近年来，我国人民在面临巨大的社会冲击之下，心理问题频发。随着精神障碍患者人数的激增，其主要照顾者身上背负的担子也越来越重，照顾者同时承受着身心压力和社交压力，照顾者不但是承担照料精神障碍患者任务的人员，更是帮助患者更好康复的重要主体。所以，做好照顾者压力缓解的工作，对精神障碍患者的病情稳定和康复起到至关重要的作用。


本研究以广东省S医院的30名负担压力较重的精神障碍患者照顾者为研究对象，开展社会工作干预研究，采用准实验设计，设定筛选标准，筛选出符合标准的照顾者，将其划分为对照组和干预组，运用量表进行前测和后测，评估小组干预的效果。根据文献梳理和需求调查，本文将承担压力情况定义为结果变量，将自我效能感、自我评价以及心理灵活性定义为中介变量。选择了ZBI护理者负担量表对照顾者所承受的压力进行测量，结合接受与行动量表中文第2版、认知融合分问卷量表对照顾者的心理灵活性进行测量，运用一般自我效能感、核心自我评价两个量表对照顾者的自我效能感以及自我评价进行测量。


在活动开展期间，对照组的研究对象没有接受治疗，干预组则参与了5次接纳承诺疗法理论指导下的小组干预活动。运用社会工作干预研究框架设计小组干预活动，找到对于照料精神障碍者压力的来源以及风险因素，构建逻辑模型；同时运用接纳承诺疗法的六大核心治疗过程以及小组工作等设计编制干预手册。社会工作者对于干预组成员通过行为训练、隐喻以及反思分享等多种方式引导其正视痛苦情绪和觉察自我，加强自我觉察意识，从而帮助研究对象正视痛苦，而不是选择回避，以此来达到照顾者压力缓解的目的。


根据定量测量数据以及干预结果，对照组和干预组的前测数值并无明显差异，干预组后测数值明显好于前测结果，对照组的后测量表评分与前测量表评分相比基本相同。所以本文认为这一研究根据接纳承诺疗法为理论设计的小组干预方案能够帮助精神障碍的主要家庭照顾者增强自我效能感，提高自我评价和心理灵活性，从而帮助这类群体缓解所承受的压力。


本次研究为社会工作介入帮助照料精神障碍患者人员缓解压力提供了可行的方案，不过本研究所提出的方法还存在许多不足，需要进一步的完善。

In recent years, Chinese people have frequent psychological problems under the huge social impact. With the surge in the number of patients with mental disorders, the burden on their main caregivers is becoming heavier and heavier, mainly manifested in social pressure, psychological pressure and physiological pressure. Caregivers are not only the bearers of the care task of patients with mental disorders, but also the helpers to promote the rehabilitation of patients. Therefore, doing a good job in relieving the pressure of caregivers plays a vital role in the stability and rehabilitation of patients with mental disorders. This study took 30 caregivers of mental disorders with heavy burden in s Hospital of Guangdong Province as the research object to carry out social work intervention research.


In this study, a quasi experimental design was used. Caregivers of patients with mental disorders who met the standards were included in the intervention group and the control group, and the scale was used for pre-test and post-test. Based on literature review and demand survey, this paper takes stress as the outcome variable and psychological flexibility, self-evaluation and self-efficacy as the intermediary variable. The stress status was measured by ZBI caregiver burden scale, the psychological flexibility was measured by acceptance and action scale (Chinese version 2) and cognitive fusion sub questionnaire, and the self-evaluation and self-efficacy were measured by Core Self-evaluation Scale and general self-efficacy scale respectively.


During the activity, the subjects in the control group did not receive any treatment, and the subjects in the intervention group participated in 5 group activities. Based on the framework of social work intervention research, the intervention design was carried out to clarify the risk factors caused by caregiver stress of patients with mental disorders, and the logical model of intervention group was designed; On this basis, based on the theory of acceptance commitment therapy, the intervention manual was developed according to the six core treatment processes and group work. In the intervention group, social workers promote caregivers of patients with mental disorders to face up to themselves, observe themselves and enhance their awareness of self-consciousness through metaphor, behavior training and sharing reflection, so as to promote the face of pain rather than avoiding, so as to achieve the purpose of relieving caregivers' stress.


The intervention results and quantitative data show that the scores of the pre measurement table in the intervention group and the control group are basically the same. There are significant changes in the scores of the pre measurement table in the intervention group, but there is no significant change in the control group. Therefore, group intervention based on acceptance commitment therapy can effectively improve the psychological flexibility, self-evaluation and self-efficacy of caregivers of patients with mental disorders, so as to alleviate their stress.


This study provides a new method for social work to intervene in the stress relief of caregivers of patients with mental disorders. Of course, this method still has many shortcomings and needs to be further improved.