A Single Case Study of Group Art Therapy for Self-expression in Siblings of Children with Developmental Disabilities

발달장애 형제를 둔 비장애 아동들은 자기만의 감정과 욕구가 있지만, 그들의 경우에는 가족 내에서 자신의 감정을 솔직하고 자유롭게 표현할 기회가 일반아동보다 상대적으로 부족하다. 이로 인해 비장애 아동들은 자기표현의 방법을 모르거나 잘못된 생각이나 판단으로 인해 자기표현을 하지 못하는 어려움이 있다. 특히, 비장애 아동의 나이가 어릴수록 자기 생각과 감정에 대한 표현의 어려움이 크기 때문에 어린 나이의 비장애 아동에게 건강한 자기표현을 위한 치료적 개입이 필요하다. 따라서 본 연구는 발달장애 형제를 둔 비장애 아동에게 집단미술치료를 실시하여 비장애 아동이 집단미술치료 과정에서 자기표현에 대해 어떤 경험을 하고 또 그 의미는 무엇인지에 대해 알아보기 위해 2019년 1월 11월부터 2019년 2월 27일까지 주 2회 60분 사전, 사후 면담을 포함한 15회기를 진행한 집단미술치료를 단일사례연구방법으로 분석하였다. 연구 참여자들는 현재 초등학교에 다니며 발달장애를 진단받는 형제를 둔 고학년 이전의 비장애 아동이다. 자료는 매회기 참여자의 결과물인 언어적, 비언어적 표현, 미술작품을 기록한 일지, 녹취록을 전사하였으며 자료를 심층적으로 분석하였다. 발달장애 형제를 둔 비장애 아동의 자기표현을 위한 집단미술치료를 진행 결과를 바탕으로 한 결론은 다음과 같다. 첫째, 비장애 아동은 집단미술치료 과정에서 미술 표현을 통해 자신의 경험과 감정표현이 증진되었으며 자신의 감정에 대해 나누거나 수용하는 기회를 얻게 되었다. 그로 인해 집단미술치료는 발달장애 형제를 둔 비장애 아동의 자기표현에 도움을 주었다. 둘째, 비장애 아동에게 집단미술치료는 긍정적 관계 경험 기회를 제공하였으며 그것으로 인해 자신이 경험하지 못했던 형제 관계에 대한 욕구를 충족할 수 있었다. 셋째, 집단미술치료를 통해 발달장애 형제로부터 겪는 경험을 나누며 이해하고 공감받는 경험을 하였고 그러한 경험은 발달장애 형제에 대한 표현과 장애 형제에 대한 인식에 도움을 주었다. 이를 종합하여 볼 때 집단미술치료를 통해 발달장애 형제를 둔 비장애 아동은 미술 매체와 미술 표현을 통하여 다양하고 복잡한 자신의 감정을 표현하였으며 자기표현이 증진되었다. 참여자들 간에 지지로 긍정적 관계를 경험하여 자신이 경험하지 못했던 형제 관계에 대한 욕구를 충족할 수 있었다. 또한, 연구자와 참여자들의 긍정적 지지와 수용은 참여자들의 정서 변화에 도움을 주었고, 장애 형제에 대한 부정적 감정을 나누고 공감하며 발달장애 형제에 대한 인식이 편안해진 것을 볼 수 있었다. 본 연구는 발달장애 형제를 둔 비장애 아동을 대상으로 한 미술치료의 방향성을 제시하며 비장애 아동의 자기표현을 위한 집단미술치료 연구에 자료로 제공할 수 있을 것이다. Siblings of children with developmental disabilities have their own feelings and needs, but they have relatively fewer chances of expressing their feelings honestly and freely in their home than other average children. As a result, the siblings of children with developmental disabilities do not know how to express themselves or have difficulty expressing themselves due to wrong thinking or judgment. In particular, the younger the siblings are, the more difficult it is for them to express their thoughts and feelings. Therefore, therapeutic intervention is needed to help them learn how to express themselves in a healthy manner. The purpose of this study is to provide group art therapy to siblings of children with developmental disabilities and to help them experience self-expression in the process and see the meaning of self-expression. Fifteen sessions of art therapy were conducted, including pre- and post- interviews for 60 minutes twice a week from January 2019 to February 27, 2019, and they were analyzed using art therapy single case study method. The subjects are children currently in elementary school and have siblings who are diagnosed with a developmental disability. At each session the subjects’ linguistic and non-verbal expressions, journals of art works, and words spoken were transcribed and analyzed in-depth. Based on the results of the group art therapy to promote self-expression of siblings of children with developmental disabilities, the conclusions are as follows. First, in the group art therapy process, siblings of children with developmental disabilities improved their ability to express their experiences and feelings through artistic expression and had the opportunity to share or accept their feelings with