延长哀伤障碍指个体亲近的人去世后，产生的持续而广泛的哀伤反应，其特征包括渴望再见到逝者或持续关注逝者，同时伴有强烈的如悲伤、愤怒与内疚等痛苦情绪，这种哀伤反应持续六个月以上，影响个体的社会功能。本研究主要关注存在延长哀伤症状但未达到临床诊断标准的严重程度的情况。

本研究的主要目的是探讨箱庭疗法缓解成年人延长哀伤症状的可行性与效果。本研究使用箱庭疗法对一位成年女性来访者进行心理咨询，选用《延长哀伤问卷》、《哀伤认知问卷》来评估来访者咨询前后的症状变化，通过量表数据结果、箱庭作品变化历程、来访者自传记忆（autobiographical memory）、情绪与自我评价变化、人物像变化、哀伤任务的完成情况等来呈现咨询过程与效果。本研究共进行了15次个体心理咨询，其中包括12次个体箱庭咨询与3次个体谈话咨询。量表数据显示，来访者《延长哀伤问卷》得分由咨询前的27分下降至17分，其分离痛苦、认知、情绪和行为症状都有明显改善；《哀伤认知问卷》得分由92分下降至59分，其中对自我、生活、未来与他人的负性信念或认知有不同程度的改善，哀伤反应的恰当性与珍惜性及自责的情绪有较大程度的改善。来访者的箱庭作品共分为三个阶段：哀伤表达阶段、处理痛苦与整合丧失阶段、适应阶段。来访者的哀伤任务已经完成。从量表和来访者的主观感受表达可以看到其延长哀伤症状有所缓解。

通过分析总结箱庭疗法在本研究中的作用机制，主要有以下几个方面：（1）箱庭的制作激发来访者的哀伤反应；（2）母子一体性促进来访者的情感表达，降低其防御；（3）箱庭制作促进来访者的情绪调节与自我评价，有利于哀伤任务的完成；（4）箱庭疗法有利于问题的呈现与解决，帮助来访者完成未完成事件；（5）玩具的心象表达有利于来访者整合逝者的冲突形象，促使来访者与逝者建立持续性联结；（6）箱庭疗法有利于来访者重新构建生命的价值。

本研究所得结论为：箱庭疗法可以应用于成年人延长哀伤症状的干预，有效缓解了成年人延长哀伤症状，并且具有独特的作用机制。

Prolonged grief disorder is defined as a persistent and widespread grief reaction following the death of someone close to the individual, characterized by a desire to see the deceased again or continuous preoccupation with the deceased, accompanied by strong distressing emotions such as sadness and anger, which lasts for more than six months and affects the individual's social function. This study focused on the presence of prolonged grief symptoms that did not meet clinical diagnostic criteria for severity.

The main purpose of this study was to investigate the feasibility, process and effective of sandplay therapy to relieve prolonged grief symptoms in adults. In this study, we used sandplay therapy to counsel an adult female client, and chose the Prolonged Grief-13 and the Grief Cognition Questionnaire to assess the symptomatic changes before and after counseling, and to present the counseling process and effects through the results of the scale data, the course of change of the sandplay works, the client's autobiographical memory, the changes in emotions and self-assessment, and the grief tasks.A total of 15 counseling sessions were conducted in this study, .which include 12 sandplay productions and 3 conversational counseling sessions. Scale data showed that client’s scores on the Prolonged Grief-13 decreased from 27 to 17, in which separation pain and cognitive, emotional and behavioral symptoms improved significantly, and scores on the Grief Cognition Questionnaire decreased from 92 to 59, in which the negative beliefs or perceptions about the self, life, the future, and others were improved to varying degrees, and the grief response of the appropriateness and value of grief response and self-blame improved greatly. The client’s sandplay work was divided into three stages: the grief expression stage, the processing of pain and integration of loss stage, and the adaptation stage. The client’s grief tasks were completed. From the scale and the expression of the client's subjective feelings, it can be seen that the symptoms of prolonged grief have been relieved.

By analyzing and summarizing the mechanism of sandplay therapy in this study, there are mainly the following aspects: （1） the making of the sandplay stimulates the client's grief response; （2） mother-child integration promotes the client's emotional expression and reduces her defenses; （3） the making of sandplay promotes the client's emotional regulation and self-assessment, which is conducive to the completion of the grief tasks; （4） the sandplay therapy facilitates problem presentations and solutions, and helps the client to complete the unfinished events; （5） the mental representation of toys facilitates client to integrate the conflicting images of the deceased, prompting client to establish a continuous connection with the deceased; （6） sandplay therapy facilitates client to reconstruct the value of life.

The conclusion of this study is that sandplay therapy can be applied to the intervention of prolonged grief symptoms in adults, effectively relieves prolonged grief symptoms in adults, and has its unique mechanism of action.