Huband N, Tantam D
The Woodlands Unit, Leicestershire & Rutland Healthcare NHS Trust, UK.
Br J Med Psychol. 2000 Dec;73(4):495-504. doi: 10.1348/000711200160688.
Self-wounding is a behaviour which remains poorly understood and which can evoke strong reactions from clinical staff. Such reaction may adversely influence treatment outcome and there have been calls for changes in the attitudes of professional staff towards this client group through improved training and awareness. There has, however, been little systematic study of how clinicians perceive those who self-injure or of how their attitudes are modified by training and other factors.
This study aims to identify and explore factors governing professional attitude towards self-injury through postal survey of a large group of mental health staff. The survey assessed attitudes towards a representative case described in a vignette.
Five key factors were identified, with perception of control being the most dominant. Attitudes of clinical staff who had obtained additional qualification in counselling or psychotherapy differed significantly from those who had not. In contrast, no effect was found for specific training in handling self-injury. Attitude to the self-wounding woman was unaffected by gender, but was affected by age and work setting. The innate potential for the sample to self-polarize was examined statistically; a line of cleavage emerged between less tolerant staff who perceived her to have more control and to be more difficult to understand and those with opposing views.
Qualification in counselling or psychotherapy may modify attitude by reducing defensive attribution, allowing staff improved containment of their anxiety; alternatively, pre-existing attitudes may encourage certain staff to obtain such qualification.
自我伤害行为仍未得到充分理解,且会引发临床工作人员的强烈反应。这种反应可能会对治疗结果产生不利影响,因此有人呼吁通过加强培训和提高认识来改变专业人员对这一客户群体的态度。然而,对于临床医生如何看待那些自我伤害的人,以及他们的态度如何因培训和其他因素而改变,几乎没有系统的研究。
本研究旨在通过对一大群心理健康工作人员进行邮政调查,确定并探讨影响专业人员对自我伤害态度的因素。该调查评估了对一个案例 vignette 中描述的代表性案例的态度。
确定了五个关键因素,其中对控制的认知最为突出。获得咨询或心理治疗额外资格的临床工作人员的态度与未获得资格的人员有显著差异。相比之下,在处理自我伤害方面的特定培训未发现有效果。对自我伤害女性的态度不受性别的影响,但受年龄和工作环境的影响。从统计学上检验了样本自我两极分化的内在潜力;在那些认为她更有控制力且更难理解的宽容度较低的工作人员与持相反观点的工作人员之间出现了一条分界线。
咨询或心理治疗方面的资格可能通过减少防御性归因来改变态度,使工作人员能够更好地控制自己的焦虑;或者,预先存在的态度可能会鼓励某些工作人员获得此类资格。