自閉症児への遊戯療法による臨床的一アプローチ

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今日においても自閉症の原因については、依然解明されないままである。自閉症の原因をめぐり様々な議論のある中で治療方法も変化してきた。そこで本論文では、これまでに行われてきた自閉症研究と自閉症治療に対する遊戯療法の歴史を振り返り、その成果と問題点を明らかにし、自閉症児における遊戯療法の意義について考察を行った。本研究は自閉症児に対して1年半にわたって遊戯療法を実施し、治療者である著者が共感的な模倣を行うことを基本的な姿勢として、受容的、共感的に関わった結果、慣れない環境に過敏に反応を示しやすかった対象児の、刺激に対する反応が緩和されたことや、人と関わることが苦手であった対象児が、コミュニケーション能力を向上させたことの事例報告である。対象児は、セッションを重ねるに連れ、攻撃性が減少し、積極的に遊びを共有するように働きかけてくるようになった。また日常場面においても、他人との関わりあい、不慣れな環境での活動に強い抵抗を示していた対象児が、一人で多く活動することができるようになったのである。これは、治療者が対象児のもつ世界へと歩み寄る姿勢を持ち続けるという配慮から、不安が除去され、信頼関係を構築できたことが、治療場面以外での対人関係に及んで般化したものと考えられる。ここに遊戯療法が、遊びを介して人と共感し合うことに有効に働くという意義が示唆されたといえる。今後、青年期を迎えるにあたって、現在すでに直面している第二次成長の受け入れと葛藤、そしてそれをどのように乗り越えていくかが大きな課題となることが予想される。対象児の思いを理解し、いかに寄り添い、折り合いをつけていくかが今後の方向性を導く鍵となるであろう。Kanner, L. (1943) About an autistic cause, it is not still elucidated even if I reach it today when I passed through 60 since an autistic study I am similar, and to get together began. A therapeutic method changed while various arguments were exchanged over an autistic cause. It came to be introduced positively as the mainstream of autism treatment since I announced psychoanalysis of the child that Klein,M. (1932) assumed play a central, basic method about the effectiveness of play therapy to an autistic children. However, as the times get worse, and a study is repeated, when the opinion which there is comes to be recognized by an obstacle of a tissue of a brain, a voice to accuse invalidity characteristics for play therapy came to be given, but I enter in 90's, and an autistic cause has been reviewed again. Therefore, in this article, I looked back toward the history of play therapy for an autism study and the autism treatment that had been performed till now and clarified the result and problems and examined an example of an autistic children and considered significance of play therapy in an autistic children. The object child that it was hard for reaction for stimulation of the object child which environmental is sensitive and was easy to show reaction in which does not fit it to be concerned with a relaxed thing and person is an example report of what was able to improve communicative competence as a result that this study enforces play therapy for an autistic children for 1 year and six month, and the author who is a healer is receptive as the posture that is basic in imitating it of sympathy, and sympathy was concerned. In this example, expression of the aggressiveness for a healer was seen in play, and solitaire was if the object child which it was rare for to show interest in most, a healer repeated a session, and the aggressiveness decreased and came to pressure it to work on it to share play positively. In addition, the object child which I showed a thing and usual times to associate with a person except a family alone and particularly strong resistance environmental, to be active that did not fit it in left a family and I was alone, and there was many it and got possible to be active every day in a scene. I worry, and this is removed by consideration that a healer continues having posture to approach the world where an object child stands, and it is thought that it amounts to personal relationships except a treatment scene that I was able to build a relationship of mutual trust and did 般化. Play therapy went through play here, and a person and significance to particularly act effectively that sympathized with were suggested; can ask it it. That it is it with a big problem how you get over acceptance and tangle of the second growth that you have already faced and it now is expected in future on greeting youth. I understand thought of an object child and snuggle up how and will become the key which leads future directionality whether you settle.
2006-12-25

自閉症児への遊戯療法による臨床的一アプローチ

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