일동장유가와 해사일기의 비교 연구

李成厚 金烏工科大學校 1996 論文集 Vol.17 No.-

문제행동 청소년을 위한 대인관계 집단치료 효과

이후경,안현주,김선재,윤성철,봉수연 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.5

Objectives : Fast change and confusion of the value system in society affect the identity formation of adolescents. So Adlescents' behavioral problems seem to be increasing yearly. It is known that the interpersonal group therapy is the most effective treatment modality among many group programs for adolescents with behavioral problems. Objectives of this study are as follows ; first, evaluate therapeutic effects of the interpersonal group therapy for adolescents with behavioral problems second, examine the therapeutic factors ; third, analyze the group process : fourth, orgamize the group therapy for adolescents with behavioral problems as an applicable treatment modality. The types of group therapy performed in this study are small, closed, homogeneous, outpatient, timelimited, and adolescent group. Methods : This study was carried out at one of the adolescents mental health services in Uiwang Mental Health Center, from April to June and from September to November in 2000. The subjects were 2nd grade students in K middle school with behavioral proplems. The experimental groups were composed of 4 groups including 2 male groups and 2 female groups (male 11, female 17), and the control groups matched the same conditions as the experimental groups (male 10, female 19). The group therapy was performed weekly in CA (club activity) time, and it took 60-70 minutes at one time. They met total 10 sessions including preparatory meeting and termination meeting. Before and after this program, self-rating scales (behavioral problems, aggression, and impulsivity) were applied for subjects, and the teacher rating scales (behavioral problems, aggression and impulsivity) were performed by teachers in charge. After each session, Yalom's 13 therapeutic factors scale was perfbrmed. At the last meeting, total assessment questionnaire was compleled. Results : The mean scores of all self-rating scales (behavioral problem, aggression, and impulsivity) were lower in the experimental groups (both male and female group) than the control groups, but not significant statistically except the behavioral problem scale of female students. The mean scores of all teacher rating scales (behavioral problem, aggression, and impulsivity) were lower in the experimental groups (both male and female group) in comparison with the control groups, all significant statistically. As faras the therapeutic factors are concerned ; first, the mean scores of all therapeutic factors in female students were higher than in male students and the mean scores of all therapeutic factors in the later half sessions were higher than the former half sessions ; second, catharsis and existential factor were high in all students and sessions ; third, identification with therapist factor was high in all students and sessions : fourth, during the later half sessions, interpersonal input was relatively high in male students and socializing technique was relatively high in female students. Its forthe total assessment questionnaires ; 100% of male students and 88.2% of female students reported that they were helped by this group therapy ; 100% of male students and 82.4% of female students reported that they would participate willingly if future opportunity of the same group therapy is given for them. Conclusion : Adolescents with behavioral problems who participated in this study showed the decrease of behavioral problems and the change of aggressive and impulsive attitudes in comparison with the control groups although they had some differences between male and female students. The group therapy with adolescents would be practiced more broadly and extensively though there are several accompanied problems including the difficulty of structuring, the deficit of motivation, and financial problem.

