本研究主要探討憂鬱症患者於引導想像音樂治療之改變歷程，以歷程研究之重要事件法進行，採立意取樣，以南部某醫學中心門診之憂鬱症患者為研究對象，共五位個案參與，過程中邀請一位治療師進行每位個案八次的音樂療程，而研究者除在現場進行觀察外，並於每次治療後24-48小時內進行電話訪談且予以錄音並將內容轉為逐字稿。資料分析則以Mahrer和Boulet所建議之重要事件的九個步驟進行。本研究結果歸納出事件主題、引發原因、事件內容、研究者觀察及後續引發衝擊，最後加以整合並呈現個案改變歷程。過程中共55件重要事件，其中53件（96.4%）發生於想像經驗段落，出現時間在治療中音樂想像期。引發原因則包括四個因素，分別為音樂、個人、治療師及環境因素，重要事件的出現多為上述因素共同影響，其中以音樂因素影響最大。內容部分多呈現與生活經驗或困擾的相關畫面，包括自然景象、過往回憶與經驗、聆聽感受、身體感覺、超乎現實場景等。後續引發衝擊則有十項，包括感受身體放鬆的新體驗、更認清問題困擾所在、宣洩積壓內心的負向情感、增加個人對自我的覺察、獲得對生活處境的新體悟、激發負面反應影響生活、在生活中表現新的正向行為、轉換正向情感表露、計畫未來目標或生活藍圖、肯定治療的協助與支持等。最後整合五位個案在音樂治療改變歷程主軸為藉由引發原因觸發有意義的想像畫面，經此畫面內容引發全身放鬆新體驗並認清當前現實困擾，可能合併宣洩內在負向情感或負向衝擊的影響，隨之增加對個人自我的覺察，進而在生活中落實新正向行為或對生活處境產生新體悟並轉換正向情感表露，最後可規劃未來生活目標。本研究初步呈現憂鬱症患者於引導想像音樂治療的改變歷程，期作為未來相關臨床實務或相關研究參考。

　　The purpose of this study is to explore the change process of the patient with depression in the Guided Imagery and Music (GIM) therapy. The study is conducted by the application of the method of important events in the Process Research and using the convenience sampling priniple recrit depression patients referred from a medical center in southern Taiwan. A total of eight sessions of GIM therapy is conducted with all of the five clients in this study. The researcher invited a therapist to conduct the GIM therapy sessions, and observed and taked notes in every session, and then administers a telephone interview within 24 to 48 hours after each session. The interviews are tape-recorded and transcribed as a verbatim; the researcher according to the nine-step method developed by Mahrer & Boulet（1999）analyzed the transcriptions. The result is categorized into event topics, causes triggering the events, contents of the events, researcher’s observation, and the therapeutic impacts on the client, which is integrated to present the change process of the individual client. There are total of 55 events, among which 53 events (96.4%) are defined and most of them occurred in the imagery stage in the GIM therapy. The causes triggering the events include four factors: music, individual, therapist and the environment factors. The events are triggered by a combination of these factors, and the music factor in particular. The contents of the events are mostly imagery relevant to life experiences or psychological disturance, such as natural sceneries, bygone memories and experiences, feelings evoked by listening to the music, physical responses, and surreal imagery. The therapeutic impacts on the client were inducted ten themes: sensing a new experience of relaxation, realizing the source of disturance, relieving the negative feelings, facilitating self-awareness, obtaining new insight of life, stirring up negative response that can affect life, demonstrating new and positive behavior, expressing positive feeling, planning future target or blueprint for life, and affirming the assistance of the therapy.
　　To integrate the five clients’ change process in continous music therapy is through a series of chain reaction. First, a meaningful imagery is triggered by some specific factors. Then, the contents of the imagey lead to a new experience of relaxation in the body and more realize source of disturance for individual, which may be accompanied by expressing negative feelings and resulting in negative impacts. Consequently, one can facilitate his self-awareness, implement new positive behaviors, express his feelings in a positive way, and eventually plan his goal for the future.This study appears the application of the GIM in the patients with depression and builds a framework for change process with the hope of providing information for the related clinical studies or researches in the future.

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