摘要
社会上的心理咨询是我国心理健康服务体系的一个重要组成部分,它们面向社会群体,对维护人们心理健康、促进我国精神文明发展具有重要作用。但我国社会心理咨询机构及从业人员发展现状究竟如何,提供的咨询服务效果又如何,这方面的研究不仅非常少,而且研究方法单一、研究内容不够深入。由于社会心理咨询也是我国新开展的现代商业活动,所以按照商业活动服务提供者、服务对象和服务本身的三要素划分,本研究对社会上的心理咨询机构及从业人员、社会群体和咨询服务三方面的内容展开了全面和深入的探讨。
本研究采取质量结合的研究方法,系统针对社会上的心理咨询发展的现状及发展的对策展开研究,主要研究结果如下：
1.通过网络搜索引擎对全国省市直辖市的社会心理咨询服务者的情况进行了调查,调查从机构成立时间、成立数量、人员数量及资质等方面进行,结果发现整体上社会心理咨询机构发展时间较短,数量比较少；服务人员一方面数量较少,而且人员结构中性别比例不均衡,同时人员资质中有一半以上不具备心理学相关知识背景,而且有相当一部分的从业人员未取得服务资格证书；在具体走访重庆市10家社会心理咨询机构调研搜集到的机构和人员信息中发现,这些机构的知名度不够,来访者对咨询机构环境、咨询师职业素养等方面有诸多不满,说明社会上的心理咨询行业中还存在很多待规范的问题,而且人们在选择社会心理咨询机构进行咨询时有诸多担心,比如机构收费昂贵、咨询内容保密性问题等。
2.针对社会上的心理咨询机构和人员现状中存在的问题,对心理咨询专家进行了访谈,探讨了机构和从业人员的发展对策。关于机构的发展,国家应该重视和鼓励机构规模的发展,尤其在很多中小城市和农村地区更应加强机构建设,同时还应建立咨询服务的社会保险体系；利用社会媒体加强机构宣传,引导公众对心理健康和咨询正确的认识;在咨询行业内部还应形成运营规范化的标准体系和健全规范的监督管理体系,如机构成立资质的认定、收费管理,以及对从业人员的考评和考核体系,资质和服务质量监督管理等;从业人员的发展应注重职业素质的培训,包括专业知识技能的学习和再学习体系,对工作的认同和责任感,以及咨询中重要的人格素质的培养,如善解人意、敏感、耐心等品质。
3.结合国内外相关资料自行编制了社会群体对待社会心理咨询的态度问卷,探索性因素分析表明问卷包含社会成见容忍性、咨询需求认知、机构信任性和人际开放性四个维度,经检测,问卷的内部一致性信度、内容效度和结构效度较好,可用作态度调查的有效工具。通过在重庆八大主城区发放问卷,调查了1162名重庆居民关于社会上心理咨询的态度情况,在对回收问卷进行数据分析后,发现整体上人们对待社会心理咨询的态度还比较保守,相比较而言年轻群体比年长群体态度开明;学历高的群体比学历低的群体态度开明：不同职业和居住区域的居民对待咨询的态度也不尽相同。
4.针对大学新生阅读和未阅读心理健康和心理咨询介绍材料的实验,对促进人们关于社会心理咨询态度的条件进行了探讨。实验证明,阅读了心理健康和心理咨询材料的大学生在对待社会心理咨询态度上更积极,而且对心理咨询的需求认知更开明,因此加强心理健康和心理咨询相关知识的宣传教育,对促进社会群体的咨询态度是非常有效的方式。同时对社会群体关于社会心理咨询服务需求的调查中显示人们对于心理健康的需求已日益凸显,而且人们对于自我认识、压力处理、亲子关系、人际关系方面的咨询服务比较关注,这说明社会心理咨询机构应该注重和加强这些领域的研究和服务,为社会群体提供高质量的咨询服务。
5.在重庆10家社会心理咨询机构进行实地咨询,使用PQS分析工具对咨询过程进行研究,发现大多数社会心理咨询机构咨询师提供服务时会使用到特殊的心理咨询技术,他们在咨询中能够采取支持的立场,向来访者传达无条件积极接纳的态度,与来访者塑造良好的咨访关系,并取得来访者信任,整体上,咨询师的职业道德良好,没有与来访者保持咨询以外或不正当的咨访关系；但在咨询过程中都倾向于给予来访者明确的建议和指导,咨询中带有说教意义；而且咨询师不会与来访者预约或安排长期的咨询计划,咨询服务中通常是一次咨询为主,每次的咨询服务时间大概会持续1.5-2小时左右。
6.通过对来访者咨询前后改变状况、咨询满意度以及咨访关系的调查,对重庆市9家社会心理咨询机构的咨询服务效果进行了评价,发现8家机构的咨询师提供的咨询服务让来访者产生了积极的改变,有一家机构使来访者情况恶化；大部分机构的服务都取得了良好的效果,在来访者满意度和工作同盟关系上得分较高。在探讨咨询效果相关的因素中,发现女性咨询师的咨询效果普遍优于男性咨询师,咨访双方相同性别的咨询效果优于不同性别的咨询效果,使用特殊咨询技术的咨询效果优于不使用特殊咨询技术的咨询效果,咨询时间越长咨询效果越差。
7.在文献综述和访谈研究基础上,形成了咨询效果评估指标体系,并通过专家评分的AHP方式确立了指标权重,形成了心理咨询效果评估模型,经验证该模型实用性较好。通过该模型的建立,既能对社会心理咨询机构的服务效果进行评价,又能为社会心理咨询机构服务效果的提升提供指导。
Private psychological practice is an important constitutor of the mental health service system in China, which can protect people's mental health and promote to construct the civilization of spirit. However, the research on private psychological practice is few and the method is single, the content is not in-depth, especially there are lack of the private psychological practice outcome researches. Private psychological practice as the commercial service in modern times consists of supplier, object and service, so these three aspects were comprehensively and thoroughly discussed in this research by integrating the methods of qualitative and quantitative.