정신보건전문가를 위한 훈련집단

이후경,김선재,윤성철 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.5

연구목적 : 집단정신치료 전문가 수련과정에는 교습적인 과정, 구성원(환자)으로서의 경험, 리더(치료자)로서의 경험이 포함된다. 이에 따라 크게 ① 이론과 실제에 대한 강의, 사례발표회와 초독회 및 세미나, ② 관찰, ③ 훈련집단(워크샵 포함). ④ 지도감독으로 나누는데, 이 중에서 훈련집단과 지도감독이 가장 효과적인 교육방법으로 인정되고 있다. 저자들은 ① 정신과 영역에서 집단정신치료의 활성화, ② 집단정신치료에서 정신과의사들의 주도적인 역할수행, ③ 자격 있는 집단정신치료자의 훈련 및 양성을 목적으로 전공의를 포함하는 정신보건전문가들을 위한 훈련집단 모텔을 개발하여 실시하였다. 구체적인 연구목표는 다음과 같다. 첫째, 정신보건전문가들을 대상으로 훈련집단을 시행한 후 나타나는 방어기제, 자아기능의 변화를 살펴본다. 둘째, 참여자들이 도움 받은 것으로 보고한 치료요인을 알아본다. 셋째, 훈련집단 진행에서 나타나는 내용과 과정을 포함한 전체적인 특징을 분석한다. 넷째, 이를 통해 훈련집단을 정신보건전문가들의 개인적인 성장과 전문가로서의 자질을 키우는데 효과적인 교육방법으로 정착시키고, 나아가 집단정신치료 전문가 수련과정 및 자격요건을 확립하기 위한 기초자료로 삼는다. 방 법 : 본 연구는 1997년부터 2000년까지 5번에 걸쳐 실시되었다. 이 기간 중 참여자는 정신과전공의를 포함하여 정신보건분야에 종사하는 전문가들로서 총 37명이었고, 이 가운데 도중 탈락한 9명을 제외한 29명(남자 2명, 여자 27명)이 최종 대상군으로 선정되었다. 본 연구에서는 우선 대상자들이 훈련집단을 참여한 후 성격변화를 평가하기 위한 사전-사후검사 실험설계를 수행하였다. 연구도구로서 객관적 질문지 형태의 이화방어기제검사와 이고그램검사를 사용하였다. 그리고 매번 훈련집단이 끝난 직후 13가지 치료요인척도와 간단한 주관적 설문지를 작성하도록 하였고, 종결 시에 자기보고식 총평가 설문지를 실시하였다. 결 과 : 이화방어기제는 사전-사후검사 비교에서 성숙방어는 유의미한 증가를 보였고, 미성숙방어는 유의미한 감소를 보였으며, 자기애적방어와 신경증방어에서는 유의미한 차이가 없었다. 이고그램은 사전-사후검사 비교에서 양육적부모(NP), 어른(A), 자유로운아이(FC) 자아에서 유의미한 증가를 보였다. 상위를 차지한 치료요인은 순서대로 대인관계학습, 실존적 인자, 리더와의 동일시, 정화, 사회화 기술의 발달이었다. 총평가 설문에서 참여자의 100%에서 도움 받은 것으로 보고하였고, 48.3%에서 생활사의 변화를 보고하였으며, 89.7%에서 훈련집단을 다른 사람에게 적극적으로 권유하겠다고 하였고, 58.6%에서 재참여 의사를 밝혔다. 결 론 : 본 연구를 통해 참여자들은 방어기제와 자아기능의 변화를 보였다. 훈련집단 경험은 참여자들에게 자신을 돌아보고 마음의 갈등을 파악하며 상대방을 이해하는 경험을 제공한다. 또한 정신보건전문가에게 필수적인 집단현상에 대한 안목과 치료요인에 대한 이해를 증진시키고, 리더십 및 기법을 터득하게 하여 집단정신치료에 대한 자신감을 갖게 하며, 정신치료 전반에 대한 이해를 높일 수 있다. 그러므로 향후 정신보건분야에서 정신과전공의를 비롯한 정신보건전문가의 정신치료 및 집단정신치료의 교육 도구로서 훈련집단을 확대 적용할 필요가 있다. Objectives : Training group with mental health professionals includes didactic process, experience as a member(patient) and a leader(therapist). It is divided into four parts as like 1) lecture, case conference, book reading and seminar about theory and practice, 2) observation, 3) training group(including workshop), and 4) supervision. Among them, the training group and the supervision have been accepted as the most effective methods. Authors have developed and practiced the training group model for mental health professionals including psychiatric residents which aim for the activation of group psychotherapy in mental health area, psychiatrists' initiative in group psychotherapy area, and the training and nurturing of qualified mental health professionals. The objectives of this study are as follows ; firstly, we examine the change of defense mechanism and ego function after performing group psychotherapy for mental health professionals ; secondly, we analyze the therapeutic factors reported that participants were helped ; thirdly, we analyze main features which include group content and process manifested in training group ; lastly, we have objectives that the training group is settled down as an effective educational method to foster the personal growth and qualification as a specialist, and also that this study provides a basic research data to set up the training program and the requirements for group psychotherapy. Mothods : This study was performed 5 times from 1997 to 2000. The participants were composed of 37 mental health professionals including psychiatric residents. Among them, 29 participants(male 2, female 27) were chosen as the final subjects 9 participants dropped out in the process of this study. At first, we take an application of pre-treatment/post-treatment experimental design to evaluate the personality change after performing the training group. EDMT(Ewha Defence Mechanism Test) and EC(Egogram Checklist), the objective questionnaires, were used as the evaluation scale. And 13-therapeutic factor scale and simple subjective questionnaires were performed just after each session and the self-report total assessment questionnaires were performed at the end of this study. Results : To compare mean scores between pre-treatment and post-treatment in EDMT, the mature defense was increased significantly, the immature defense was decreased significantly, and the narcissistic defense and neurotic defense were not changed significantly. To compare mean scores between pre-treatment and post-treatment in EC, Nurturing parent(NP), Adult(A) and free Child(FC) were increased significantly. Therapeutic factors ranked highly were in-terpersonal learning, existential factor, Identification with therapist, catharsis, and socializing technique in order. The total assessment questionnaires reported that the 100% of participants were helped, the 48.3% of participants were changed in their lives, the 89.7% of participants would propose training group to others positively, and the 58.6% of participants had minds to join this kind of program if given again for them. Conclusions : This result showed that the defense mechanism and ego function of parti-cipants were changed. The training group experience makes participants reflect themselves, examine their conflicts and understand others. That also gives them chances of improving insight about group phenomena and understanding about therapeutic factors essential to the mental health professionals, having confidence on the group therapy by learning leadership and techniques, and improving understanding about the psychotherapy on the whole. Therefore, it is needed in the future that the training group would be widely adapted as an educational tool of psychotherapy and group psychotherapy for the mental health professionals as well as psychiatric residents in mental health area.

