청소년 자살예방 심화 프로그램 개발

이귀숙; 김은영; 장은희

서지반출

국문초록

본 연구는 2008년 개발된 청소년자살예방교육 프로그램 ?높이 날아올라 새롭게?(지승희 등, 2008)의 개정 프로그램을 개발하기 위하여 수행되었다. 프로그램 개발과정은 김창대 등(2011)이 제한 절차모형에 따라 기획단계(목표수립→문헌연구→요구분석), 구성단계(모형개발→내용구성), 실시 및 평가단계(예비연구→평가 및 수정?보완→개발완료)의 모형이 적용되었다. 기획단계에서는 우선 국내?외의 자살예방 프로그램 및 자살관련 주요 변인에 관한 문헌분석 을 통해 우리나라 청소년의 자살예방교육에 관한 시사점을 도출하였다. 그리고 기존 청소년자 살예방교육 프로그램 ?높이 날아올라 새롭게?(지승희 등, 2008)에 대한 평가를 위하여 프로그 램에 참여한 청소년의 경험보고서(103부) 분석 및 프로그램 지도자 대상 설문조사(40부)를 실 시하여 프로그램의 유익한 점과 개선해야 할 점을 분석하였다. 또한 개정 프로그램 개발을 위 한 현장 요구조사로 청소년 8명 및 자살예방교육 지도자 5명을 대상으로 포커스그룹 인터뷰를 실시하여 청소년 자살예방교육의 필요성과 효과, 청소년 자살예방교육 시 필요한 내용과 적절 한 방법 등을 분석하여 결과를 도출하였다. 그리고 자살예방교육 지도자 222명을 대상으로 개 정 프로그램 개발 시에 고려되어야 할 내용, 진행방식, 방해요소 등에 관하여 설문조사를 실시 한 후 결과를 도출하였다. 구성단계에서는 문헌연구 및 요구분석 결과를 바탕으로 프로그램의 구성원리, 프로그램의 운 영원리를 도출한 후 프로그램의 주요내용을 도출하고 현장전문가와 학계전문가의 자문을 거쳐 프로그램을 구성하였다. 프로그램은 주요내용 및 진행은 도입단계(오리엔테이션 → 자살에 대 한 관심 환기). 전개 1단계(자살의 비합리성 인식, 나에게 일어날 수 있는 자살 위기상황 인 식), 전개 2단계(자살위기 상황에서의 인지, 정서, 행동, 관계적 특성 인식과 대처전략 학습), 강조단계(예시를 통한 적용), 마무리단계(소감문 작성)로 구성하였으며, 학급단위로 2회기에 걸 쳐 실시하도록 하였다. 실시 및 평가단계에서는 부산시에 소재한 중학교 2개교 및 고등학교 1개교 총 3개 학급의 94명을 대상으로 시범운영을 실시하였다. 이 때 환경적 조건이 유사한 통제집단으로 동일 학 교의 동일 학년 113명을 통제집단으로 선정하여 프로그램의 효과성을 검정하였다. 효과성 검 증은 자살위험성, 자살태도, 스트레스 대처방식의 사전-사후 점수에 대한 대응표본 t-검증을 통 하여 이루어졌다. 시범운영을 실시한 결과는 다음과 같다. 첫째, 본 프로그램은 청소년의 자살 위험성의 하위 영역 가운데 부정적 자기평가, 절망감을 유의미하게 감소시키는 것으로 나타났 다. 반면, 자살위험성 하위영역 가운데 적대감과 자살생각에 대해서는 유의미한 변화를 일으키 지 못하였다. 둘째, 본 프로그램은 청소년의 자살태도 하위영역 가운데 허용가능한 자살, 예측 가능한 자살, 예방 가능한 자살에 대한 태도에 유의미한 긍정적 변화를 준 것으로 나타났다. 반면, 자살태도 하위 영역 가운데 금기로서의 자살, 일반행동으로서의 자살에 대한 태도에는 유의미한 변화를 주지 못하는 것으로 나타났다. 셋째, 청소년의 스트레스 대처방식에는 총점 및 하위영역 모두에서 유의미한 변화를 주지 못하는 것으로 나타났다. 이상에서 본 프로그램은 청소년의 자살위험성 및 자살태도변화에 긍정적인 변화를 줄 수 있음이 입증되었다고 할 수 있다. 최종 프로그램은 시범운영 실시에 따른 통계결과와 참가자 피드백을 반영하여 수정 및 보완한 한 후 상담관련 학계 및 현장전문가 2인의 감수를 받아 완성되었다. 본 연구는 자살의 잠재 위험군이면서도 자살예방교육의 사각지대에 놓여있는 일반 청소년에게 자살의 위험성과 자살에 대한 태도에서 긍정적인 변화를 줄 수 있다는 점에서 연구의 의의를 가진다고 할 수 있다.

