나일락(樂) 프로그램(아동청소년의 자해예방을 위한 초단기간 변증법적 행동치료 기술 훈련)의 나이, 성별, 자해 경험 여부, 프로그램 시행 방법에 따른 효과성 분석 = Effectiveness Analysis of School-Based Self-Harm Prevention Program for Children and Adolescent Using Brief Dialectical Behavior Therapy Skills Training: Based on Age, Sex, Self-Harm History and Program Implementation Methods

국문 초록 (Abstract)

연구목적본 연구는 나일락(樂)프로그램(아동청소년의 자해 예방을 위한 학교 기반의 초단기간 변증법적 행동치료 기술훈련)이 나이, 성별, 자해 경험 여부, 프로그램 시행 방법에 따라 그 효과성을 나타내는지 검증해보고자 하였다.
방 법본 연구는 2021년 9월부터 2023년 12월 말까지 충청지역 초등학생과 중학생 1012명을 대상으로 수행되었다.
나이, 성별, 자해 경험 여부, 프로그램 시행 방법에 따라 나일락(樂) 프로그램 전후에 우울감에 대한 반응양식(이하 RDQ)과 정서조절곤란 척도-16 (이하 DERS-16), 미래 자해 가능성의 변화를 분석하여 비교하였다.
결 과전체 대상자들은 프로그램 전후 ‘반추(RDQ)’(t=10.49, p＜0.001), ‘역채점 주의전환(RDQ)’(t=10.67, p＜0.001), 전체 DERS-16척도(t=5,56, p＜0.001)가 감소하였고, ‘미래 자해 가능성’도 감소하였다(t=4.26, p＜0.001). 초등학생, 중학생 모두에서 반추(RDQ)와 주의전환(RDQ)은 감소하였지만, DERS-16와 대부분의 하위척도가 중학생에서만 감소하였다. 성별, 자해 경험 여부, 프로그램 시행 방법에 관계없이 반추(RDQ)와 주의전환(RDQ), 전체 DERS-16와 대부분의 하위척도가 감소하였다.
결 론나일락(樂) 프로그램은 학교 기반의 1차 예방 프로그램으로서 아동청소년의 자해 예방에 효과가 있을 것으로 보인다

다국어 초록 (Multilingual Abstract)

Objectives：This study aims to confirm the effectiveness of a school-based very-short-term dialectical be havior therapy-skills training (DBT-ST) program for preventing self-harm among children and adoles cents, considering factors such as age, sex, self-harm history, and methods of program implementation.
Methods：The study was conducted from September 2021 to December 2023, targeting 1,012 elementary and middle school students in the Chungcheong region. Changes in responses to the Depressed Mood Questionnaire (RDQ), the Difficulties in Emotion Regulation Scale-16 (DERS-16), ‘future self-harm possibility’ scores were analyzed and compared before and after the program, based on age, sex, self-harm history, and methods of pro gram implementation.
Results：Overall, participants showed a decrease in the ‘rumination(RDQ) scale’ (t=10.49, p<0.001), ‘reverse scored distraction (RDQ)’ (t=10.67, p<0.001) and the total DERS-16 (t=5.56, p<0.001) as well as a decrease in ‘future self-harm possibility’ score (t=4.26, p<0.001). Both elementary and middle school students showed de crease in ’rumination (RDQ)’ and distraction (RDQ), but only middle school students showed a decrease in the DERS-16 and most sub-scales. Regardless of sex, self-harm history, or methods of program implementation, a decrease in ’rumination (RDQ)’, distraction (RDQ) and the total DERS-16 scale and most sub-scales decreased.
Conclusions：Our program appears to be effective as a primary prevention program for preventing self-harm among children and adolescents in a school setting

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