열희석법에 의한 심박출량 측정 : 제1보 : 맥박 및 환기의 영향에 관한 생체외실험 Part 1: Experimental Rearch in Effect of Pulse and Ventilation in Vitro System

이후전,조형상 중앙대부설한국의과학연구소 1987 한국의과학 Vol.19 No.3

외래환자를 위한 시간제한 집단정신치료

이후경,차정화,윤성철,김정일 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3

연구목적 : 최근 외래집단정신치료는 전통적인 장기치료에서 단기치료나 시간제한치료로 전환되고 있는 추세다. 단기는 보통 10∼40회 걸쳐 실시되는 것에 비해 시간제한(time-limited)은 시작부터 종결시기 및 횟수를 미리 정해놓고 실시한다. 이는 치료자와 환자간에 가능성 있는 구체적인 치료목표를 설정하고 적극적인 공동작업을 통하여 정해진 기간에 효과적인 치료결과를 가져올 수 있기 때문에 효율적인 치료방법으로 점차 부상되는 있는 양식이다. 본 논문의 연구목표는 다음과 같다 ① 정신과의원 외래환자를 대상으로 시간제한 집단정신치료를 시행하여 치료효과와 치료요인을 조사한다. ② 집단정신치료 시행과정에 나타나는 특징을 살펴본다. ③ 본 집단정신치료의 적절성과 타당성을 검증하여, 현재 한국 의료상황에 맞는 저비용, 고효율적인 모델로서 정착시켜 외래치료를 보다 효과적으로 할 수 있는 기반을 마련하다. 방 법 : 본 연구는 2000년 4월부터 동년 7월까지 매주 1회, 한번에 70∼80분씩, 총 12회 걸쳐 실시되었다. 실험군은 정신과의원 외래환자중 기능수준이 높은 정신병환자를 대상으로 하였다. 대조군은 비슷한 나이, 성별, 진단군, 유병기간을 일대일 짝을 지어 선정하였다. 각각8명이 참여하였다. 평가도구는 BDI, STAI,MMPI, 이화방어기제를 사전, 사후에 실시하였고, 매회 마다 13가지 치료요인 척도를 실시하였으며, 총평가 설문지를 마지막에 실시하였다. 결 과 : BDI는 실험군에서 대조군에 비하여 유의미하게 감소하였다. STAI-S는 실험군, 대조군 모두에서 차이가 없었고, STAI-T는 실험군에서 대조군에 비하여 유의미하게 감소하였다. MMPI는 실험군에서 대조군에 비하여 통계적으로 유의미하게 감소하였지만, 사전-사후 변화량에 대한 집단간 검사에서 유의미하지 않았다. 이는 두 군에 동일하게 노출된 약물치료와 지지치료의 영향으로 추측된다. 이화방어기제는 실험군에서만 미성숙 방어기제와 신경증적 방어기제의 유의미한 감소를 보였다. 치료요인은 초기, 중기, 말기로 나누어 비교했을 때, 전 회기에 걸쳐 실존적 인자가 1위를 차지하였고, 카타르시스, 치료자동일시, 보편성, 집단응집력이 내내 상위를 차지하였다. 초기, 중기에 중하위를 차지하였던 대인관계학습은 말기에 2위를 기록하였다. 총평가 설문에서 참여자의 100%에서 도움 받은 것으로 보고하였고, 75%에서 생활의 변화를 보고하였으며, 75%에서 재참여 의사를 밝혔다. 결 론 : 외래환자들에게 단순히 약물치료와 지지치료만을 시행하는 것에 덧붙여 시간제한 집단정신치료를 시행할 때 증상호전뿐만 아니라 성격변화의 효과도 가져오는 것으로 나타났다. 또한 참여자들의 집단정신치료에 대한 만족도도 매우 높은 것으로 나타났다. 집단정신치료는 정신치료에 뿌리를 두면서 이에 필적하는 치료효과가 있는 것으로 공인된 치료양식이다. 의약분업 및 의료비 감축 등의 급변하는 현 의료환경에서 집단정신치료와 시간제한치료가 정신치료와 장기치료만큼 효과 있으면서 저비용, 고효율적인 양식으로서 정착될 수 있을 것이다. Objectives : Recently, the outpatient group psychotherapy has been changed from traditional long-term therapy to short-term or time-limited therapy. The termination time and session numbers are given from start line in the time-limited therapy while 10 to 40 sessions are needed in the short-term therapy. And therapist and patients come to an agreement of the accomplishable therapeutic goal and work together actively. The time-limited group psychotherapy is being accepted newly as an efficient therapeutic modality because effective therapeutic outcomes within given time have been reported. The objectives of this study are as follows ; firstly, we examine the therapeutic outcomes and the therapeutic factors after performing the time-limited group psychotherapy for outpatients in the psychiatric clinic ; secondly, we analyze the characteristics showed in the process of study ; lastly, we verify the feasibility and the validity of this group psychotherapy and then establish the basis of the effective outpatient therapy that would be settled down as an applicable treatment modality economically and efficiently in the current medical environment of Korea. Methods : This study was performed weekly in total 12 sessions from July 1999, April 2000 to and each session took 70-80 minutes. The