정신건강상담의 통합 절충적 4단계 실천모형 모색: 상담 관점과 상담 목표를 중심으로

고수현 한국복지상담교육학회 2019 복지상담교육연구 Vol.8 No.1

The process of rapid industrialization and modernization of Korean society brought about psychological and social problems such as the economic polarization of the gap between the rich and the poor, as well as mental disorders of the members of society. Divorce rates, suicide rates, drug addiction rates and indiscriminate crimes against the general public are evidence of this. In addition, various shamanic services and Pseudoreligion are active on-off-line, which is a basis for demonstrating the unstable mental state of modern Koreans. However, national mental health counseling services and academic researches in response to the mental health problems of ordinary people except mental illnesses are extremely rare. Especially in the academic field, there is a tendency to focus on specific psychotherapy theories, and there is little theoretical and practical research accumulation of integrated eclectic mental health counseling practice. From this point of view, the purpose of this study is to explore a four-step integrated eclectic mental health counseling practice model focusing on counseling perspective and counseling goals. The results of the study are as follows. First, at the stage of exploration level, it was found useful to set up a counseling perspective and a counseling goal with the background of humanism and existentialism. Second, at the stage of insight level, it was found useful to set the counseling perspective and counseling goal in the background of psychodynamics and cognitive theory. Third, in the stage of action level, counseling perspective and counseling goal setting are set as useful in the background of cognitive-behavioral theory and behaviorist theory. Fourth, in the stage of maintenance level, it is suggested that it is useful to set up the counseling perspective and counseling goal in social environment system theory and strength-centered background theory. These findings are different from the existing integrated eclectic three-stage model. Therefore, this study suggests that there is a theoretical and practical implication that it can contribute to the improvement of mental health counseling practice theory and practice skill for mental health problems as well as mentally ill patients as a new model of integrated eclectic mental health counseling. 한국사회의 급격한 산업화와 현대화 과정은 국민들 간의 빈부격차 등의 경제적 양극화문제는 물론 사회구성원들의 정신장애 등 심리사회적인 문제를 가져왔다. 이혼율, 자살률, 약물중독률, 일반 대중을 겨냥한 무차별적인 범죄 등이 폭증하였다는 점은 그 증거가 된다. 아울러 온-오프라인을 통한 각종 무속 서비스나 유사종교가 성행하고 있는 것도 현대 한국인들의 불안한 정신건강상태를 방증하는 근거가 된다. 하지만 정신질환자를 제외한 일반인들의 정신건강문제에 대응한 국가차원의 정신건강상담 서비스나 학술적 연구는 극히 미진하다. 특히 학술분야에서는 특정한 심리치료이론에만 치우쳐진 연구경향이 농후하며, 통합 절충적인 정신건강상담 실천에 대한 이론적이고 실제적인 연구축적물은 거의 없는 실정이다. 이러한 관점에서 본 연구의 목적은 4단계로 구성된 통합 절충적인 정신건강상담 실천모형을 상담 관점과 상담 목표를 중심으로 모색하는 것에 있다. 연구결과는 다음에서와 같다. 첫 번째, 탐색수준단계에서는 인본주의와 실존주의 이론에 배경을 둔 상담 관점과 상담 목표를 설정하는 것이 유용한 것으로 보았다. 두 번째, 통찰수준단계에서는 정신역동주의와 인지주의 이론에 배경을 둔 상담 관점과 상담 목표를 설정하는 것이 유용한 것으로 설정되었다. 세 번째, 실행수준단계에서는 인지-행동적 이론과 행동주의 이론을 배경으로 한 상담 관점과 상담 목표 설정이 유용한 것으로 설정되었다. 네 번째, 유지수준단계에서는 사회환경체계이론과 강점중심주의적 배경이론에서 상담 관점과 상담 목표를 설정하는 것이 유용한 것으로 제시하였다. 이러한 연구결과들은 기존의 통합 절충적 3단계 모형과는 차별성을 가진다. 따라서 본 연구는 통합 절충적인 정신건강상담의 새로운 모형으로서의 정신질환자는 물론 일반인들의 정신건강문제를 대상으로 한 정신건강상담 실천이론과 실천기술의 향상에도 기여할 수 있다는 이론적․실천적 함의가 있다고 본다.

