研究目的：2021年5月全國學校因COVID-19三級防疫停課，臨床心理師發起與台北市教育局合辦「兒青心理諮商免付費專線」，希望能對台北市國高中生與家長在疫情下的壓力與焦慮提供服務。本研究以「科學家-實務者」的內涵，將專線的實施過程與效果展現，以供未來類似專線的參考。研究方法：藉由行動研究探討此專線供需失衡問題、經由反思、修正、觀察、評鑑、再修正的循環歷程論述之。研究結果：供需率獲得改善，以評量表的結果分析，不論初次或追蹤會談都呈現來電者前後壓力評值明顯的下降。經由專線諮商，發現促進家長親子溝通與教養技巧等對孩子情緒行為有正向的影響。參與的臨床心理師不僅學習自身的專業如何於電話諮商的脈絡中實踐，其親身參與的經驗也是本研究的收穫。研究結論：運用行動研究探討專線供需失衡問題，最終問題改善，且提供了三級防疫下青少年家庭心理健康服務的空窗照顧，達成預防青少年及其家庭精神健康危機的效果。

 Purpose: Schools across Taiwan suspended classes during the level 3 alert of the COVID-19 pandemic and mental health services at health facilities were reduced. A group of 33 licensed clinical psychologists co-organized a toll-free counseling line for youth and their parents in cooperation with the Education Bureau of the Taipei city government to provide services to relieve students' stress and anxiety during the pandemic. The purpose of this article is to document the level of need for this service and its implementation process, and to investigate the impact of the service from a scientist-practitioner perspective as a reference for similar toll-free lines in the future. Methods: The 33 clinical psychologists counselled and interviewed callers using a questionnaire and entered the information into a google form. The questions concerned age, gender, chief complaint, parent-child interaction, characteristics of the child/youth, and the relationship between the child's emotional or behavioral disturbances and the pandemic. Before and after this conversation, they asked callers to indicate from 0 to 10 their level of stress with regard to their chief complaint. After the initial stage of hotline implementation, it became clear that the number of clinical psychologists providing services was more than needed for the number of callers. We explored the supply-demand imbalance using the action research technique of discussion through a cycle of reflection, correction, observation, evaluation, and re-correction. Results: The psychologists responded to 103 calls with complete consultation records. Of these, 33 were youth, 39 were parents, and the remainder were teachers or other adults. Forty-three were repeat callers; 18 had 2 conversations, and 25 had 3 or more conversations. According to mean difference tests, both initial and follow-up interviews showed a significant decrease in the stress evaluation rating provided before and after a given interview. Examination of changes in parent-related factors such as parenting distress, lack of confidence, and difficulty setting boundaries suggested that telephone consultation can promote parent-child communication and parenting skills. Three adolescents' had extended episodes requiring repeated follow-up care to stabilize them. They were eventually referred to a community psychotherapy center or their school's services. We addressed the supply-demand ratio for the hotline using action research techniques. Initially, the hotline used a landline that could not accept calls from cell phones. Lack of privacy prevented teens from using the hotline at home, and some parents resisted access to counseling resources. We added Skype access and invited teachers to consult the hotline before referring parents. We also reduced the number of psychologists on call to 1 per shift. The psychologists reported that they learned how to adapt their practice to the context of telephone consultation in which they have no visual cues to guide their responses; they learned to increase their attention to audio cues such as the caller's tone of voice, intonation, or delay in response in order to assess the caller's emotional state. Most of the psychologists (85%) expressed that this experience was helpful to their professional abilities. Conclusions: This project provided mental health services for teenage students and their families. It was effective in reducing perceived stress and improving parent-child communication, which can have a positive effect on children's emotional behavior, and may have prevented mental health crises for some adolescents. Participating psychologists also found the program to be professionally beneficial. Action research indicated ways to improve the service and balance supply and demand for this hotline.

COVID-19疫情 ； 兒童青少年熱線 ； 行動研究

COVID-19 pandemic ； youth hotline ； action research ； counseling