experimental group were composed of the highly-functioning psychotic patients among outpatients in the psychiatric clinic. The control group were composed of the similar patients through one-to-one matching of age, sex, diagnosis, and duration of illness. The participants were 8 patients each. BDI(Beck Depression Inventory), STAI(Spielbergs State-Trait Anxiety Inventory), MMPI(Minnesota Multiphasic Personality Inventory), and EDMT(Ewha Defence Mechanism Test)as the evaluation scales were performed before and after treatment. And 13-therapeutic factors scale was performed just after each session and the self-report total assessment questionnaire was performed only in experimental group at the end of this study. Results : The mean score of BDI was decreased significantly in experimental group in comparison with control group. The mean score of STAI-S was not changed significantly in both group, and the mean score of STAI-T was decreased in experimental group in comparison with control group. The mean score of MMPI was decreased significantly in experimental group in comparison with control group, but the comparison of difference scores(post-treatment score-pre-treatment score) between the experimental and control group was not decreased significantly. This result may come from psychopharmacotherapy and individual supportive psychotherapy given equally to both group. The mean scores of immature defence and neurotic defence in EDMT were decreased significantly in experimental group compared with control group. Comparing the therapeutic factors to divide into the first, middle, and the last stage, existential factor was ranked first, and catharsis, identification with therapist, universality, and group cohesiveness were ranked high in all stages. Interpersonal learning was ranked first in the last stage altinough being ranked low in the first and middle stage. The total assessment questionnaires about group psychotherapy were reported that 100% of participants were helped, 75% of participants were changed in their lives, and 75% of participants had minds to join this kind of program again if given for them. Conclusions : This result shows that not only symptom relief but also personality change was achieved when the time-limited group psychotherapy was practiced in addition to simple psychophamarcotherapy and individual supportive psychotherapy for outpatients. The degree of satisfaction for group psychotherapy of participants were evaluated highly. Group psychotherapy has been accepted in public as therapeutic modality that must be as equally effective as psychotherapy although group psychotherapy derives from individual psychotherapy. In out current medical environment that has been changed suddenly by the separation of medical practice and pharmaceutical dispensing and the decrease of medical fee, group psychotherapy or time-limited therapy would be settled down as low-expense and high-efficiency therapeutic modalities that were as equally effective as individual psychotherapy or long-term therapy

