佔領助人專業的剩餘地帶：臺灣精神疾病家屬同儕支持實踐經驗探討

Abstract

作為當代精神衛生與心理健康系統的重要資源，精神疾病家屬與使用者的生命經驗漸趨在系統合作中受到重視。然而以經驗知識為支持核心的家屬同儕支持，儘管實踐在各地發展，目前在臺灣的相關研究仍不多，也經常性地面臨正式系統對其知識體系的質疑。本研究期盼探索本土的精神疾病家屬同儕支持實踐經驗，從其實作知識、同儕支持者的培力歷程，到家屬同儕作為經驗專家帶來的專業反思，藉由整理在地的實踐敘事，豐富同儕支持相關討論。 本研究選取建構主義的質性研究方法，採用半結構式深度訪談，共採納9位臺灣本土精神疾病家屬同儕支持者之分享，分析其同儕支持經驗的共通性，指出參與者的歷程與經驗差異，藉此描繪在地家屬同儕支持之圖像。 研究發現從家屬同儕之實作方法內涵切入，藉由二維光譜定位目前在臺灣家屬社群中仍舊模糊之同儕支持概念，並且展開說明家屬同儕平等自由的故事交換哲學觀、自我揭露的助人技術與其在支持中的實作意識。再以自助助人與公共性之觀點，分析家屬同儕之投身動機與成長和改變。最後說明照護知識之價值與其所面臨之論述挑戰，並且藉由定位為「佔領」助人專業剩餘地帶之姿，以平行的專業位置為現行助人與精神醫療工作者帶來提醒。 本研究藉深入探索家屬同儕之經驗，輔以研究者與家屬社群工作之實務觀察，論述精神疾病家屬如何作為「生活的專家」，成為精神衛生系統中重要的聲音。期盼此研究能為與家屬合作的助人專業帶來深刻反思，並成為家屬社群運動往下邁進的討論素材。

As an essential resource for contemporary mental health systems, the life experiences of mental health users and families are increasingly emphasized in system collaboration. However, despite the development of family peer support focusing on experiential knowledge, there is still little related research in Taiwan. Moreover, the formal system has also often questioned the peer knowledge system. Thus, this study aims to explore the practice of family peer support in Taiwan’s mental health system and to enrich the discussion by organizing the local practice narratives. The study starts with practical knowledge of peer support, the process of peer supporters' empowerment, and finally, the reflection of professionalization brought by family peers as experiential experts. This study adopted a constructivist qualitative research methodology and semi-structured in-depth interviews with nine Taiwanese family peer supporters. It aims to analyze the commonalities of their peer support experiences and highlight the differences in their journeys and experiences to depict the experiences of family peer support in Taiwan. Findings identified the connotation of family peer supporters’ practical experience, using a two-dimensional spectrum to locate the concept of peer support that is still ambiguous in the Taiwanese mental health family community. It develops a philosophy of equal exchange in storytelling among family peers and reveals the disclosure techniques in helping and their awareness of practice in peer support. Also, the motivation and changes in the growth of family peers are analyzed from the perspectives of self-help and publicness. Finally, it illustrates the value of caring knowledge and the discursive challenges it faces. Positioning family peers as 'occupying' the remaining territory of the helping professions reminds current professions in the mental health system of peers' parallel professional positions. This study explores the experiences of family peers and the researcher's observations of family members' communities. It discusses how family members with mental illness can serve as 'experiential experts' and bring an important voice to the mental health system. The study will provide insightful reflections on the helping professions working with families and serve as a source of discussion for the family community movement moving forward.