상상연습이 일어서기와 앉기 과제를 수행하는 동안 편마비 환자의 대퇴사두근 활성도에 미치는 영향

김진섭,김선엽,오덕원,Kim, Jin-Seop,Kim, Suhn-Yeop,Oh, Duck-Won 대한물리치료과학회 2008 대한물리치료과학회지 Vol.15 No.3

Background : We aimed to determine the effect of a mental practice on the electromyography (EMG) activity of the quadriceps femoris muscle of the affected side in a hemiplegic patient during sit-to-stand and stand-to-sit tasks. Methods : We recruited a male patient who had suffered from right hemiplegia. A single-subject experimental A-B-A design was used. The reliability of visual analysis, which was primarily employed in this study design, was supported by using the "2- standard-deviation band" method. The target motions consisted of two activities: sit-to-stand and stand-to-sit. The EMG measurements of the quadriceps femoris muscles of the affected and unaffected sides were made in 8 sessions in the baseline (A), mental-practice (B), and follow-up (A) phases. During the mental practice phase, the 10-min mental practice was performed, and the mental practice was withdrawn in the follow-up phase in order to identify the carry-over effects of the treatment. Data was calculated as the percentage of the ratio of the quadriceps EMG activity values of the affected side on unaffected side. Result : The percentage EMG-activity ratio showed a greater increase in the mental-practice phase than in the baseline, and it was maintained during the follow-up phase. Most of the data points in the mental-practice and follow-up phases were positioned above the "2-standard-deviation band." Conclusion : These findings suggest that mental practice can be used to improve the physical function of hemiplegic patients.

정신연습과 신체연습 배분이 운동학습의 전이에 미치는 영향

김윤래 한국스포츠학회 2017 한국스포츠학회지 Vol.15 No.4

본 연구는 남자대학생을 대상으로 정신연습과 신체연습 배분이 골프 퍼팅 기능학습에 어떠한 영향을 미치는 가를 규명함과 동시에 정신연습을 운동학습 현장에 응용적으로 적용하는데 필요한 자료를 제공하는데 목적이 있다. 연구결과 사전검사에서는 집단 간에 유의한 차가 없었다. 사후검사에서는 정신연습 25%와 신체연습 75%집단, 신체연습 100%집단 간에는 차가 없으면서 가장 유의하게 우수하였고, 정신연습 50%와 신체연습 50%집단 또한 정신연습 75%와 신체연습 25%집단, 정신연습 100%집단 보다 의미 있게 우수하였다. 운동학습 효과를 구체적으로 알아보고자 실시한 전이검사에서는 신체연습 100%집단이 가장 우수하였다. 그 다음은 정신연습 50%와 신체연습 50%집단, 정신연습 25%와 신체연습 75%집단 간에는 의미 있는 차가 없으면서 정신연습 100%집단, 정신연습 75%와 신체연습 25%집단 보다 운동학습 효과가 유의하게 우수하였으며, 정신연습 100%집단, 정신연습 75%와 신체연습 25%집단 간에는 의미 있는 차가 없었다. This study was figuring out for the effect on golf putting task according to combination of mental and physical practice The subjects are right handed male students attending G university without experience of golf putting. Based on the stratified sampling, they were divided into 5 groups within 7 membered in each one. First one is 100% mental practiced, second is 75% mental and 25% physical practiced, and third is 50% mental and 50% physical practiced. Then, the forth one is 25% mental and 75% physical practiced, and final one is 100% physical practiced. After the post test done, 25% mental and 75% physical practiced and 100% physical practiced are equally most superior. And then 50% mental and 50 physical practiced is significantly superior then the other two groups; 75% mental and 25% physical group and 100% metal practiced one. For the transfer test, 100% physical practiced groups is the most superior. And then 50% mental and 50% physical practiced group and 25% mental and 75% physical group are equally superior then the other two groups. The rest two groups; 100 mental practiced and 75% mental and 25% physical one are equally inferior then the upper groups.

상상연습을 병행한 발목 운동이 자세정렬에 미치는 영향

양회송 ( Yang Heosong ),강효정 ( Kang Hyojeong ),허재원 ( Heo Jaewon ) 대한통합의학회 2018 대한통합의학회지 Vol.6 No.2

Purpose : Various studies effects of mental practice. However, there is a lack of research on the effects of practice on postural alignment. Therefore this study to the effect of ankle exercise combined with mental practice on postural alignment of legs. Method : Subjects were randomly assigned to mental practice group (experimental group n=15) and general exercise group (control group n=15). Postural alignment was the hip, knee, and ankle joints. When viewed from the side, an arbitrary point in front of the malleolus makes a straight line with the plumb line. Exercise was performed a week for weeks. Exercise programs included muscle strengthening, relaxation, and proprioception exercise. The experimental group mental practice. Result : Both groups showed significant differences in postural alignment ankle joint, knee joint, and hip joint. In particular, the experimental group showed a larger change than the control group. However, significant difference in postural alignment change only the knee joint (p<0.05), and there was no significant difference the hip joint (experimental group=0.77±0.81, control group=0.87±1.13) and ankle joint (experimental group=0.52±0.63, control group=0.48±0.41). Conclusion : This study suggests that mental practice is effective as an exercise method postural alignment. Mental practice also expected to be musculoskeletal disorders. Therefore, additional studies should be conducted to verify the effect of mental practice on the alignment of various parts.