백서 간세포 핵소체 인산단백질 B23의 진화론적인 특성 규명

이혜정,윤상인,박주인,정진숙,김영대,김정만,곽종영,김인후 동아대학교의과대학 1997 동아의대학술지 Vol.9 No.1

입원환자를 대상으로 한 대집단 싸이코드라마의 치료요인 연구

이후경,김선재,윤성철,이규항,홍향희,함웅 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.2

연구목적 : 본 연구는 개인정신치료와 집단정신치료의 훈련을 받은 정신과 의사라면 누구든지 쉽게 이용할 수 있는 우리나라 입원환자에게 적합한 대집단 싸이코드라마의 모델을 개발하고, 이를 입원환자에게 적용한 후 치료요인을 조사하여, 입원환자 치료에 도움이 되고자 하는 목적으로 본 연구를 시행하였다. 방 법 : 본 연구는 1998년 3월부터 1998년 9월까지 계요병원 입원환자 싸이코드라마에 참가한 모든 환자들과, 보조자아로 참석한 모든 치료팀을 대상으로 하였다. 대상자는 환자가 346명(남자 152명, 여자 194명)이었고, 치료팀은 총 60명이었다. 환자에게는 13가지 치료요인 척도, 싸이코드라마에 대한 일반적인 태도 척도, 도움이 되었던 점에 대해 기술하도록 한 설문지를 사용하였으며, 치료팀에게는 13가지 치료요인과 환자에게 도움이 되었던 점에 대해 기술하도록 한 설문지를 사용하였다. 환자집단은 관객, 보조자아의 역할을 한 환자, 공유(sharing)시간에 참여한 환자, 주인공으로 나누어 치료요인을 비교하였다. 결 과 : 먼저, 환자의 관점에서 본 치료요인은 다음과 같다. 1) 싸이코드라마에서의 역할에 관계없이 거의 대부분의 환자집단에서 실존적 인지와 일차가족집단의 교정적 감정경험을 매우 중시하였다. 2) 주인공, 보조자아의 역할을 한 환자, 공유시간에 참여한 환자와 같이 어떤 형태로든 싸이코드라마에 직접적으로 참여한 환자들은 사회화 기술의 발달을 중시하였으며, 보다 직접적인 형태인 행동으로 참가한 주인공이나 보조자아의 경우 카타르시스를 중시하였다. 3) 주인공을 제외한 모든 환자들은 희망의 고취를 중시하였다. 4) 관객의 경우 치료자와 환자에 대한 동일시와 보편성을 중시하였다. 환자와의 동일시는 공유에 참가한 환자의 경우 특히 중시하였고, 보편성은 보조자아로 참가한 환자의 경우 또한 중시하였다. 다음으로 치료팀이 평가한 치료요인을 환자들이 평가한 치료요인과 비교하면, 치료팀은 환자들보다 집단응집력을 더 중시하였으며, 반면 환자들이 중시한 사회화 기술의 발달과 치료자나 환자에 대한 동일시는 매우 낮게 평가하였다. 결 론 : 환자들의 역할에 따라 세분화하여 조사한 치료요인을 통해 입원환자 대집단 싸이코드라마의 특성과 환자의 역할에 따른 치료요인의 특성을 파악할 수 있었다. 본 모델은 입원환자 치료에 쉽게 적용될 수 있었으며, 전체적으로 많은 환자들에게 도움이 되었다. Objectives : This study was performed to make a model of large group psychodrama suitable for Korean inpatients and easy for psychiatrists trained in the individual psychotherapy and the group psychotherapy to use, to investigate the therapeutic factors after applying this model to inpatients, and then to contribute to the treatment of inpatients. Methods : The study subjects were all the inpatients and the therapists(the auxiliary ego's) who participated in psychodrama from March 1998 to September 1998. The subjects were composed of 346 inpatients (152 males, 194 female) and 60 therapists. To the inpatients 13-Therapeutic Factors Scale, Scale of General Attitude to Psychodrama, and the Questionnaire describing helpful things in psychodrama were administerd. To the therapists 13-Therapeutic Factors Scale and the Questionnaire describing helpful things in psychodrama were administered. The inpatient group were divided into 4 groups(the audience, the auxiliary ego's, the participants in sharing, the protagonists). The therapeutic factors among 4 groups were compared. Results : First, the therapeutic factors described by the inpatients group were as follows : 1) Most inpatients made great account of ‘existential factor’ and ‘the corrective recapitulation of the primary family group’ regardless of their roles in psychodrama. 2) The inpatients who participated in psychodrama directly as the protagonists, the auxiliary ego's, or the participants in sharing made much account of ‘development of socializing techniques’. The inpatients who participated in psychodrama more directly as the protagonists or the auxiliary ego's made much account of ‘catharsis’. 3) All the inpatients except the protagonists made much account of ‘instillation of hope’. 