others. As a result, group art therapy helped the siblings of children with developmental disabilities to improve their self-expression. Second, group art therapy provided an opportunity for siblings of children with developmental disabilities to experience positive relationships, which could satisfy their desire for relationships with their siblings that they had not experienced before. Third, through group art therapy, they acquired experience, understanding, and empathy, while sharing experiences with their brothers with developmental disabilities. Their experiences helped to raise their awareness of disabled siblings as well as their ability to communicate with their siblings with developmental disabilities. In conclusion, siblings of children with developmental disabilities expressed their diverse and complex feelings through art media and art expressions through group art therapy. In doing so, they increased their ability to express themselves. They also experienced a positive relationship through support with other subjects and were able to meet their sibling-related needs that they had not experienced before. Also, positive support and acceptance from the researcher and subjects helped to change the subjects’ emotions. The subjects shared and sympathized with the negative feelings for disabled siblings, and as a result improved their perception of those children with developmental disabilities. This study presents the direction of art therapy for siblings of children with developmental disabilities. In addition, this study can be used as a research material for group art therapy to promote self-expression of siblings of children with developmental disabilities.Ⅰ. 서론 1 A. 연구의 필요성 및 목적 1 B. 연구의 문제 5 Ⅱ. 문헌고찰 6 A. 발달장애 형제를 둔 비장애 아동과 자기표현 6 B. 집단미술치료와 자기표현 10 Ⅲ. 연구방법 14 A. 단일사례연구 14 B. 연구 참여자 15 C. 집단미술치료 사례구성 19 D. 자료 수집 23 E. 자료 분석 23 F. 연구의 윤리적 고려 24 G. 연구의 신뢰도와 타당도 25 Ⅳ. 연구결과 26 A. 집단미술치료 회기 내용 및 의미분석 26 B. 집단미술치료에 관한 참여자별 분석 76 Ⅴ. 결론 및 제한점 85 참고문헌 89 부록1. 연구참여동의서 95 ABSTRACT 9

(A) study on knowledge, attitudes and practice for herb medicine

보건학과/석사[한글] 긴 동양문화의 역사적인 배경속에서 한방의학은 대중과 더불어 육성되어 왔고 (노, 1961), 우리나라에 도입된 후 그 필요도와 더불어 점차 체계화되어가고 있으며 서양의학과도 더욱 많은 분야에서 유기적인 연결을 시도하고 있다. 이와 같은 한의학의 과학화 내지는 현대화는 대중에서 새로운 한의학에 대한 관심 (김, 1945)을 불어 일으키는 것으로 생각되어 최근의 한의학에 대한 관심을 추정하기 위하여 이에 대한 지식, 태도 및 이용에 관하여 조사하기에 이르렀다. 조사대상은 서울시내 및 지방의 남녀고등학교 3학년 학생들을 대상으로 하여 그 가운데 각각 10학급을 확률추출하여 1979년 3월 6일부터 3월 15일에 설문조사하였다. 조사결과에 있어서 한방의학은 보약을 포함하여 한약을 짓는 것이라고 대답한 학생이 51.6%로 가장 높은 비율을 나타내었고 동양의 의술이라고 대답한 학생이 42.0%였다. 90% 이상이 한방의학이 필요하다고 했고 매우 필요하다가 27.3%나 되었다. 한방은 현상유지한다가 40.6%로 가장 많고 이어서 38.7%는 보건 의료분야에서 크게 공헌한다고 말했다. 한약의 효과는 보약의 경우 64.2%, 기타의 경우 4.9%가 효과가 있다고 대답했으며, 질병진단에서는 한의사(6.7%) 보다 양의사 (52.1%)를 더 믿는 것으로 나타났다. 한방의학에 대한 흥미에 있어서 좋다가 41.4%, 나쁘다가 0.9%로 나타났고, 앞으로의 치료를 받을 때는 한의원이 6.4%, 병원을 원하는 학생이 85.5%였다. 침을 맞는 학생은 59.7%, 뜸을 뜬학생이 9.2%로 나타났다. A Study on Knowledge, Attitudes and Practice for Herb Medicine Hee Joo Chae Graduate School of Health Science & Management Yonsei University (Directed by Prof. Myung Ho Kim) In order to find out knowledge, attitudes and behavior relate to herb medicine by high school students, a study was carried out. The questionnaire survey was employed in this study for 1,066(269 boys and 250 girls in Seoul, 271 boys and 276 girls in rural areas), and they responded as follows; 1. A large portion (51.6%) recognized as the herb medicine is effective for energetic restoration. 