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집단미술치료 프로그램 연구

Title
집단미술치료 프로그램 연구
Other Titles
A Study of the Group Art Therapy Program: Based the Children with Cancer and Their Siblings
Authors
김소정
Issue Date
2014
Department/Major
교육대학원 미술교육전공
Publisher
이화여자대학교 교육대학원
Degree
Master
Advisors
박숙영
Abstract
With the development of medical technologies, the concept of a pediatric cancer turned from an incurable disease to a chronic disease, but still the course of its treatment is lengthy and arduous. Regarding pediatric cancer, beyond a matter of survival, issues of the children's psychological changes during treatment and their social adjustment after the end of the treatment stand out. The occurrence of pediatric cancer causes psychological problems in the sick children's siblings as well as themselves and affects them in forming correct relationships with their siblings. Children with cancer and their siblings have problems of negative self-esteem and low sociability, which may be factors that can lower interactions in their relationships with siblings. Group art therapy is effective for the improvement of self-esteem and sociability of children with cancer and has positive impacts on their sociability and self-esteem as well. In addition, group art therapy is effective for the improvement of their relationships with siblings. It is more effective when conducted together than when conducted separately to increase positive interaction and bond between children with cancer and their siblings. Art therapy by them together has positive influences on their relationship with siblings and further increases the individual's self-esteem and sociability as well. This study plans and applies group art therapy of children with cancer and their siblings to examine its effectiveness. To develop a group art therapy program, this study inquired into literature on the characteristics and theories of group art therapy, and through the 1st and 2nd simulations, it analyzed the subjects' characteristics and the merits and demerits of the experimental class. Based on theoretical review and simulation, appropriate procedures of this study were designed and models were produced to select the subjects. The group art therapy program was formed based on Adler's theory divided into start, navigation, action and conclusion. In planning for the program, considering the characteristics of the subjects, children with cancer and their siblings, art media matching the stages of their development were investigated and then the contents and materials of the activities were selected. An experimental class was carried out applying the group art therapy program for children with cancer and their siblings produced over this development process and then this study examined the effects of art therapy. For this purpose, a total of 12 rounds of experiment were conducted three times a week for 100 to 120 minutes, and three groups of children with cancer and their siblings that applied for the Korea Pediatric Cancer Foundation's Emotional Support Project and three groups only with children with cancer were divided into an experimental group and a control group, respectively for the experiment. For the evaluation of its effects, as a quantitative assessment by measuring tools, tests on the quality of their relationship with siblings and their ego resilience were conducted, while as a qualitative assessment by projection tools, tests with tree and house pictures and fish family drawing were conducted before and after the study, and whether there were significant positive changes