). Alexandria, VA: American Counseling Association.
[24] Pettersson, C. (2018). Psychological well-being, improved self-confidence, and social capacity: Bibliotherapy from a user perspective.J Poet Ther, 31(2), 124-134. doi: 10.1080/08893675.2018.1448955
[25] Qi F., Soh K. G., Mohd Nasirudddin N. J., & Mai Y. (2022). Effects of Taichi on physical and psychological health of college students: A systematic review.Front Physiol, 13, 1008604. doi:10.3389/fphys.2022.1008604
[26] Qi F., Soh K. G., Nasiruddin N. J. M., Leong O. S., He S., & Liu H. (2023). Effect of Taichi Chuan on health-related physical fitness in adults: A systematic review with meta-analysis.Complement Ther Med, 77, 102971. doi: 10.1016/j.ctim.2023.102971
[27] Santomauro D. F., Mantilla Herrera A. M., Shadid J., Zheng P., Ashbaugh C., Pigott D. M., ... Ferrari A. J. (2021). Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic.Lancet, 398(10312), 1700-1712. doi: 10.1016/s0140-6736(21)02143-7
[28] Tarsha M. S., Park S., & Tortora S. (2020). Body-centered interventions for psychopathological conditions: A review.Front Psychol, 10, 2907. doi: 10.3389/fpsyg.2019.02907
