緩和ケアにおける心理療法 : 面接導入時の配慮と面接構造の工夫

Abstract

本研究では，緩和ケア領域での心理療法の先行研究，当院の緩和ケアの一貫として筆者が行った心理療法の検討をもとに，緩和ケア領域での心理療法導入に関する特殊性を抽出し，緩和ケア領域で心理療法を導入する際に必要な配慮や面接構造の工夫について考察した．その結果，心理療法導入の慎重な見極め，面接構造の柔軟性が求められる一方で，臨床心理士が自らの行っていることの意味を常に内省し，何故そうした特殊な面接構造がその患者には必要なのかという理由を常に意識しておくことの重要性が示唆された．

In this study, the particularities in introducing psychotherapy into palliative care were extracted based on previous studies on psychotherapy in palliative care and the case studies of psychotherapies this author practiced as a part of palliative care in Kyoto City Hospital．The considerations necessary when a clinical psychologist starts psychotherapy in palliative care，and also ingenuit'es of the psyohotherapy structure were discussed．This study showed that the clinical psychologist was expected to assess carefully the psychological state of the patient and to make the psychotherapy structure more flexible．This study also suggested that it was important for the clinical psychologist to reflect the meaning of what he/she does in psychotherapy and to consider the reason why the particular psychotherapy structure is needed in psychotherapy with the patient at all times.