2. 42.0% of respondents answered that the herb medicine is an oriental one. 3. 27.3% understood herb medicine as the best medicine and also a large portion (63.7%) were wanting herb medicine as necessary medicine. 4. 38.7% of respondents explained that the herb medicine is increasingly appreciated in future on one hand and on the other hand, 40.6% answered that the herb medicine may maintain as well as today. 5. For efficiency of herb drug, restorative drug was highly appreciated by 64.2% of respondents and for other drugs only 4.9% thought as effective. 6. For the diagnosis of diseases, 6.7% believed herb medicine as the better medicine, however, 52.1% of respondents preferred western medicine. 7. 41.1% liked herb medicine and 0.9% disliked it. 8. 54% had experienced in visitation to the herb doctor and 24% of them responded that it was effective. 9. Majority of respondents (85.5%) explained their opinion that they want to visit a hospital rather than herb doctor. 10. The reason why they visited herb doctor, 16.6% answered that gerb medicine fit in our physical body and 13.5% by friends recommendation and 10.2% from vary early ages. 11. 59.7% of all respondents aupuncturated and 9.2% cauterized with moxa. 12. 66.6% of respondent's family used to go herb doctor. [영문] In order to find out knowledge, attitudes and behavior relate to herb medicine by high school students, a study was carried out. The questionnaire survey was employed in this study for 1,066(269 boys and 250 girls in Seoul, 271 boys and 276 girls in rural areas), and they responded as follows; 1. A large portion (51.6%) recognized as the herb medicine is effective for energetic restoration. 2. 42.0% of respondents answered that the herb medicine is an oriental one. 3. 27.3% understood herb medicine as the best medicine and also a large portion (63.7%) were wanting herb medicine as necessary medicine. 4. 38.7% of respondents explained that the herb medicine is increasingly appreciated in future on one hand and on the other hand, 40.6% answered that the herb medicine may maintain as well as today. 5. For efficiency of herb drug, restorative drug was highly appreciated by 64.2% of respondents and for other drugs only 4.9% thought as effective. 6. For the diagnosis of diseases, 6.7% believed herb medicine as the better medicine, however, 52.1% of respondents preferred western medicine. 7. 41.1% liked herb medicine and 0.9% disliked it. 8. 54% had experienced in visitation to the herb doctor and 24% of them responded that it was effective. 9. Majority of respondents (85.5%) explained their opinion that they want to visit a hospital rather than herb doctor. 10. The reason why they visited herb doctor, 16.6% answered that gerb medicine fit in our physical body and 13.5% by friends recommendation and 10.2% from vary early ages. 11. 59.7% of all respondents aupuncturated and 9.2% cauterized with moxa. 12. 66.6% of respondent's family used to go herb doctor.restrictio