4) The audience made much account of 'identification' and 'universality'. Especially,'identification with members' was much accounted of by the participants in sharing. ‘Universality’ also was much accounted of by the auxiliary ego's. Next, when we compared the therapeutic factors in the inpatient group with those in the therapist group, the therapist group made much account of ‘group cohesiveness’ which the inpatient group made little account of. And the therapist group made no account of ‘development of socializing techniques’which the inpatient group made much account of. Conclusion : By dividing the inpatient group according to their roles, we found the characteristics of the inpatient large group psychodrama and of the therapeutic factors according to the roles of the inpatients. This model could be applied to the treatment for the inpatients easily and was helpful to many inpatients on the whole.

입원환자 집단정신치료 모델: 주치의 중심의 통합적인 모델

이후경,윤성철 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.2

Group psychotherapy is an important therapy for inpatient treatment. A lot of studies proved the effect of inpatient group psychotherapy. Therefore it is necessary to use group psychotherapy actively for inpatient treatment There are many models of inpatient group psychotherapy made in foreign countries. But it is difficult to apply those models themselves directly in Korean inpatient unit, and so it is an urgent issue to make an inpatient group psychotherapy model that fits Korean inpatient unit setting. According to this need we made our paper in order to introduce an effective model of group psychotherapy for Korean inpatients in detail, and then to provide opportunity for effective inpatient treatment. The characteristics of this inpatient group psychotherapy model are as follows. 1) This model of group psychotherapy give a field in which a therapist encounter inpatients as a human being. 2) This model is easy to perform generally, and helpful to a comprehensive therapeutic approach for inpatients. 3) In this model heterogeneous inpatients participate in a same one group, therefore this model is able to apply various inpatients. 4) This model makes the basis of continuous outpatient treatment or day hospital treatment, and the basis of outpatient group psychotherapy or individual psychotherapy. 5) Group functions as a social microcosm, and so reveals patient's interpersonal relationship and gives the opportunity to treat it. Therefore group helps patients to be adapted well to inpatient unit and society. 6) In this model, social workers, nurses, or students in practice play a role of healthy egos or observers, and so they can activate group psychotherapy. And this model can be used as a practical and useful tool of the education for psychiatric residents, medical students, social workers, and other students. Psychiatrists seem to be less interested in group psychotherapy than other mental heath practitioners. But it may be appropriate for well trained psychiatrists to use group psychotherapy with individual psychotherapy.

