A Mixed-Methods Study of Clinician Adaptations to Parent-Child Interaction Therapy - What about Culture?
A Mixed-Methods Study of Clinician Adaptations to Parent-Child Interaction Therapy - What about Culture?
复制标题
临床医生对亲子互动治疗适应的混合方法研究——文化怎么样？
DOI：
10.1080/23794925.2022.2070883
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Barnett,MiyaL
中科院分区：
文献类型：
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作者：
LuisSanchez,BErika;Klein,CorinnaC;Corcoran,Frederique;Barnett,MiyaL
亲子互动疗法（PCIT）是一种针对具有挑战性行为的幼儿的循证实践（EBP）。PCIT已适应于治疗不同的介绍和文化多样的家庭。虽然已作出努力，传播PCIT到社区环境，往往服务于临床复杂，社会文化多样性，边缘化社区，传播适应模型的障碍仍然存在。了解如何增加获得适当适应的PCIT的另一种策略是从社区临床医生的实践为基础的适应，以满足其客户的临床表现，文化和语言相关的不同需求。这项混合方法研究调查了社区临床医生对PCIT的适应。通过PCIT列表服务器招募临床医生（N= 314），以完成收集背景信息和PCIT适应性的调查。大多数临床医生拥有硕士学位（72.1%），有执照（74.2%），并获得PCIT认证（70.7%）。定性访谈进行了有目的的样本23个社区临床医生，谁是39%的西班牙语，是30%的拉丁裔，和30%的报告服务≥50%的拉丁裔客户。临床医生报告说，与涉及去除核心组件的适应性调整相比，参与旨在增强PCIT的适应性调整更广泛。定性访谈的主题与定量研究结果相融合，临床医生最常描述增强适应，并强调适应PCIT的原因。临床医生主要加强治疗，以解决客户的临床表现。临床医生很少专门针对文化调整治疗，但当提到时，临床医生讨论了为讲西班牙语的客户定制习语和短语以匹配客户的文化。培训PCIT临床医生干预适应的影响将进行讨论。
Parent-Child Interaction Therapy (PCIT) is an evidence-based practice (EBP) for young children with challenging behaviors. PCIT has been adapted to treat varying presentations and culturally diverse families. Although efforts have been made to disseminate PCIT into community settings, which often serve clinically complex, socio-culturally diverse, and marginalized communities, barriers to disseminating adapted models remain. An alternative strategy to understanding how to increase access to appropriately adapted PCIT is to learn from community clinicians’ practice-based adaptations to meet their clients’ diverse needs related to clinical presentation, culture, and language. This mixed-method study investigated community clinician adaptations of PCIT. Clinicians (N= 314) were recruited via PCIT listservs to complete a survey collecting background information, and adaptations to PCIT. Most clinicians had a master’s degree (72.1%), were licensed (74.2%), and were PCIT-certified (70.7%). Qualitative interviews were conducted with a purposeful sample of 23 community clinicians, who were 39% Spanish-speaking, were 30% Latinx, and 30% reported serving a ≥50% Latinx clientele. Clinicians reported engaging in adaptations aimed at augmenting PCIT more extensively than adaptations involving removing core components. Themes from qualitative interviews converged with quantitative findings, with clinicians most frequently describing augmenting adaptations, and highlighted reasons for adapting PCIT. Clinicians primarily augmented treatment to address clients’ clinical presentations. Clinicians rarely adapted treatment specifically for culture, but when mentioned, clinicians discussed tailoring idioms and phrases to match clients’ culture for Spanish-speaking clients. Implications for training PCIT clinicians in intervention adaptations will be discussed.