was analyzed and verified. As for the pre- and post-test, in quantitative analyses of the differences in the quality of relationship with siblings and the children's ego resilience scale before and after the study were compared in graphs by statistics using Korean Educational Statistics Software (KESS), and the mean of the results of the pre- and post-test in the experimental group and the control group was compared and presented. To increase the reliability of the qualitative analysis, for the interpretation of the results of pre- and post-test of drawing, they were analyzed by the verification of an expert in art therapy. The results of the analysis summarizing the main results are as follows: First, group art therapy for the children with cancer and their siblings was more effective in the tests of the quality of their relationship with siblings and ego resilience than the control group. Second, group art therapy for the children with cancer and their siblings showed dynamic in which they tried to balance between siblings, and accordingly, it was effective for improving their relationship with siblings positively. Third, group art therapy for the children with cancer and their siblings was more effective for improving the individual's self-esteem and sociability. As a result, group art therapy together by the children with cancer and their siblings had positive impacts on the improvement of self-esteem and sociability of them and their siblings and their relationship with siblings. This study has significance in that it was suggested as an empirical study that a group art therapy would be more effective when conducted together than when conducted separately.;의학 기술의 발달로 소아암은 불치병이 아닌 만성질환의 개념으로 전환되었지만 여전히 소아암의 치료 과정은 길고 힘들다. 소아암은 생존의 문제를 넘어서, 치료 중 환아의 심리적 변화와 치료 종료 후 사회 적응 문제가 부각되고 있다. 소아암 발병은 환아 뿐 아니라 환아의 형제까지도 심리적 문제를 야기하고 형제와 올바른 관계 형성을 맺는데 영향을 끼친다. 소아암 환아와 형제는 부정적 자아존중감과 낮은 사회성의 문제점을 갖고 있으며, 이는 형제 관계의 상호작용을 저하시킬 수 있는 요인이 된다. 집단미술치료는 소아암 환아의 자아존중감과 사회성 향상에 효과적이며, 소아암 환아 형제의 사회성과 자아존중감에 긍정적인 영향을 미친다. 또한 집단미술치료는 형제관계 개선의 효과적이다. 소아암 환아와 형제 간 긍정적인 상호교류와 유대감을 높이기 위해서는 환아와 형제를 격리시키기보다 함께 공유할 때 더 효과적이다. 환아와 형제가 함께 미술치료를 함으로써 형제관계의 긍정적인 영향을 미치며 나아가 개개인의 자존감과 사회성도 높아진다. 본 연구에서는 소아암 환아와 형제가 함께하는 집단미술치료를 계획하고 적용하여 그 효과성을 알아보고자 한다. 집단미술치료의 프로그램 개발을 위해 집단미술치료의 특성과 이론을 문헌고찰 하였으며, 1, 2차 모의실험을 통해 연구 대상의 특성과 실험 수업의 장단점을 분석하였다. 이론적 고찰과 모의실험을 토대로 본 연구의 적합한 절차를 설계하고 모형을 제작한 후 연구 대상을 선정하였다. 집단미술치료 프로그램은 Adler 이론의 근거하여 시작-탐색-활동-종결 4단계로 나누어 구성하였다. 프로그램 계획 시 연구 대상인 소아암 환아와 형제의 특성을 고려하여 발달단계에 맞는 미술매체를 조사한 후 활동내용과 재료를 선정하였다. 이러한 개발 과정을 거쳐 제작된 소아암 환아와 형제를 위한 집단미술치료 프로그램을 적용하여 실험수업을 실시한 후 미술치료가 어떤 효과를 미치는지 알아보았다. 이를 위해 총 12회기로 주 3회, 100~120분에 걸쳐 실험을 실시하고, 한국소아암재단 정서지원 사업에 신청한 소아암 환아와 형제 3그룹과 환아만 있는 3그룹으로 실험집단과 통제집단을 나누어 실험연구를 실시하였다. 효과에 대한 평가를 위해 측정도구에 의한 양적 평가로 형제관계의 질과 유아의 자아탄력성 검사를 실시하였으며, 투사도구에 의한 질적 평가로 나무, 집 그림검사와 물고기 가족화 그림검사를 연구 사전과 사후에 실시하여 긍정적으로 유의미하게 변화하였는지 분석, 검증하였다. 사전-사후 실시한 검사는 양적 분석인 형제관계의 질, 유아의 자아탄력성 척도는 KESS(Korean Educational Statistics Software) 프로그램을 사용하여 통계를 내 사전‧사후의 차이를 그래프로 비교하였으며, 실험집단과 통제집단의 사전‧사후 검사 결과 값의 평균을 그래프로 비교‧제시하였다. 질적 분석의 신뢰도를 높이기 위해 사전‧사후 그림검사 결과에 대한 해석은 미술치료 전문가의 검증을 받아 분석하였다. 주요 결과를 종합한 분석결과는 다음과 같다. 첫째, 소아암 환아와 형제가 함께한 집단미술치료가 형제관계의 질 검사와 자아탄력성 검사에서 통제집단에 비해 더 효과적이다. 둘째, 소아암 환아와 형제가 함께한 집단미술치료는 형제 간 균형을 맞추려는 역동성이 나타났으며 이로 인해 형제관계가 긍정적으로 개선하는데 효과적이다. 셋째, 소아암 환아와 형제가 함께한 집단미술치료는 개개인의 자아 존중감과 사회성 향상에 더 효과적이다. 결론적으로, 소아암 환아와 형제가 함께한 집단미술치료는 소아암 환아와 형제의 자아존중감과 사회성 향상 및 형제관계 개선에 긍정적인 영향을 미쳤다. 본 연구는 집단미술치료가 소아암 환아와 형제가 격리되기보다 함께하였을 때 더 효과적이라는 연구에 대한 실증적 연구로서 제시하였다는데 의의가 있다.
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