감각운동심리치료 기반 집단미술치료가 가정폭력 피해 여성의 심리 및 생리적 변화에 미치는 영향

다국어 초록 (Multilingual Abstract)

Intimate partner violence is typically chronic and repetitive, exposing women to sustained physical and psychological harm (Hoff, 1990). The central therapeutic task in trauma recovery is the integration of dissociated implicit and explicit memories and the regulation of chronic hyperarousal (Kim Na-young, 2010). In line with a recent paradigm shift in psychotherapy that emphasizes embodied experience and sensation over purely language-based approaches, this study examined a sensorimotor psychotherapy–based group art therapy program for women who have experienced domestic violence—a modality that has rarely been investigated empirically.
This study employed a sequential mixed-methods design to evaluate the psychological and physiological effects of the intervention. Quantitatively, the program’s effectiveness was tested by assessing posttraumatic stress symptoms, emotion dysregulation, body awareness, and depression, in order to determine whether sensorimotor psychotherapy–based group art therapy improved participants’ subjective psychological state. In parallel, objective physiological indices—salivary cortisol, DHEA, and autonomic nervous system indicators—were measured to identify changes at the neurophysiological level, including sympathetic and parasympathetic activity and heart rate variability.
Participants were 13 adult women residing in a shelter for survivors of domestic violence. They received 12 weekly group sessions (120 minutes each) of sensorimotor psychotherapy–based art therapy. Quantitative results showed that posttraumatic stress scores decreased from a pretest mean of 39.23 to a posttest mean of 30.00 (Δ = −9.23), indicating a statistically significant reduction. Depressive symptoms decreased from 40.69 to 31.15 (Δ = −9.54), emotion dysregulation from 106.54 to 82.38 (Δ = −24.16), and body awareness increased from 116.69 to 136.15 (Δ = +19.46), reflecting substantial improvements in emotional regulation and embodied
self-awareness. Physiologically, the intervention was associated with decreased salivary cortisol, increased DHEA, reductions in autonomic stress indices and sympathetic activation, increased parasympathetic activation, and enhanced heart rate variability, suggesting improved stress regulation at the neurophysiological level.
On the basis of quantitative outcomes, two high-response and two low-response cases were selected through extreme-case sampling for in-depth qualitative analysis. Using a six-step thematic analysis, the following themes emerged. In the high-response group, themes included:
“Recovery of the body: from silence to giving bodily experience a language,” “Finding meaning through reconciliation and reconstruction of the past,” “Being recognized despite difficulty in emotional expression,” and “Becoming a new self.” In the low-response group, themes were:
“Understanding with the head while blocking the body,” “A time when the past is cognitively acceptable but not integrated into the present,” “Resistance and a sense of impossibility,” and “Returning to unfulfilled longing and repetition.”
Qualitative findings indicated that high-response participants clearly perceived and remained with their bodily sensations, and, through these sensations, were able to access traumatic memories and associated emotions. Within a safe and attuned relationship with the therapist and group members, they reinterpreted past trauma from the vantage point of the present and experienced a sense of rebirth as a more autonomous self. In contrast, low-response participants tended to immediately block or prematurely exit bodily sensations, oscillating between approach and avoidance, and relied heavily on cognitive control rather than embodied experience, which limited integration.
Overall, the study demonstrates that sensorimotor psychotherapy–based group art therapy can be an effective intervention for trauma recovery among women exposed to domestic violence, yielding both psychological symptom reduction and measurable physiological regulation. By combining a bottom-up, body-based approach with the symbolic and relational dimensions of art therapy, the program supported the safe integration of traumatic memories within the window of tolerance. Academically, this study is significant in that it proposes a theoretically integrated model bridging sensorimotor psychotherapy and group art therapy, and it evaluates treatment effectiveness multidimensionally—across bodily, emotional, and cognitive domains—through the concurrent use of psychological and physiological measures.

Key words : Domestic Violence Survivors, Sensorimotor Psychotherapy, Group Art Therapy, Trauma, Mixed Methods Research, Physiological Indicators

목차 (Table of Contents)

• 목 차 ⅰ
• 표 목 차 ⅴ
• 그림목차 ⅶ
• Ⅰ. 서 론 1
• 1. 연구의 필요성 1
• 2. 연구의 목적 6
• 3. 연구 문제 7
• 4. 용어 정의 9
• Ⅱ. 이론적 배경 12
• 1. 가정폭력 피해 여성의 심리 및 생리적 특성 12
• 1) 가정폭력 피해 여성 선행 연구 15
• 2. 감각운동 심리치료 19
• 1) 감각운동 심리치료 개념 19
• 2) 감각운동 심리치료의 기술 20
• 3) 감각운동 심리치료의 치료적 세 단계 26
• 4) 감각운동 심리치료 선행 연구 28
• 3. 트라우마와 신체감각 32
• 1) 트라우마와 신체감각 치료 선행 연구 35
• 4. 스트레스 호르몬 39
• 1) 스트레스 호르몬 선행 연구 42
• 5. 선행연구 종합 및 본 연구의 차별성 45
• 6. 집단미술치료 47
• 7. 혼합연구방법 51
• Ⅲ. 연구 방법 55
• 1. 연구 설계 55
• 2. 연구의 윤리적 고려 57
• 3. 양적 연구 방법 58
• 1) 연구 참여자 선정 요건 및 포함기준 58
• 2) 양적 연구 설계 59
• 3) 집단미술치료 프로그램 61
• 4) 측정 도구 65
• (1) 심리적 측정 도구 65
• ① 외상 후 스트레스 척도(PDS) 65
• ② 정서조절 곤란 척도(K-DERS) 66
• ③ 한국판 다차원 신체 자각 척도(K-MAIA) 68
• ④ 우울 척도(BDI) 69
• (2) 생리적 측정 도구 70
• ① Cortisol 71
• ② DHEA 71
• ③ 자율신경계 72
• 5) 자료 수집 73
• 6) 자료 분석 73
• 4. 질적 연구 방법 75
• 1) 질적 사례연구 75
• 2) 자료 수집 76
• 3) 자료 분석 78
• Ⅳ. 연구 결과 80
• 1. 양적 자료 분석 결과 80
• 1) 연구 대상자의 인구 통계학적 특성 80
• 2) 연구 대상자의 가정 폭력 및 쉼터 입소 관련 특성 82
• 3) 심리적 척도 검증 결과 83
• (1) 외상 후 스트레스 검증 결과 83
• (2) 정서조절 곤란 검증 결과 84
• (3) 다차원 신체 자각 검증 결과 85
• (4) 우울 검증 결과 87
• 4) 생리적 척도 검증 결과 88
• (1) Cortisol에 대한 효과 검증 88
• (2) DHEA 호르몬에 대한 효과 검증 88
• (3) 자율신경계에 대한 효과 검증 89
• (4) Cortisol과 DHEA 호르몬의 상관관계 92
• 2. 질적 자료 분석 결과 93
• 1) 고효과 군 사례 분석 결과 93
• 2) 저효과 군 사례 분석 결과 125
• 3) 집단 간 비교 분석 148
• Ⅴ. 고 찰 150
• Ⅵ. 결 론 및 제 언 163
• 1. 결 론 163
• 2. 연구의 제한점 164
• 3. 후속 연구 제언 166
• 참 고 문 헌 168
• 영 문 초 록 197
• 부 록 201
• 감 사 의 글 209