Reporting the present system and situation of “Health Counselling Unit” of the branch hospital of the University of Tokyo, the significance of the activity of health counselling unit in hospital was discussed.
Regarding technique applied for health counselling carried out in the unit, directive as well as non-directive counselling seemed to be equally essential. About the management of health counselling, the referal systeur of counsellee to clinical consultation, medical social.: work, activity of preventive medicine etc should carefully be established, and close team approach among these referal units are extremely imporant.
In addition to the health counselling, the unit is also active in home extension service of medical care. Through all cases concerned in this kind of service, it was thought that counselling toward the family of case is very important so as to make the service more effective.
As a conclusion, the authors consider that every hospitalshould have health counselling unit as a part of health guidance unit, and that the health, guidance uuit also can offer home extension service of medical care in orderto establish comprehensive health care which is said to be a diserable type of health and medical care.

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(1) There are many Problems to do psychotherapy in the juvenile detention and classification home, because the main purpose of the home is to classify the delinquents, and the term of detention is not so long for psychotherapy, and it is rather difficult to get psychotherapists in the institution, It is said that such facilities in the U. S. are under the same condition as in Japan. But in France, the term of detention is from 6 to 12 months, therefore, psychotherapy in the institutions is more easily done by medical doctors, psychotherapists and counselors. However, I believe that we can do psychotherapy in the juvenile detention and classification home, even if the term is not long enough.

(2) Even at present, some counselors in the section of custody are trying to apply a kind of bibliotherapy, music therapy and the other mental working. These are literally not psychotherapy, but we may say that they are practising group counseling including the orientation for delinquents. We have tried to do individual psychotherapeutic counseling by psychologist. In our institution the delinquents are usually detained for about 3 weeks. So that we can have 6-9 sessions, if we have 2 or 3 times a week. We have applied the technique of client-centered therapy. We found that the delinquents could regain their mental stability, and have insight in some degree. When they are released, it is desirable to continue the therapeutic relation by a form of out patient, but it may actually be very difficult.

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Vol. 7 No. 4 p. 205-271
修正箇所：その他

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In regard to a kind of neurosis which is called School Refusal (socalled “school-phobia”), it is said that there is a tendency to increase in recent days.
The factor in that outbreak is not simple. Interpersonal relationship in a family, as well as the moment of outbreak and the specific character of the sick child, is one of the important factors.
The environment in which the child in question is brought up, and the inclination of the attitude in the family show phenomenal tendencies to over-protection and overinterference.
The emotional entanglement between the parents, which is the motive of those tendencies (sometimes between the parents and grandfather-and-mother) and between the parents and the child (or, between the grandfather-and-mother and the child), especially the disposition and the role relation between the parents have a much influence on the formation of personality in addition to the disposition of the child.
Consequently, the child fails to take in the images of their parents which should be the psychological support over again. As a result, enlarging their sever wound, the child is driven to bay and isolated gradually. On the other hand, his parents grow increasingly uneasy, and regard the child as wilfulness on account of his rejection. In spite of this attitude, the parents are at a loss how to bring up their child, and reveal their immature disposition. These attitudes of the parents produce the vicious circle that they are drawn about by their child against their will.
On the occasion of treatment, if a case is serious, it is necessary to separate the child from his home (take to hospital) and to make him reconstruct his own self.
Moreover, the members of the family is required the efforts to recognize the role with one another, to understand their own disposition and to admit the others' situation.
In our hospital, we have the situation for the group guidance as well as the individual guidance for the family with the child in question.
Through the interaction between the members of several families, they accomplished the following aims: improvement of the immature disposition of the parents, the reduction and rmmovement of the conflict in their home, the conquest of anxiety, finding out their own roles, and adjustment of the relation to the children.
The treatment of the family with the child rejecting the school attendance is not accomplished by itself alone, It becomes meaningful when it keeps the close and imseparable connection with the treatment of the child, Besides, the effect of such a treatment can not be expected till we keep the connection with the school.

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The first aim of this study was to determine by Q-sorts the nature of the self, ideal self and ideal opposite sex concept of the adolescent. The second aim was to confirm the relationship among those concepts by Q-technique.
85 cards were prepared and on each of them was described a word which indicated one of various personality traits. The subjects were required to classify the cards into seven grades in the order of the accordance of the personality traits first with their self concept, second with ideal self concept, and third with ideal opposite sex concept.
The results are as follows:
1. There is a similarity between the self concept and ideal self concept. The self concept should be reflected in the ideal self concept.
2. On the other hand, the ideal opposite sex concept shows a considerable contrast with the self concept. In the ideal opposite sex concept, the subject is likely to highly appreciate the traits he lacks in his self concept.
3. Those subjects who show greater discrepancies between self sorting and ideal self sorting and those who show less discrepancies were selected.As a result of the analysis of them by Q-technique, two factors are found.
The first factor reflects the tendency toward introspection or self reflection, and is found mostly among the subjects who show greater discrepancies.
The second factor reflects a tendency toward self acceptance and of setting a high value on social adjustment. It is found primarily among subjects who show less discrepancies.

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What the author wants to discuss and insist upon in this report, are the counselor’s attitude toward the client, reconsideration about counseling techniques and necessity for receiving supervision.

For those purposes mentioned above, a concrete counseling case is demostrated.

Counseling was done under supervision of the Japan Counseling center in Tokyo. The client is an eighteen-year-old boy who has been committed to the Urawa Juvenile Detention & Classification Home a couple of times.

The main points discussed by the author here in this paper are:

(1) the counselor’s attitude, especially his congruency and transparency. Because the counselors who work with such kind of Home, are compelled to play double roles, i. e. they have to work as a diagnostician and also therapist.

