Therapist adaptations to evidence-based practices and associations with implementation outcomes in child therapy sessions.
Therapist adaptations to evidence-based practices and associations with implementation outcomes in child therapy sessions.
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DOI：
10.1037/ccp0000667
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发表时间：
2022-01
影响因子：
5.9
通讯作者：
Lau AS
中科院分区：
文献类型：
--
作者：
Yu SH;Brookman-Frazee L;Kim JJ;Barnett ML;Wright B;Lau AS
社区治疗师不可避免地采用循证实践（ebp）来满足他们的客户和实践环境的需求。然而，自发的、治疗师驱动的适应对EBP实施结果的影响尚未得到很好的理解。我们采用了顺序全量→等量混合方法设计来检验不同类型的治疗师描述的适应性如何与观察者评价的治疗师在会话水平上提供EBP内容和技术策略的广泛性相关。数据来自一项观察性研究，该研究是由系统驱动的多个ebp在公共儿童心理健康服务中的实施。社区治疗师（n = 103）描述了他们在273名来访者（50.92%为女性，49.08%为男性，年龄9.72岁，70.70%为西班牙裔/拉丁裔）的680次治疗中做出的适应。编码员将治疗师描述的适应分为五种类型：1)修改表现，2)整合，3)扩展，4)减少和5)概括。独立观察员使用EBP和谐护理评估（ECCA）观察编码系统对会话记录中EBP策略交付的广泛性进行评分。使用多水平回归的定量分析表明，修改表示适应与EBP技术交付的广泛性相关，而扩展适应与EBP内容和技术交付的广泛性相关。对适应描述的定性分析确定了定量结果的解释。研究结果表明，与广泛性较高相关的修改型演示适应包括创造性地使用活动和材料、语言修改和个性化EBP内容以满足客户的多样化需求，而与广泛性较低相关的扩展型适应包括减缓EBP节奏以应对客户的挑战。讨论了对提供者培训的影响。
Community therapists inevitably adapt evidence-based practices (EBPs) to meet the needs of their clients and practice settings. Yet, the implications of spontaneous, therapist-driven adaptations for EBP implementation outcomes are not well understood. We used a sequential QUAN→qual mixed methods design to examine how different types of therapist-described adaptations were associated with observer-rated extensiveness of therapist delivery of EBP content and technique strategies at the session-level. Data were drawn from an observational study of a system-driven implementation of multiple EBPs into public children’s mental health services. Community therapists (n = 103) described adaptations they made in 680 sessions with 273 clients (50.92% female, 49.08% male, Mage = 9.72 years, 70.70% Hispanic/Latinx). Coders classified therapist-described adaptations into five types: 1) Modifying Presentation, 2) Integrating, 3) Extending, 4) Reducing, and 5) Generalizing. Independent observers rated the extensiveness of EBP strategy delivery from session recordings using the EBP Concordant Care Assessment [ECCA] Observational Coding System. Quantitative analyses using multilevel regression revealed that Modifying Presentation adaptations were associated with higher extensiveness of EBP technique delivery, whereas Extending adaptations were associated with lower extensiveness of EBP content and technique delivery. Qualitative analysis of adaptation descriptions identified explanations for the quantitative findings. Findings suggest that Modifying Presentation adaptations, associated with higher extensiveness, involved creative use of activities and materials, language modification, and personalization of EBP content to meet clients’ diverse needs, whereas Extending adaptations, associated with lower extensiveness, involved slowing EBP pacing in response to client challenges. Implications for provider training are discussed.
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影响因子：
3.5
作者：
Elliott, DS;Mihalic, S
通讯作者：
Mihalic, S
DOI：
10.1080/15374416.2018.1485107
发表时间：
2019-11-02
影响因子：
4.2
作者：
Barnett, Miya L.;Brookman-Frazee, Lauren;Lau, Anna S.
通讯作者：
Lau, Anna S.
DOI：
10.1023/b:mhsr.0000024351.12294.65
发表时间：
2004-06-01
期刊：
Mental health services research
影响因子：
--
作者：
Aarons, Gregory A
通讯作者：
Aarons, Gregory A
DOI：
10.1007/s10488-020-01054-x
发表时间：
2021-01
期刊：
Administration and policy in mental health
影响因子：
--
作者：
Brookman-Frazee L;Stadnick NA;Lind T;Roesch S;Terrones L;Barnett ML;Regan J;Kennedy CA;F Garland A;Lau AS
通讯作者：
Lau AS
推进适应文化的预防干预措施的方向：当地适应、参与和可持续性
影响因子：
3.5
作者：
Barrera, Manuel, Jr.;Berkel, Cady;Castro, Felipe Gonzalez
通讯作者：
Castro, Felipe Gonzalez