Child and family therapy process: concordance of therapist and observational perspectives.
Child and family therapy process: concordance of therapist and observational perspectives.
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DOI：
10.1007/s10488-009-0251-x
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发表时间：
2010-05
影响因子：
2.6
通讯作者：
Brookman-Frazee, Lauren
中科院分区：
文献类型：
--
作者：
Hurlburt, Michael S.;Garland, Ann F.;Nguyen, Katherine;Brookman-Frazee, Lauren
本研究的目的是检验社区门诊诊所提供的门诊心理健康服务的特点，比较从两种不同来源获得的信息，服务儿童和家庭的治疗师，以及观察性编码员观看相同治疗过程的录像带。治疗师和独立编码员对每次治疗过程中的目标和策略进行了录像评估。记录了由11位治疗师为18名儿童及其护理人员提供的63次门诊护理。儿童年龄在4-13岁之间，家庭接受服务的部分原因是报告的儿童行为问题，由儿童行为检查表和康纳斯父母评定量表-修订版的评分证实。分析从治疗师和观察编码员的角度评估了治疗过程中目标和策略的频率、类型和强度。观察者评价的可靠性和治疗师和观察者报告之间的对应关系也被检查。目标和策略的观察编码的可靠性为中等至良好，39个编码中76%的ICCs为。5或更大。治疗师报告说，他们在每次治疗中追求的目标和策略平均是观察编码员所确定的目标和策略的2.5倍。治疗师和编码者在治疗过程中关于特定目标和策略的对应度很低，20.5%的编码者Kappa为。4或更高。治疗师和独立编码员在门诊治疗过程中报告的情况存在实质性差异。这两种观点都表明，社区门诊诊所提供的服务内容与基于证据的项目结构之间存在重大差异，后者强调在每次治疗过程中强烈追求少数目标和策略。研究结果对社区精神卫生保健机构质量改进工作的影响进行了讨论。
The objective of this study is to examine the characteristics of outpatient mental health services delivered in community-based outpatient clinics, comparing information obtained from two different sources, therapists serving children and families, and observational coders viewing tapes of the same treatment sessions. Videotaped therapy sessions were rated by therapists and independent coders regarding goals and strategies pursued during each session. Sixty-three sessions were taped of outpatient care provided to 18 children and their caregivers by 11 therapists. Children were 4–13 years old and families were receiving services at least in part due to reported child behavior problems, confirmed by ratings from the Child Behavior Checklist and Conners Parent Rating Scale—Revised. Analyses assessed the frequency, type, and intensity of goals and strategies pursued in therapy sessions from both therapist and observational coders’ perspectives. Reliability of observer ratings and correspondence between therapist and observer reports were also examined. The reliability of observational coding of goals and strategies was moderate to good, with 76% of 39 codes having ICCs of .5 or greater. Therapists reported pursuing 2.5 times more goals and strategies per session, on average, than identified by observational coders. Correspondence between therapists and coders about the occurrence of specific goals and strategies in treatment sessions was low, with 20.5% of codes having a Kappa of .4 or higher. Substantial differences exist in what therapists and independent coders report as occurring in outpatient treatment sessions. Both perspectives suggest major differences between the content of services provided in community-based outpatient clinics and the structure of evidence-based programs, which emphasize intense pursuit of a small number of goals and strategies in each treatment session. Implications of the findings for quality improvement efforts in community-based mental health care settings are discussed.
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影响因子：
22.4
作者：
CASEY, RJ;BERMAN, JS
通讯作者：
BERMAN, JS
影响因子：
2.5
作者：
Hogue, A;Liddle, HA;Samuolis, J
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通讯作者：
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通讯作者：
Azrin, ST
影响因子：
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作者：
Henggeler, SW;Melton, GB;Hanley, JH
通讯作者：
Hanley, JH