Then main finding are summarized as follows:
1. The private psychology clinics and practitioners in private psychological practice all over the central cities in China were investigated on internet, including the time which clinics come into existence, the amount of the clinics and practitioners, and the competence of the practitioners. It was found that clinics appeared in a short time, the amount and the competence of the clinics were devoid. Having interviews with 10 clinics in Chongqing, we found that they were unknown by most people and there were many problems exist, such as clients were not satisfied with the clinics'environment, the practitioners' professional accomplishment and they took thought for the charge and secrecy in counseling.
2. Aimed at the problems of private psychology clinics and practitioners, we opened out the interview on counseling experts for the developmental contermeasures. To develop the private psychology clinics, the government should pay attention to the development of the clinics'quantity and size, especially in small cities and countries, and the counseling charges should be brought into insurance system. The medium should strengthen in publicizing about clinics and mental health knowledge to lead the public to the correct cognition. The standardization system about operation and management in private psychological practice should be established, such as the congnizance of competence, the management of charge, the supervising in practitioners' aptitude and counseling outcome. The development of practitioners should set up the cultivation system not only in professional knowledge and skills, but also in responsibility and personality, such as intellect, sensitivity and patience.
3. The attitude on private psychological practice questionnaire was worked out making reference to the correlate researches. Exploratory factor analysis of attitude questionnaire resulted in construction of four sub factors:stigma tolerance, recognition of need for counseling help, confidence in private psychology clinics and interpersonal openness. It was tested that attitude questionnaire had good internal reliability, content validity and structure validity, and could be an effective tool to evaluate public attitude on private psychological practice.1162 questionnaires were collected in 8 districts in Chongqing, and the data showed that the publich attitude on private psychological practice is conservative. But people with different ages, education backgrounds, occupations and living areas have different attitude, such as the youth have more positive attitude than the oldness, people with higher education background have more positive attitude than the lower.
4. The experiment on reading the mental health and counseling introduction materials was carried out to probe into the changing condition about attitude. The result showed that the testee who read the materials had more positive attitude than the testee who didn't read the materials, so publicizing the knowleged of mental health and counseling is good for changing public attitude on private psychological practice. Meanwhile, people has the increasing demand in mental heath, especially in cognitive themselves, dealing with pressure, parentage and interpersonal relationship, so the clinics should pay attention to these aspects to enhance the quality of counseling service.
5. In the field survey about 10 private psychology clinics in Chongqing, the counseling process was studied by PQS. Most counselors in these clinics used the special counseling skills in consultation, but they have the professional morality that they don't keep the unjustice relationship with clients, who can take the sustaining position to admit the clients, acquire the trust of the clients and figure out the fine relationship between them. But the counselors used to giving the homiletic words in counseling and straightforward advices. They didn't arrange the long-term counseling plan with client, so there were mostly one time session which lasted out 1.5 to 2 hours per session.
6. Through the survey on the clients'change before and after the counseling, the client's satifaction with the counseling and the alliance, we evaluated the counseling outcome of the 9 private psychology clinics in Chongqing. The counseling service offered in 8 clinics gained the good effect by improving the clients'status and having a high score in clients'satisfaction and working alliance, but there was one clinic deteriorate the client's status. In the research on the influence factors with counseling outcome, we find that the service offered by women counselors had better outcome than men counselors, the same gender betweent the counselors and clients had better outcome than different gender, using the special counseling skills had better outcome than not using, the longer counseling time had worse outcome than the shorter.
7. The counseling evaluating index system was formed by summarizing the researches and analyzing the experts'interview contents. After experts grading these index by AHP mode, the counseling evaluating model was built up, which has good practicability under validated and can be used to evaluating the outcome and giving advices to improve the counseling outcome.
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