통합예술치료가 노년기 비장애 자매의 스트레스에 미치는 효과에 관한 단일사례 연구

Abstract

ABSTRACT

A Single Case Study on the Effects

of Integrative Arts Therapy Program for Stress

of One Senior-sister with Her Disabled Sibling

Ma, Ji In

Dept. of Arts Therapy, Education and Counseling

The Graduate School of Counseling Psychology,

Hanyang University

Directed by Prof. Kim, Mi Nam

Non- disabled siblings with a disabled sibling experience a lot of stress in various aspects throughout their whole lives. However, they are always being alienated from secondary environments and incidentally from home to society. In the family, their parents are always focused on their disabled son or daughter, so most non-disabled siblings may feel alienated from the family. They also might feel lonely because they feel they do not belong anywhere. Likewise, they feel excluded and think society is hostile and unfriendly.

These various negative emotions can be a source of stress affecting the lives of non-disabled siblings and cause various secondary problems. Therefore, many experts and psychologists say it is important to deal with the stress and negative emotions of non-disabled siblings.

In understanding the stress of non-disabled siblings, we must consider their entire lives. The stress of the non-disabled siblings is permanent because a disability is completely hard to healed. Therefore, the stress they experience continues after adulthood and is an important issue to be dealt with consistently.

Recently, the awareness of the welfare of the disabled has expanded, and experts have begun to pay attention to the psychological difficulties of their non-disabled siblings and their lives here. But, still in my country, the nation's welfare services for its non-disabled siblings are extremely insufficient, with most having difficulty resolving psychological conflicts at an appropriate time.

There are also studies of stress and psychological conflicts among non-disabled siblings among previous studies, but most of them are for childhood and adolescence. However, as the average life expectancy of people increases due to the development of science and medical technology, the life expectancy of people with disabilities is also increasing. This means an increase in the population of non-disabled siblings who take care of their disabled siblings after adulthood. It also means a lifetime approach to dealing with the issue of psychological conflict for the non-disabled should be taken at various stages of development. Because they being deeply involved in each others' lives from a long term perspective.

Therefore, this study recognized the importance of stress on non-disabled siblings who have supported disabled siblings since adulthood and shaped the study. Among other things, special focus was on non-disabled siblings who entered their senescence.

The purpose of this research explores the influences of mental stress on adults who grew up with disabled siblings in the family. Appropriate integrative arts therapy programs were developed in order to relieve stress as well as reinforce the participant’s stress coping ability, ultimately allowing a path to spend an optimistic and healthy life. This particular research program, involving a 63 year old woman (referred to as “C”) who has been living with her younger sister suffering severe intellectual disability, consisted of 20 episodes of 90-minute Integrative Art Therapy sessions, including pre-program and post-program examination (3 times a week, from 2019.10.3 to 2019.11.21).

In order to deduct the results of the experiment, both quantitative and qualitative researches were executed. The quantitative research included assessments testing the participant’s stress coping ability before and after the program by examining her results of the PITR (Draw-a-Person-in-the-Rain) test. The qualitative research included voice-recording and filming of the experiment procedure as well as documenting all observations, further examining and analyzing the participant’s linguistic and behavioral characteristics. The participant’s level of stress and stress coping ability were comprehensively investigated based on both quantitative and qualitative outcomes.

The following is the summary of this particular research.

Firstly, Integrative Arts Therapy programs effective to stress caused to the non-disabled adult with a disabled sibling consisted of a precisely tailored program aiming to positively help the participant with their various sources of stress and the specific type of stress as well as their method of dealing with those types of stress. The results and information collected from the integrative arts therapy program conclusively indicated positive effects on the participant’s stress levels.

Secondly, analysis on the quantitative research of integrative arts therapy program conclusively indicate positive results on strengthening the participant's stress coping ability. According to the results of the stress coping skills test, the participant’s ability handle mental stress increased by 0.65 from the pre-program score of 2.67 to post-program score of 3.32. The participant’s problem solving skills showed the largest score improvement of 1.33, with positive reframing strategy showing an increased score of 0.5. Furthermore, total score from the PITR (Draw-A-Person-in-the-Rain) increased from a score of 1 to 16, while showing a noticeable improvement in the overall coping skills. The stress index showed a decrease from a score of 22 to 16, and finally the overall score of the entire quantitative examination increased from pre-program score of 23 to post-program score of 30.

Thirdly, analysis on the qualitative research of the integrative arts therapy program showed the participant’s positive progress on being aware of stress and dealing with a stressful situation. Through the arts therapy program, the participant was able to reflect back on her life and express her suppressed emotions, consequently decreasing her stress levels. Additionally, the art therapy procedure that allowed her to experience different methods of self-understanding and expression successfully showed positive changes in the participant’s behavior and attitude towards the act of taking care of her disabled sibling.