간호대학생의 정신간호 실습전후 정신질환에 대한 태도

이미련(Mi-Ryon Lee),곽윤경(Youn-Kyong Kwag) 인문사회과학기술융합학회 2018 예술인문사회융합멀티미디어논문지 Vol.8 No.8

The purpose of this study was to evaluate attitudes toward mental illness in nursing students after clinical practice of psychiatric nursing. A quasi-experimental study with one group pretest-posttest design. Data were collected by questionnaires from 77 nursing students from T university, Busan. The clinical practice of psychiatric nursing was given 5 days, total 45 hours in psychiatric hospital located in Busan. The data were analyzed using descriptive statistics and t-tests. There were not significant differences in self-acceptance, communication competence. In the areas of the attitudes toward mental illness, scores of authoritarianism (t=16.81, p<.001), Benevolence (t=14.18, p<.001), social restrictiveness (t=9.67, p<.001) and community mental health concept(t=12.08, p<.001) were significantly different before and after the clinical practice of psychiatric nursing. In the all areas of the attitudes toward mental illness, scores were decreased after the clinical practice. In the benevolence and community mental health concept, the positive attitudes toward mental illness were increased. The results indicate that psychiatric clinical practice provides positive effects on benevolence and community mental health concept in the areas of the attitudes toward mental illness. 본 연구의 목적은 간호대학생의 정신간호 실습전후 자기수용, 의사소통능력 및 정신질환에 대한 태도가 어느 정도 향상되었는지를 알아보는 것이다. 연구설계는 단일군 전후설계의 유사실험연구로 연구기간은 2017년 10월 16일부터 12월 5일까지였으며 대상자는 B시에 소재하는 T대학교 간호학과 3학년 학생 77명이었다. 정신간호실습은 정신과병원 5일, 총 45시간 실습으로 이루어졌다. 수집된 자료는 SPSS프로그램을 이용하여 기술통계와 t-test로 분석하였으며 결과는 다음과 같다. 정신간호 실습전 후 간호대학생의 자기수용과 의사소통능력은 유의한 차이를 보이지 않았다. 반면 정신질환에 대한 태도의 하위영역에서는 모두 유의한 차이를 보였다. 이러한 결과는 본 연구에서의 정신간호실습은 간호대학생의 자기수용과 의사소통능력을 향상시키기에는 부족하며, 정신질환에 대한 태도의 하위영역 중 자비심과 지역정신보건개념에서 정신질환에 대한 긍정적인 태도를 가져옴을 알 수 있었다. 정신간호실습을 통해 간호대학생의 자기수용, 의사소통능력 및 정신질환에 대한 태도를 향상시키기 위해서는 보다 구체적인 이론 교육과 실제 실습에서의 적용이 강화되어야 할 것이다.

