高次脳機能障害者に対するグループ作業療法

Group occupational therapy for patients with higher brain dysfunctions

要旨：復職や復学を目標にする高次脳機能障害者に対し，「障害の自己認識改善」，「対人関係技能の向上」を目的としたグループ作業療法を実施している．病院の特性から対象者の障害重症度や訓練期間が異なり，構成メンバーは流動的である．プログラムは，意見交換，情報処理を要するゲーム，共同作品製作を中心に構成した．評価には，訓練場面で観察可能な評価表と自由回答のアンケートを作成・使用した．結果として，体験的気づきや対人関係技能の改善が得られている．メンバー間の能力差が大きい場合は，個別の障害や能力に応じた役割分担や援助方法などについて，綿密な計画を立てて実施することが重要であった．

　We have been providing group therapy for patients with higher brain dysfunctions for the purpose of improving the patients' interpersonal skills and self-awareness deficits. Because of the characteristics of our institute, the severity of the deficits and the length-of-training period differ depending on the patient's individual condition and life situation; therefore, we have different members in the group from session to session. The training program includes group discussion, games that require information processing, and cooperative craft works. For assessment, we use an original checklist consisting of items that we can observe in the therapy situation and a questionnaire.

　We found this group therapy effective for the participants to improve their emergent awareness and inter-personal skills. We also found that, when the participants vary in terms of their abilities, it is important for the therapists to thoroughly consider each member's role in the group and the support we provide, based on the individuals' deficits and abilities.