治疗性评估的效果和机制及其在中国文化情境中的发展
Effects and mechanism of therapeutic assessment and its development in Chinese culture
摘要
治疗性评估是一种评估和干预的半结构化模型, 强调当事人和评估者的协作, 在实现评估目标的同时, 能够促进当事人的改变。其主要效果体现为减轻症状, 增加自尊和希望感以及促进参与治疗的动机等。和传统咨询技术相比, 它还具有时间短、效率高以及能与其他治疗技术联合使用等优势。其主要局限为缺乏足够多的大样本研究, 在跨国别、跨文化情境中的适用性及其作用机制还需进一步探讨。治疗性评估在中国文化情境下的发展, 则受到测验工具的汉化修订、专业人员心理评估胜任力不足等挑战。
Abstract
As an emerging evidence-based counseling and treatment technique, Therapeutic Assessment (TA) is a semi-structured model of assessment and intervention that uses standardized psychological tests to understand the client's psychological functioning and personality traits, and achieves assessment goals while being able to promote change in the client. The main effects are a reduction in symptoms, increases in self-esteem and a sense of hope, and motivation to participate in treatment.Based on a review of the literature, we summarized the strengths and limitations of TA. The advantages of TA are fourfold: First, TA can obtain better therapeutic results in a relatively short period of time. Second, it is suitable for most groups, such as individual clients of all ages and for marital and family therapy settings. Third, it is open-ended, and can be used both in conjunction with other counseling techniques and as a diagnostic tool or antecedent counseling, and can also be a driving force in breaking the counseling impasse. Fourth, it emphasizes evidence-based and the joint application of high-quality psychometric tools, giving specific evidence-based practice approaches across treatment schools and diagnoses. However, there are situations in which TA is not applicable. It is not recommended for clients who come to counseling involuntarily or who are in acute crisis or trauma. In addition, TA is usually not considered when the goals of the assessment can be achieved through traditional, non-collaborative testing. By combing through the existing literature, we believe that the mechanism of action for the effectiveness of TA can be interpreted in two ways: collaborative assessment and understanding of the client. Collaborative is a new application of psychometric tests in TA, which is the central mechanism for the effectiveness of TA. In TA, psychometric tests are not only a source of data, but the instruments themselves become "empathy magnifiers" and have therapeutic effects. We believe that collaborative sessions and feedback are more useful than traditional, non-collaborative assessments, allowing for a more coherent and fluid client narrative and an enhanced counseling alliance. In addition, TA's unique understanding of the client is an important prerequisite for its effectiveness, as it uses multiple concepts to understand the client's inner world in depth: unique narratives and stories, self-validation and curiosity, attachment patterns, and epistemic trust. Due to the recent development of the theoretical basis of TA and the short time of its application, there are still some shortcomings in the current research and many issues to be explored in depth. Examples of issues include small sample size, lack of population diversity, and fewer randomized controlled studies. In the existing studies, there are more studies on adults and fewer studies on children and adolescents. Future research should expand sample sizes and increase sample diversity with more studies on partners, couples, and children and adolescents. Second, research on the applicability of TA in cross-national and cross-cultural contexts is still not abundant. Most of the current empirical research related to TA has been conducted in the United States, and there have been some attempts in other cultures, but there is a lack of research in Asian cultural contexts. In addition, even within the same country, there are still some limitations to the cultural diversity of the subjects of TA research. Factors such as social class, religion, and sexual orientation do not appear much. Therefore, there is a need for research on therapeutic evaluation in more countries and in more diverse cultural contexts. Third, the mechanisms by which TA works are not clear. When does the person undergo the greatest or most significant change? What makes the change? How does each session of TA, as well as written feedback, affect the client? Is it the philosophy or the standardized process of TA that makes a difference compared to other counseling schools? Specific empirical research is needed to answer these questions. On this basis, the similarities and differences between the efficacy of TA and other counseling modalities also need to be more fully investigated.There are also some challenges and opportunities to use TA in a Chinese cultural context. The first is the Chineseization of the test instruments and their normative models, the Chineseization of copyright, and the Chineseization of research. The second is the training of Chinese evaluators to master TA. The third is the need for Chinese TA practice to be combined with empirical research, and the timely correction of parts of TA that are incompatible with Chinese culture based on research findings, along with the addition and improvement of parts of Chinese culture that are unique and useful.关键词
治疗性评估/心理测验/协作/效果/作用机制/中国文化Key words
therapeutic assessment/psychological test/collaboration/effect/mechanism/Chinese culture引用本文复制引用
沈芝羽,严文华,王铭,岳冰洁,孙启武.治疗性评估的效果和机制及其在中国文化情境中的发展[EB/OL].(2023-10-09)[2026-04-01].https://chinaxiv.org/abs/202310.00218.学科分类
医药卫生理论/神经病学、精神病学/文化理论
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