상상연습과 동작관찰 동안 전방머리자세의 대뇌겉질 활성도 비교

양회송,강효정 대한통합의학회 2019 대한통합의학회지 Vol.7 No.3

Purpose : The purpose of this study was to investigate the difference in motor cortical excitability during mental practice and action observation in subjects with forward head posture. Methods : This study was performed in two groups, a forward head posture group (n=17) and a normal posture group (n=17). Electroencephalography (EEG) was conducted to investigate cerebral cortex activity, and six electrodes were attached to Fp1, Fp2, C1, C2, C3, and C4 to measure the relative alpha power, relative beta power, relative gamma power, and mu rhythms. The subjects were requested to perform the four different conditions, which were eye opening, eye closing, mental practice, and action observation for 300 seconds. Results : The results showed that the relative alpha waves showed a significant difference between the normal and forward head posture groups in the C1, C2, C3, and C4 regions with the eyes open (p<.05). The relative beta waves also showed a significant difference between the two groups in the Fp1 and Fp2 regions during action observation (p<.05). The relative gamma waves were significantly different between the normal and forward head posture groups in the Fp1 and Fp2 regions during action observation (p<.05) in C1, C2, and C3 with eyes closed (p<.05) and in C1, C2, C3, and C4 with eyes open (p<.05). Conclusion : The results of this study showed that EEG change in the forward head posture group was different from that in the normal control group in action observation rather than in mental practice. Therefore, we are expected to provide a neurophysiological basis for applying action observation to motor skill learning during exercise for correcting forward head posture. Purpose : The purpose of this study was to investigate the difference of motor cortical excitability during mental practice and motion observation in subjects with forward head posture. Method : This study was performed on the two groups; forward head posture(n=17) and normal(n=17). Electrocephalography was conducted for the investigation of the cerebral cortex activity and the sixth electrodes were attached to Fp1, Fp2, C1, C2, C3, C4 in order to measure the relative alpha power, the relative beta power, the relative gamma power, and mu rhythms. The subjects were requested to perform the four different conditions, which were eye-opening, eye-closing, mental practice, and action observation for 300 seconds. Result : The results showed that of the relative alpha waves were a significant difference between the normal group and the forward head posture group in the C1, C2, C3, and C4 regions in the eye open(p<0.05). The relative beta waves were a significant difference between the normal group and the forward head posture group in the Fp1 and Fp2 regions during motion observation(p<0.05). Relative gamma waves were significantly different between the normal group and the forward head posture group in the Fp1 and Fp2 regions during motion observation(p<0.05), in C1, C2, and C3 in the eye closed(p<0.05), C1, C2, C3, and C4 regions in the eye open(p<0.05). Conclusion : The results of this study showed that EEG change in the forward head posture group was different from that in the normal control group when motion observation than mental practice. Therefore, we are expected to provide neurophysiological basis for applying motion observation to motor skills learning when exercising for correcting forward head posture.

The Effects of Mental Practice about Leg Exercise Muscle Activities of the Rectus Femoris

Kim, Tae-Hoon,Kim, Kyung-Hun,Kim, Ju-O Korean Physical Therapy Science 2017 대한물리치료과학회지 Vol.24 No.3

Purpose: This study aimed to investigate the effects of mental practice about leg exercise muscle activities of the rectus femoris. Method: 20 subjects were participated in this study. The values before the experiment were measured and those after the mental performance from the first experiment to the fifth experiment were measured. Electromyography (EMG) was used to measure the muscle activity of rectus femoris. Result: The muscle activity of the both rectus femoris after mental practice increased steadily and showed significant differences. Conclusion: In the present study, it was found that the muscle activity of both legs was increased during the mental practice. It can be seen that there was a difference before and after mental practice, and muscle activity of rectus femoris was increased.

근거기반 정신건강 프로그램 발굴을 위한 지역사회 프로그램 현황 조사

안성희,손지훈,서화연,이해우,조성주,김성남,민혜영,소민아,유세영,조성준,박지은 대한신경정신의학회 2024 신경정신의학 Vol.63 No.2

Objectives This study analyzed the current state of community mental health programs in Korea to develop evidence-based criteria for these programs. Methods Seventy community mental health facilities nationwide were surveyed about the scope of their operated mental health programs. Details, including program structure, staff expertise, standardization, and quality management, of the 511 programs submitted by the facilities as their representative programs were also analyzed to evaluate their efforts for evidence-based practice. Results The average number of programs operated by community mental health welfare centers was 15.9. The most common programs were those related to serious mental illness (SMI), followed by child/adolescent mental health programs, early psychosis programs, and non-SMI adult mental health programs. In the case of community addiction management centers, there were 7.2 different addiction-related programs per center. Among the psychiatric rehabilitation facilities for SMI, the average number of programs for SMI was 13.1, with some programs for early psychosis. Of the 511 programs submitted as representative programs in their facilities, only 12.3% were judged to be good evidence-based programs. Conclusion More efforts by mental health professionals and governments are needed to implement evidence-based programs in Korea.

