Working Alliance and Treatment Fidelity as Predictors of Externalizing Problem Behaviors in Parent Management Training
Working Alliance and Treatment Fidelity as Predictors of Externalizing Problem Behaviors in Parent Management Training
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DOI：
10.1037/a0033825
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发表时间：
2013-12-01
影响因子：
5.9
通讯作者：
Ogden, Terje
中科院分区：
文献类型：
--
作者：
Hukkelberg, Silje S.;Ogden, Terje
目的：该研究调查了治疗的忠诚度和工作联盟的父母管理培训俄勒冈州模型（PMTO），并调查了这些如何与儿童的外化问题行为，报告的父母和教师。方法：参与者是331名挪威父母，他们在3个时间点（第3、12和20次会议）对客户-治疗师工作联盟进行了评价。PMTO专家使用实施保真度（Fidelity of Implementation，FIMP）系统（Knutson，Forgatch，& Rains，2003）对录像治疗过程进行评估，以评估对PMTO治疗方案的合格依从性。父母和老师在基线和治疗结束时报告儿童的问题行为。采用结构方程模型对重复测量数据进行分析。结果如下：父母报告的联盟和忠诚度从时间1到时间3的高和稳定的水平，2之间没有相关或直接的关系。治疗忠诚度预测减少父母报告的外化行为，而工作联盟与问题行为的变化较小。联盟和忠诚是无关的教师报告的行为问题。结论：研究结果指出，治疗的忠诚度作为一个积极的成分，在PMTO和工作联盟作为一个负面的预测评估后，父母报告的外化行为。需要更多的研究来调查这些发现是否可以复制和扩展到PMTO之外。
Objective: The study investigated treatment fidelity and working alliance in the Parent Management Training-Oregon model (PMTO) and investigated how these relate to children's externalizing problem behaviors, as reported by parents and teachers. Method: Participants were 331 Norwegian parents who rated the client-therapist working alliance at 3 time points (Sessions 3, 12, and 20). Competent adherence to the PMTO treatment protocol was assessed by PMTO specialists from evaluations of videotaped therapy sessions using the Fidelity of Implementation (FIMP) system (Knutson, Forgatch, & Rains, 2003). Parents and teachers reported children's problem behaviors at baseline and at the end of therapy. Structural equation modeling was used to analyze the repeated measures data. Results: Parents reported high and stable levels of alliance and fidelity from Time 1 to Time 3, with no correlational or direct relations between the 2. Treatment fidelity predicted reductions in parent-reported externalizing behavior, whereas working alliance was related to less change in problem behavior. Alliance and fidelity were unrelated to teacher-reported behavior problems. Conclusions: The findings point to treatment fidelity as an active ingredient in PMTO and working alliance as a negative predictor of postassessment parent-reported externalizing behavior. More research is needed to investigate whether these findings can be replicated and extended beyond PMTO.