The results of this comprehensive Integrative Arts Therapy program conclusively demonstrated the undeniable positive effects it had on non-disabled adults who grew up with disabled siblings in the family. Being a non-disabled sibling to a disabled person can be very difficult and challenging. The program used in this research can hopefully be further studied so that a helping hand may reach the countless numbers of non-disabled siblings.|국문 요지

본 연구의 목적은 통합예술치료 프로그램이 노년기에 접어든 비장애 자매의 스트레스에 미치는 효과를 알아보는 데 있다. 따라서 연구 대상에게 적합한 통합예술치료 프로그램을 개발하여 효과적으로 스트레스를 해소하며 동시에 단계별로 연구 참여자의 스트레스 대처능력을 강화함으로써, 궁극적으로는 남은 노년의 삶을 긍정적이고 건강하게 영위할 수 있도록 도움을 주고자한다. 이를 위해 지적장애 3급 여동생과 함께 00시에 거주하고 있는 만 63세 여성 C를 대상으로 2019년 10월 3일부터 2019년 11월 21일까지 주3회 90분씩 사전·사후 검사를 포함하여 총 20회기의 통합예술치료 프로그램을 진행하였다.

프로그램의 연구결과를 도출하기 위해 양적 분석과 질적 분석을 병행하였다. 양적 분석으로는 프로그램 사전 사후에 스트레스 대처능력 척도 검사, 빗속의 사람 그림검사를 실시하고 비교 분석했다. 질적 분석을 위해서는 프로그램 매 회기 녹취 및 영상 촬영을 기반으로 하여 관찰 일지를 작성하고 이를 토대로 연구 대상의 단계별 변화과정을 언어적, 행동적으로 기록하고 분석하였다. 이렇게 수집된 자료를 바탕으로 연구 대상자의 스트레스와 대처능력의 변화의 수준을 종합적으로 분석하였다.

본 연구 결과를 요약하면 다음과 같다.

첫째, 노년기 비장애 자매의 스트레스에 효과적인 통합예술치료 프로그램은 비장애 형제자매가 겪는 전 생애적인 스트레스 구성요인과 연구 대상의 스트레스 특성 및 스트레스 대처능력을 분석하여 선정된 치료적 요인과 각 단계별로 설정된 통합예술치료 프로그램의 목표를 바탕으로 이에 맞는 세부적인 프로그램이 구성되었다. 이렇게 구성된 통합예술치료 프로그램은 연구 대상자인 노년기 비장애 자매의 스트레스에 긍정적인 효과가 나타났음을 알 수 있었다.

둘째, 연구의 양적 분석결과 통합예술치료 프로그램이 노년기 비장애 자매의 스트레스 대처능력을 강화시키는데 효과적이라는 연구 결과가 나타났다. 스트레스 대처능력 척도 검사 결과 연구 대상의 스트레스 대처 능력은 사전 2.67점에서 사후 3.32점으로 0.65점 상승하는 결과가 나타났다. 특히 적극적 대처 방식 중 문제해결 중심 대처능력이 1.33점으로 가장 높은 향상을 나타내었고, 뒤이어 소망적 사고 대처능력이 0.5점 상승하였다. PITR 그림 검사에서역시 총 점수가 사전 1점에서 16점으로 스트레스 완화와, 대처능력 향상의 결과가 동시에 나타났다. 스트레스 영역점수는 사전 22점에서 사후 16점으로 감소하였으며, 대처자원 점수는 사전 23점에서 사후 30점으로 상승하는 결과가 나타났다.

셋째, 연구의 질적 분석 결과 연구 대상자의 스트레스 감소와 스트레스 상황을 대처하는 태도에서 긍정적인 변화가 났다. 연구 대상자는 통합예술치료 프로그램을 통해 자신의 삶을 회상하며 억눌린 감정을 표출하는 예술 활동을 통해 스트레스가 감소한 것으로 보였다. 또한 예술작업 과정에서 자기이해와 표현에 대한 다양한 방식을 경험함으로써 장애인 동생을 돌보는 과정에서 마주하는 다양한 스트레스 상황에 적절히 대처하고 효과적인 방법을 모색하는 긍정적인 태도로 변화가 관찰되었다.

따라서 본 연구의 결과를 통해 통합예술치료 프로그램이 노년기 비장애 자매의 스트레스에 긍정적인 효과가 있었음을 확인할 수 있었다. 장애인의 비장애 형제자매로 산다는 것은 많은 어려움이 따른다. 따라서 본 연구에서 적용한 통합예술치료 프로그램이 실제 많은 어려움을 겪는 비장애 형제자매들에게 도움이 되어 비장애 형제자매들의 스트레스에 관한 보다 심층적인 연구가 지속적으로 이어지기를 바란다.; ABSTRACT

A Single Case Study on the Effects

of Integrative Arts Therapy Program for Stress

of One Senior-sister with Her Disabled Sibling

Ma, Ji In

Dept. of Arts Therapy, Education and Counseling

The Graduate School of Counseling Psychology,

Hanyang University

Directed by Prof. Kim, Mi Nam

Non- disabled siblings with a disabled sibling experience a lot of stress in various aspects throughout their whole lives. However, they are always being alienated from secondary environments and incidentally from home to society. In the family, their parents are always focused on their disabled son or daughter, so most non-disabled siblings may feel alienated from the family. They also might feel lonely because they feel they do not belong anywhere. Likewise, they feel excluded and think society is hostile and unfriendly.

