中文摘要
本研究旨在探討諮商心理師在醫療場域提供心理服務的經驗。本研究邀請4位於醫療場域不同科別工作的諮商心理師為訪談對象，每位研究者參與者接受1～2次，每次90～150分鐘的深度訪談。本研究採質性研究的現象學取向，以主題分析法分析訪談逐字稿，以瞭解諮商心理師在醫療場域諮商實務的運作雛形，瞭解促進或阻礙諮商心理師於醫療場域運作實務的影響面向，以及透過諮商心理師對阻礙面向的反思或實務突破經驗，提出於醫療場域提供心理服務所應面對的專業課題與因應策略。研究結果如下：
一、4位諮商心理師在醫療場域諮商實務的運作雛形，其經驗各具獨特性，其中共通性為：以團隊的形式共同服務病患，但專業間的業務性質是各自獨立的；醫療團隊主導者經常是醫師。
二、4位諮商心理師於醫療場域運作實務時，發揮專業的程度受到6個面向的影響，包括：醫院主管態度；民眾對心理專業的負向知覺；法令制度的框限；醫療團隊抱持不同觀點；多樣化的落實實務對專業發揮的影響，以及反思諮商傳統訓練應用於醫療場域的影響等。上述這些影響的面向分別會促進或阻礙諮商心理師在醫療場域的實務運作。
三、諮商心理師針對阻礙實務運作的影響面向，提出所需面對的專業課題與因應策略，包括：1.醫院主管態度牽制諮商實務運作的調適策略；2.以專業行動推廣並教育民眾正確的心理專業知能；3.正視修法行動與彈性運作的策略為制度框限解套；4.逐步建立內、外在專業效能以匡正醫療團隊的偏頗觀點；5.補強諮商傳統訓練以符合醫療場域的專業需求，以及6.具備正向實務態度可提升專業運作的適應力等。
本研究針對上述結果加以討論，並提供若干建議作為諮商心理實務工作者及未來研究的參考。

ABSTRACT
This study aims at exploring the experiences of 4 counseling psychologists who offered psychological services at medical settings. The study adopted phenomenology approach. Each research participant was interviewed once or twice, each interview lasted for 90-150 minutes. The thematic analysis method was used to analyze the in-depth interview data. The research findings are as follows:
The operational models of those counseling psychologists who worked at medical settings included that they worked as a team with other interdisciplinary professionals, nevertheless, the doctors usually served as the dominate roles in the team.
Some aspects had influences on their counseling practice at the medical settings, such as the attitude of the directors, the negative perceptions on counseling services from the public, the restrictions of the licensure law or related regulations, the inappropriate expectations from other interdisciplinary team, the diverse services offered to the public, the inadequacy of academic training, and the attitudes of the counseling psychologists themselves. Some of these aspects could facilitate their counseling practice while others might hinder their practice. Those counseling psychologists had their own coping strategies regarding these obstacles.
The issues related to the counseling practice at medical settings included: The attitude of directors have influence on their practice, counseling psychologists should promote the understanding of counseling profession to the public, the revision of the Licensure Law and other related regulation, the enhancement of the counseling effectivenesss so as to correct the bias or prejudice from other interdisciplianary team members, the traditional counselor training program needs to keep current so as to meet the professional needs of medical settings, and that counseling psychologists need to possess positive working attitude so as to adjust themselves in this professional setting.
The research findings were discussed and some suggestions for counseling practitioners and researchers were addressed.

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