정신건강사회복지사의 임파워먼트 실천에 관한 질적 연구: 이론과 실천의 딜레마를 중심으로

정현주,김요완 한국보건복지학회 2019 보건과 복지 Vol.21 No.4

The purpose of this study is to clarify what research-participants experience and which difficulties they experience while applying empowerment theory to practice as a mental health social worker. For this purpose, four mental health social workers were interviewed in-depth with generic qualitative research method, and 6 topics, 26 sub-topics, and 49 semantic units were derived. Results of this study are related to 6 topics. First, participants of this study experienced ‘Empowerment Practice’, ‘Awareness’, ‘Growth’ during applying empowerment theory to practice. Second, they have experienced ‘Dilemma’, ‘Individual Difficulty’, and ‘Experience & Coping with Burnout’ as the difficulties in the process of empowerment practice. Based on the results of this study, it suggested an institutional attempt to minimize the gap between the theory of empowerment and the practice process, to prevent the burnout of mental health social workers, and to enhance the sense of accomplishment through strengthening capacity. 본 연구는 연구참여자들이 정신건강사회복지사로서 임파워먼트 이론을 실천에 적용하면서 무엇을 경험하고, 이론과 실천 간에서 어떠한 어려움을 경험하는지를 확인하고자 한 연구이다. 이를 위해 일반적 질적 연구 방법으로 정신건강사회복지사 4명을 심층면접 하여 6개의 주제, 26개의 하위주제, 49개의 의미단위를 도출하였다. 연구결과는 6개의 주제와 관련이 있는데, 첫째, 참여자들은 임파워먼트 이론을 실천하면서, ‘임파워먼트 실천을 위한 원칙’, ‘임파워먼트 실천과정에서의 자각’, ‘임파워먼트 실천과정을 통한 성장’ 등을 경험하였다. 둘째, 참여자들은 임파워먼트 이론을 실천하는 과정에서 ‘임파워먼트 실천과정에서의 딜레마’, ‘임파워먼트 실천과정에서 경험하는 개인적 어려움’, ‘소진의 경험과 대처’ 와 같은 어려움을 경험하였다. 본 연구의 결과를 토대로, 임파워먼트의 이론과 실천과정에서의 괴리를 최소화하려는 노력, 정신건강사회복지사의 소진예방을 위한 시도와 역량 강화를 통한 성취감 제고를 위한 제도적인 시도를 제언하였다.

간호대학생의 임상실습스트레스, 자아개념 및 정신건강

박광옥,김영선 한국자료분석학회 2013 Journal of the Korean Data Analysis Society Vol.15 No.4

본 연구는 간호대학생의 자아개념, 임상실습스트레스 정도와 정신건강 수준을 알아보고 이들의 관계를 파악하고자 시도된 서술적 상관관계 연구이다. 연구대상은 P시와 G시에 소속되어 있는 한 학기동안 임상실습을 경험한 간호대학생 3학년, 169명이며 구조화된 설문지를 이용하였다. 자료수집은 2012년 9월 17일에서 10월 12일까지이며, 자료의 분석은 SPSS 21.0 program을 이용하여 분석하였다. 본 연구결과 간호대학생의 임상실습스트레스 정도는 높았고, 자아개념 정도와 정신건강 수준은 낮았다. 임상실습스트레스 하위요인 중 실습교육환경, 바람직하지 못한 역할모델, 실습업무 부담 등이 높은 스트레스 요인으로 나타났다. 또한 실습교육환경, 바람직하지 못한 역할모델, 대인관계갈등, 환자와의 관계에 대한 스트레스가 높을수록 정신건강이 낮은 것으로 나타났다. 또한 자아개념의 하위 영역 중에서는 개인적 자아, 사회적 자아, 신체적 자아와 임상실습스트레스 하위 영역 중에서는 대인관계갈등이 간호대학생의 정신건강을 유의하게 설명하는 변인으로 32.9%의 설명력을 나타내었다. 본 연구 결과 간호대학생의 정신건강을 향상시킬 수 있는 긍정적 자아개념 형성과 임상실습스트레스 해소를 위한 중재방안마련의 기초자료를 제공하고자 한다. The purpose of study was to explore the mental health level of nursing students according to their clinical stress and self-concept, and to identify influencing factors of mental health. A cross-sectional study design was used in this study. The participants for this study were 169 nursing students in B and C city. The collected data were analyzed using t-test, ANOVA, Pearson's correlation and multiple regression with SPSS/win21.0 program. The mean scores of stress of clinical practice, self-concept and mental health were 2.86, 3.05 and 1.56. The mental health of the nursing students was significantly different according to the sex and the location of high school. The mental health showed the significant positive relationship with stress of clinical practice and negative relationship with self-concept. Personal self-concept, social self-concept, physical self-concept and interpersonal relationship conflict accounted for 32.9% of variance in mental health of nursing students. Finding of this study allow a comprehensive understanding of nursing students. It is necessary to develop nursing intervention program for improving mental health of nursing students by considering self-concept and relieving stress of clinical practice.