治療式遊憩/休閒治療(Therapeutic Recreation/Recreation Therapy）

憂鬱症
1. 病因：與癌症、愛滋病一同被預為二十一世紀危害人類健康的三大疾病之一，造成憂鬱症的三主要因素為生理、心理（如情感上不穩定、思考上有扭曲）及家庭人際因素（如家庭功能失調、孤獨沒朋友）。（Beck,1979）
2. 發病率、人口：約有1/5的人一生中有憂鬱的危險（Gilbert,2000），推估過去百年來罹病率增加十倍（黃宗正,2001）。

1. 陳惠美（民92）。遊憩治療對憂鬱症治療效果之研究。國科會專題研究計畫
NSC-91-2415-H-130-005，民國91年8月1日至民國92年7月31日。
 內容：本研究以在台安醫院精神科接受治療的13位憂鬱症病患為研究對象，實驗共分為狀況評估、活動設計、治療前憂鬱程度測量、遊憩態度五部分。所接受的治療方式分別為戶外遊憩治療1位，運動療程1位，藝文活動2位，園藝活動1位，室內娛樂1位。受測者在實驗結束後對遊憩治療的效益認知、情感反應、行為傾向之前測分數均高於後測，顯示遊憩治療確實會增進參加者之正面休閒態度。
 心得：
 此實驗經過評估後才決定給與不同患者不同的遊憩活動，若在這樣的情形下是否會影響「研究結果第二點」的客觀性。或許同樣因為失戀而患憂鬱症的患者不見得皆認同運動治療是最有效的。
 研究中僅提道執行治療四個月後，每月對患者的憂鬱成舵皆有顯著改善，但憂鬱症的復原期與觀察期應該屬長時間的研究觀察，若能提供後續的追蹤研究結果，我個人認為會更具研究價值與意義。
 研究中並無提及抽抽樣方法，且不同的遊憩治療受測者人數僅一至兩人，好像有點不客觀。

2. 陳莉榛（民91）。藝術治療在憂鬱症的介入效果。東南學報，24民91.01頁
203-212。
 內容：本研究主要以藝術治療為介入技術探討它對憂鬱症的助益情形，採個案研究方式，進行一週一小時共十次的藝術治療活動，期透過此介入了解個案的內心世界並尋找出改善之道。研究結果發現個案在曾氏心理健康量表的焦慮分數有輕微下降，顯示藝術治療的介入之影響是肯定的。
 心得：雖然研究過程不夠客觀，但我依然覺得這是一個非常有意思的研究，因為將研究中收集的文獻與結果相對應，可以得到許多類似的映證。有趣的是，本研究重點不在用藝術「治療」憂鬱症，而是利用藝術的「介入」了解個案的內心想法近一步找出導致憂鬱的根源問題。雖然與老師要求我們收集的研究不盡相同，但卻有異曲同工之妙的道理，因為遊憩治療的方式廣泛，其中也包含了藝術應用這一種方式。能透過藝術的方式呈現口語表達不出的痛苦及傳達非言語所能權釋的感受確實是相當溫和且有效的方式之一。
3.Dieser,Rodney B（2002）.Effects of attribution retraining during therapeutic
recreation on attributions and explanatory styles of adolescents with
depression. .Therapeutic Recreation Journal, First Quarter 2002,
from http://www.findarticles.com/p/articles /mi_qa3903/is_200201/ai_n
9030983
 Summary：The purpose of this study was to examine the effects of verbal persuasion based attribution retraining during therapeutic recreation on attributions and explanatory styles of 18 adolescents（aged14-17） with a clinical diagnosis of major depression. The Attribution Style Questionnaire was used to measure explanatory styles, and Attributions（locus of causality, stability, personal control, and external control.）were measured by the Causal Dimension Scale II.Twice a week the researcher met individually with participants and asked them the following open question：”Tell me one successful and unsuccessful therapeutic recreation activity you were involved in ……….”The control group received minimal verbal responses such as “good,” ”un-huh,”and”I see.” The experimental group received optimistic message, for example,”It sounds like the activity was successful because you put much effort into it. ”
Results from this study suggest that the attribution retraining verbal persuasion in a therapeutic recreation setting can have a significant effect on stability and personal control attributions.
 My opinions：當一個人在憂鬱的時候，回應者若是能給予正面的回應將激發被諮商者的正向思想。以我自己為例，應該盡量避免對人或事太過主觀的批判或限於自己心中的判斷，因為最後終陷於痛苦的感覺而脫離不出而不自覺對別人產生敵意。

4.Richard Williams（2002）.Humor as a therapeutic recreation intervention.
Parks & Recreation, May 2002,from http://www.findarticles.com/p/articles/mi_m1145/is_5_37/ai_86505433
 Summary：According to amount and quality of humor research, humor is not only a sunny disposition but also provides real psychological and physical benefits. For instance, exposure to humorous material appears to bolster the immune system, helping people with cognitive or learning impairments, and reduce pain during uncomfortable treatments or recovery from surgery. Additionally, humor can effectively treat both depression and anxiety which are among the most common characteristics of people seeking therapeutic recreation services. As long as we could avoid negative form of humor including sarcastic, racial and sexist which are contrary to therapeutic goals, humors would be a justifiable, inexpensive and appropriate tool for use in therapeutic recreation services.
 My opinions：By our nature, humor seems plainly incompatible with depression, but according to this article, it does alleviate symptoms of depression. So, therapeutic recreation specialist should integrate humor into their programs in order to achieve therapeutic outcomes.
5. Gillispie, Charles（2003）. A Case Report Illustrating the Use of Creative Writing As A Therapeutic Recreation Intervention in a Dualdiagnosis Residential Treatment Center. Therapeutic Recreation Journal, Fourth Quarter 2003.
 Summary：The purpose of this article is to present a case report on the use of creative writing as part of a comprehensive therapeutic recreation program in a dual-diagnosis, residential treatment center. Patty（匿名）, 24 year-old, single white female from California, was admitted into treatment with a preliminary diagnosis of Alcohol Abuse, Recurrent Major Depression and Impulse Control Disorder Because her primary therapist noted Patty's strong interest in literature and writing, and she also expressed some confidence in her ability to write poetry. They decided to choose creative writing as a therapeutic recreation intervention. The goal was to help Patty learn to use her interest in writing as an alternative to ineffective, self-destructive coping behaviors.
 My opinions：從個案的進步可發現，造成憂鬱的成因可追溯至幼童時期的不好經驗，而這些不好的經驗或結果導致某些有憂鬱傾向的人在面對群眾或同儕時產生羞愧及不安感，以文字抒發心中的情感與藝術介入療法很相像，且個案從creative writing 中找到自信，進而願意和他人分享心得且產生互動，從團體中找到支持的力量。這又是另一個治療式遊憩的成功案例。

我也想打資料,可是ㄉ是.........我都找不到,阿........我瘋掉ㄌ