Ⅰ. 서 론·······················································································1
1. 연구의 목적과 필요성 ····································································1
2. 연구과제 ·······················································································3
Ⅱ. 이론적 배경·······················································································4
1. 자살의 정의 ··················································································4
2. 청소년 자살의 현황 ·······································································5
3. 청소년 자살의 특징 ·······································································9
4. 청소년의 자살에 영향을 미치는 요인 ············································12
가. 위험요인 ··············································································12
나. 보호요인 ··············································································22
5. 자살의 원인에 대한 이론적 모델 ··················································27
가. 사회-심리적 모델 ··································································28
나. 인지 행동적 모델 ··································································29
다. 통합적 모델 ··········································································31
6. 청소년 자살 예방에 대한 접근 ·····················································33
가. 인지행동적 접근 ···································································34
나. 현실치료적 접근 ···································································36
다. 마음챙김에 기반한(Mindfulness-Based) 접근 ····························38
라. 심리교육적 접근 ··································································40
7. 국내외 청소년 자살예방프로그램 ·················································42
가. 자살예방프로그램의 유형 ·······················································42
나. 국외 청소년 자살예방 프로그램 ··············································45
다. 국내 청소년 자살예방 프로그램 ··············································48
라. 국내외 청소년 자살예방 프로그램 고찰에 따른 시사점 ·············59
8. 선행연구를 통한 기존 자살예방프로그램의 개정의 시사점 ···············61
Ⅲ. 연구방법·······················································································66
1. 프로그램의 개발절차 모형 ····························································66
2. 프로그램 개발을 위한 사전조사 ····················································68
가. 문헌연구 결과분석 ································································68
나. 기존 ｢높이 날아올라 새롭게｣ 프로그램에 대한 평가 ················69
다. 프로그램 개발을 위한 현장요구 분석 ······································75
3. 프로그램의 구성 ··········································································93
가. 프로그램의 목표 ··································································93
나. 프로그램의 구성원리 ·····························································93
다. 프로그램의 운영원리 ·····························································94
라. 프로그램의 내용 ··································································95
4. 프로그램 시범운영을 통한 효과성 평가 ·······································97
가. 시범운영의 실행 ··································································97
나. 프로그램의 수정·보완 ·························································97
Ⅳ. 프로그램의 평가···································································98
1. 프로그램의 효과성 검증 ·····························································98
가. 연구설계 ··············································································98
나. 연구방법 ··············································································98
다. 연구결과 ············································································100
2. 프로그램 참가자 만족도 및 평가의견 ··········································105
Ⅴ. 요약 및 논의········································································107
●참고문헌·······················································································112
●부록·······················································································145
1. 현장전문가 대상 포커스그룹 인터뷰 질문지 ·································149
2. 청소년 대상 포커스그룹 인터뷰 질문지 ·······································150
3. 현장전문가 대상 요구조사 설문지 ···············································151
4. 청소년용 자살태도 척도 ·····························································156
5. 청소년용 자살위험성 척도 ··························································158
6. 청소년용 스트레스 대처방식 척도 ···············································160
●Abstract·······················································································162

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