3DFT-CISS를 이용한 감각신경성 난청 환자의 MBI

김성원,여상원,김상후,김종수,조재흥,이동희,이승균 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.7

만성정신병환자의 재활치료를 위한 주간보호 모델

이규항,김한오,이후경,윤성철,성상경,함웅,윤배중 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 본 연구는 전문병원 위탁형 정신보건센터에서 실시한 주간보호의 전체적인 체계, 운영, 프로그램에 관한 모델을 소개하고, 이 모델을 주간보호에서 시행한 후 그 결과와 시행과정에서 나타난 특징을 분석하여, 우리 실정에 맞는 주간보호 모델을 발전시켜 만성정신병환자의 생활유지와 재활을 촉진시키기 위한 목적으로 실시되었다. 방 법 : 본 주간보호 모델(이하 본 모델이라 함)을 1997년 3월부터 1998년 2월까지 의왕시 정신보건센터에서 총 23명의 환자를 대상으로 실시하였다. PANSS, Quality of Life, 삶의 만족 척도를 주간보호 전과 주간보호 실시 3개월 이후에 조사하였다. 프로그램 유익성 척도, 13가지 치료요인 척도를 주간보호 1개월째와 주간보호 실시 3개월 이후에 조사하였다. 결 과 : 1) 본 모델은 만성정신병환자의 증상을 감소시키고 삶의 질을 향상시켜, 환자의 생활유지 및 재활에 도움을 주었다. 2) 본 모델은 다양한 형태의 집단치료들을 사용하여 만성정신병환자에게 유익을 주었으며, 특히 예술치료와 활동치료가 환자의 신체적, 심리적, 사회적 기능회복을 위해 중요한 역할을 하였다. 3) 본 모델에 작용하는 치료요인의 특징을 보면 주간보호 초기와 후기에 모두 중시된 치료요인은 치료자와의 동일시, 치료자의 조언, 일차가족집단의 교정적 감정경험이었다. 주간보호 초기에 중시된 치료요인은 집단응집력, 이타심이었으며, 주간보호 후기에는 희망의 고취가 중시되었다. 4) 본 모델은 여러 분야의 치료자들과 다양한 치료방법들을 전체적으로 통합하여 사용하는데 유용하였다. 결 론 : 본 모델은 만성정신병환자의 생활유지와 재활을 위해 우리 나라에서 효과적이면서 효율적으로 적용될 수 있을 것으로 생각된다. Objectives : The purpose of this study was to present general system, operation, and program of a day care model managed by a psychiatrist, to evaluate the results of performing this model, and thus to develop a day care model applied to Korean situation appropriately for promoting maintenance and rehabilitation of chronic psychotic patients. Methods : We performed this day care model(hereinafter called as this model) from March 1997 to February 1998. The subjects were composed of 23 psychotic patients. PANSS, Quality of Life Scale, Life Satisfaction Self-Rating Scale were used before beginning this model and after three months of performing this model. Program Helpfulness Scale, 13 Therapeutic Factors Scale were used at one months of day care and after three months of day care. Results : 1) This model helped maintenance and rehabilitation of chronic psychotic patients through reducing their symptoms and increasing quality of life. 2) This model used the various group therapy, especially creative art therapy and activity therapy, played an important role for recovering physical, psychological, and social functions. 3) Important therapeutic factors at early and late period of this model were identification with therapists, guidance of therapists, and the corrective recapitulation of the primary family group. Important therapeutic factors at early period were group cohesiveness and altruism, and at late period instillation of hope. 4) This model was useful for integrating the multidisciplinary therapeutic team and the various therapeutic methods. Conclusion : This model would be applied to day care in this country effectively and efficiently for maintenance and rehabilitation of chronic psychotic patients.