中華心理衛生協會

 Purpose: Taiwan's population is aging at an extremely fast rate, and a great number of families are faced with long-term care needs. Many Taiwanese adult children hire foreign caregivers to take over their responsibility for caring for their older parents. However, this phenomenon has provoked widespread concern about how these employers establish mutual trust and cooperate with their foreign caregivers. With high filial anxiety, many employers distrust foreign caregivers' abilities. As a result, they overly control foreign caregivers' jobs and cannot tolerate any mistake. This behavior not only makes the foreign caregiver feel restricted, but also exhausts employers themselves. We assumed that an employer's controlling behavior reflects the characteristics of perfectionism, filial anxiety, and cognitive distrust. Based on rational-emotive behavior therapy and psychological displacement writing, we designed a learning program to address these employers' irrational ideas. We hypothesized that no matter at the end stage of the learning program or 3 weeks afterwards, this program would be able to decrease employers' over-controlling behaviors, perfectionism, and filial anxiety. We also expected this program would be able to effectively assist participants in boosting their trust of their foreign caregivers. Methods: We targeted employers who overly controlled their foreign caregivers as participants. All participants took part in a 3-week learning program online. The first week, participants focused on a recent negative care experience. Through case guidance and intervention activities, this stage helped participants to detect and reflect on their intrinsic thinking that had aroused the negative emotions. In the second week, participants engaged in role-playing to separate themselves from their original positions. They were then asked to follow the cues to identify the irrational ideas in their replies from the first week. Next, participants tried to take the perspective of the opposing party, and reflected on their initial irrational beliefs by focusing on 3 aspects (rationality, reality, and emotion). In the third week, the participants examined the ins and outs of their negative experience macroscopically. This stage guided participants in thinking about other factors (aside from the negligence and laziness of foreign caregivers) that might have caused the negative event. By weakening the link between the negative experience and the foreign caregiver, this stage helped participants to adjust their initial over-simplified thinking and build trust with their foreign caregivers. The learning program lasted for 2 months, including a pretest, three-week learning program, posttest, and follow-up test (taken three weeks after the posttest). A total of 15 adults who were the primary caregivers for their older parents took part in the learning program, and 9 of them completed it. Results: We examined the differences between the pretest and posttest scores, and between the pretest and follow-up scores. The learning program significantly reduced participants' tendency to over-control their foreign caregivers and their filial anxiety when they interacted with their foreign caregivers. The score of the follow-up test also showed that the learning program could help participants improve their cognitive trust of their foreign caregivers and it decreased their perfectionism ideology regarding care for their parents. Conclusions: A learning program combining rational-emotive behavior therapy and psychological displacement writing is feasible. It is worthy to be promoted and applied in the future.