(2) importance of desirable client-centered responses. The author puts special emphasis on importance of understanding and clarifying the symbolic meanings which are realised through both flow of the client’s feelings and his verbalized responses, during counseling is done.

(3) reconsideration of the counselor’s schematic, stereotypic or formal responses and manners.

(4) significance of the client’s “experiencing”.

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本論文では, クライエントの心理状態を考慮し, 自然言語を用いて効果的なカウンセリングを行うシステムを提案する. カウンセリング理論において, クライエントの状態に適したカウンセリングを行うことは非常に重要である. そこで, システムにクライエントの状態を表現するクライエントモデルを導入する. そして, そのモデルの状態よりカウンセリングのタイプを表す最適なカウンセリング態度を判断し, 応答に反映させる. また, カウンセリング対象を交通問題に限定し, 交通に関するデータベースを作成することによりクライエントに的確な応答を与える.

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1. Two cases - 17 year-old high-school girls - were found suffering from repeated syncopie seizure. Both of these cases were medically diagnosed as free from detectable medical findings. 2. Author's study of their personality profile and social environment, such as domestic and class-mate relationship revealed some clues of interpretation. Case 1 is an adopted daughter. She temporality felt rather alienated in the family. Case 2 was over-protected. 3. The author counseled the first case, presented advice to the teacher and supervised the development. For the second case, the author counseled, by personal interview, the patient and mather as well as groups of her class-mates. The result was gratifying for both cases. The seizure ceased occurring and they could resume their school life, in a perfecthy normal way. 4. The success obviously owes to the cooperation odtained from the teachers, parents, and physicians. In order to cope with mental troubles of teen-age pupils with complex social backgrounds and mental enviroment, the organization of supportive efforts with full understanding and good-will from various sides is most important.

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According to Rogers' theory, self-acceptance is a goal of psychotherapy, and the real-ideal discrepancy is acriterion of adaptation. Self-acceptance is to change one' s view-point toward himself, and it is considered to be regulated by a real-ideal discrepancy together with self-consciousness. The main purpose of this study is to clarify the relationship between three variables. The research was enforced by handing a questionnaire to junior high school and college students:(1) SD self-concept scale for two self-images:‘like-self’ and ‘real-self’;(2) self-consciousness scale; and (3) self-acceptance scale. As a result, the grade differences of the mechanism for the relationship between a discrepancy, self-consciousness (sc) and self-acceptance, was examined. Jonior high school students showed that a discrepancy and PubSC had a negative effect, while PriSC had a positive one, and that there was an interaction effect between PriSC and PubSC. But college students were little affected concerning self-acceptance, and little difference between PubSC' and PriSC's effect was seen. Such result of college students suggested that self-acceptance concerned the factor except in cognitive self-images and self-consciousness.

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　本研究の目的は、看護における傾聴の概念が持つ特性を明らかにすることである。｢傾聴｣をタイトル、抄録に含む40文献をRodgersの手法を用いて概念分析を行い、属性、先行要件、帰結について検討した。その結果、傾聴の先行要件には、患者がストレスを抱えていること、看護師が傾聴の必要性を判断し環境を整えることが挙げられた。属性は、看護師が患者に共感し受容することであり、コミュニケーションの構成要素、ケアの基本として位置付けられていた。傾聴の帰結として、患者－看護師間の信頼関係構築により、患者の問題解決に向けた行動へと至ること、看護師は患者への理解が深まることで必要なケアの提供が可能となることが示された。さらに、看護師にとっては傾聴によりアイデンティティが強化される一方、患者の辛さや苦しさを傾聴することで、看護師が情緒的に巻き込まれる危険性があることが示唆された。

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 抄録 歯科臨床の経験のない第3学年後期の学生に対して, 傾聴技法を用いた初診時の医療面接をロールプレイで体験させる前に, 今回開発したワークシートを用いた演習を導入した. ワークシートは表形式を用いて作成したものをA3判横の用紙に印刷したものである. 横1行に, 左から (1) 病歴聴取の項目, (2) 歯科医師の質問, (3) 患者の回答, (4) 歯科医師の応答の4つの欄が設けられている. なお, (1) と (3) の文面はすでに印刷されており, (2) と (4) は空欄となっており, ここに学生が記入する. この1行を1つのユニットとして位置づけ, 34行の歯科医師の質問と患者の回答, 歯科医師の応答欄, それに要約を2カ所 (面接の途中と最後 : 会話番号なし) 設け, あわせて36行で初診時医療面接 (急性症状) の場面を記述するものである.

 本ワークシート開発の視点は以下の通りである.

 ①歯科診断学の専門知識をまだ習得していなくとも一応の質問作成は可能であること. すなわち, すでに提示されている患者の回答を引き出すための質問を考えるという方法によるためである.

 ②学生は医療面接の構造に沿った反応をしており, 医療面接の大きな流れを, 紙上ではあるが体験できるものであること.

 ③疾患を探る伝統的な診断法と, 患者の心理的体験を尊重しラポールを形成していく2つのアプローチの統合を目指す患者中心医療への導入となること.

 学生に本ワークシートを実施し分析した結果, 本ワークシートによる紙上応答訓練を行うことは有効であることが示された.

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Two questionnaires were administered to 125 male and 131 female senior high school students to investigate the influence of parental child-rearing attitudes on adolescent self-esteem. The results indicated that the influence of parental child-rearing attitudes on children's self-esteem depends on their sex. In males, only when the father strongly limited the autonomy of his son, the father's weak identification with his son was associated with the son's high self-esteem. In females, only when the mother identified with her daughter weakly, the mother's strong control was associated with the daughter's low self-esteem. These results were discussed from various points of view, such as the differences in functions and roles between the father and mother, and the psychological weaning that is a developmental task in adolescence.

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