These various negative emotions can be a source of stress affecting the lives of non-disabled siblings and cause various secondary problems. Therefore, many experts and psychologists say it is important to deal with the stress and negative emotions of non-disabled siblings.

In understanding the stress of non-disabled siblings, we must consider their entire lives. The stress of the non-disabled siblings is permanent because a disability is completely hard to healed. Therefore, the stress they experience continues after adulthood and is an important issue to be dealt with consistently.

Recently, the awareness of the welfare of the disabled has expanded, and experts have begun to pay attention to the psychological difficulties of their non-disabled siblings and their lives here. But, still in my country, the nation's welfare services for its non-disabled siblings are extremely insufficient, with most having difficulty resolving psychological conflicts at an appropriate time.

There are also studies of stress and psychological conflicts among non-disabled siblings among previous studies, but most of them are for childhood and adolescence. However, as the average life expectancy of people increases due to the development of science and medical technology, the life expectancy of people with disabilities is also increasing. This means an increase in the population of non-disabled siblings who take care of their disabled siblings after adulthood. It also means a lifetime approach to dealing with the issue of psychological conflict for the non-disabled should be taken at various stages of development. Because they being deeply involved in each others' lives from a long term perspective.

Therefore, this study recognized the importance of stress on non-disabled siblings who have supported disabled siblings since adulthood and shaped the study. Among other things, special focus was on non-disabled siblings who entered their senescence.

The purpose of this research explores the influences of mental stress on adults who grew up with disabled siblings in the family. Appropriate integrative arts therapy programs were developed in order to relieve stress as well as reinforce the participant’s stress coping ability, ultimately allowing a path to spend an optimistic and healthy life. This particular research program, involving a 63 year old woman (referred to as “C”) who has been living with her younger sister suffering severe intellectual disability, consisted of 20 episodes of 90-minute Integrative Art Therapy sessions, including pre-program and post-program examination (3 times a week, from 2019.10.3 to 2019.11.21).

In order to deduct the results of the experiment, both quantitative and qualitative researches were executed. The quantitative research included assessments testing the participant’s stress coping ability before and after the program by examining her results of the PITR (Draw-a-Person-in-the-Rain) test. The qualitative research included voice-recording and filming of the experiment procedure as well as documenting all observations, further examining and analyzing the participant’s linguistic and behavioral characteristics. The participant’s level of stress and stress coping ability were comprehensively investigated based on both quantitative and qualitative outcomes.

The following is the summary of this particular research.

Firstly, Integrative Arts Therapy programs effective to stress caused to the non-disabled adult with a disabled sibling consisted of a precisely tailored program aiming to positively help the participant with their various sources of stress and the specific type of stress as well as their method of dealing with those types of stress. The results and information collected from the integrative arts therapy program conclusively indicated positive effects on the participant’s stress levels.

Secondly, analysis on the quantitative research of integrative arts therapy program conclusively indicate positive results on strengthening the participant's stress coping ability. According to the results of the stress coping skills test, the participant’s ability handle mental stress increased by 0.65 from the pre-program score of 2.67 to post-program score of 3.32. The participant’s problem solving skills showed the largest score improvement of 1.33, with positive reframing strategy showing an increased score of 0.5. Furthermore, total score from the PITR (Draw-A-Person-in-the-Rain) increased from a score of 1 to 16, while showing a noticeable improvement in the overall coping skills. The stress index showed a decrease from a score of 22 to 16, and finally the overall score of the entire quantitative examination increased from pre-program score of 23 to post-program score of 30.

Thirdly, analysis on the qualitative research of the integrative arts therapy program showed the participant’s positive progress on being aware of stress and dealing with a stressful situation. Through the arts therapy program, the participant was able to reflect back on her life and express her suppressed emotions, consequently decreasing her stress levels. Additionally, the art therapy procedure that allowed her to experience different methods of self-understanding and expression successfully showed positive changes in the participant’s behavior and attitude towards the act of taking care of her disabled sibling.

The results of this comprehensive Integrative Arts Therapy program conclusively demonstrated the undeniable positive effects it had on non-disabled adults who grew up with disabled siblings in the family. Being a non-disabled sibling to a disabled person can be very difficult and challenging. The program used in this research can hopefully be further studied so that a helping hand may reach the countless numbers of non-disabled siblings.