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破茧·重生——家长拒医下一位复杂创伤女童的整合式心理辅导实践与生命守护

Cocoon-Breaking and Rebirth: Integrated Psychological Counseling Practice and Life Protection for a Complexly Traumatized Girl Under Parental Refusal of Medical Treatment

Theory and Practice of Psychological Counseling / 2025,7(8): 540-547 / 2025-09-08 15 11

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• Authors: 孙宗明
• Information:

  砀山师范附属小学，宿州

• Keywords:
  Complex childhood trauma; Suicide crisis intervention; Home-school collaboration; Sandplay therapy; School safety net; Ethical decision - making
  复杂性童年创伤; 自杀危机干预; 家校协同; 沙盘治疗; 校园安全网; 伦理决策
• Abstract: This case involves the intervention of a high-risk psychological crisis concerning an 11-yearold fifth-grade girl, “Jiajia” (pseudonym). The situation was complicated by her parents’ refusal to seek medical treatment while insisting on sending her to school daily. Jiajia presented with moderate depression (PHQ-9 = 17), knife-related self-harm behavior, and a clear suicide plan (clinically rated as level 7). Using the school as the primary intervention setting, the counselor employed sandplay therapy, the LECARA crisis model, emotional stabilization techniques, and strategic home-school communication, successfully resolving the immediate knife crisis and reducing her PHQ-9 score to 9. A key measure was preventing her return to the original boarding environment associated with trauma. This case offers a replicable reference for schools independently managing extremely high-risk cases without access to medical support. 本案涉及一名11岁五年级女生“佳佳”（化名）的高危心理危机干预。个案面临家长拒医却每日送校的困境，佳佳当时存在中度抑郁（PHQ-9=17分）、持刀自伤及明确自杀计划（临床7级）。辅导师以校园为主要干预场所，借助沙盘疗法、LECARA危机模型、情绪稳定技术及策略性家校沟通，成功解除持刀危机，PHQ-9分数降至9分。关键举措是避免其返回原寄宿创伤环境。本案例为无法获得医疗支持时，校园独立处置极高危个案提供了可复制的参考。
• DOI: https://doi.org/10.35534/tppc.0708060
• Cite: 孙宗明. (2025). 破茧·重生——家长拒医下一位复杂创伤女童的整合式心理辅导实践与生命守护. 心理咨询理论与实践, 7(8), 540-547.