Evaluating Supervision Models in Functional Family Therapy: Does Adding Observation Enhance Outcomes?
Evaluating Supervision Models in Functional Family Therapy: Does Adding Observation Enhance Outcomes?
复制标题
DOI：
10.1111/famp.12399
复制
发表时间：
2019-12-01
期刊：
影响因子：
3.9
通讯作者：
Ozechowski, Timothy
中科院分区：
文献类型：
--
作者：
Robbins, Michael S.;Waldron, Holly Barrett;Ozechowski, Timothy
本研究考察了基于观察的监督与基于观察的监督治疗（BOOST治疗师= 26，家庭= 105）与常规监督（SAU治疗师= 21，家庭= 59）对(a)青少年外化行为问题和(b)家庭功能变化对接受功能家庭治疗（FFT）的青少年外化行为的调节作用。探索性分析考察了监管条件对青少年内化问题的影响。在8个社区机构中，经验丰富的FFT治疗师（M = 1.4年）在准实验设计中接受BOOST或SAU监督。男性（59%）或女性（41%）青少年被转介治疗行为问题（如犯罪、药物使用）。客户为西班牙裔（62%）、非裔美国人（19%）、非西班牙裔白人（12%）或其他（7%）族裔/种族。治疗师（女性，77%）西班牙裔占45%，非裔美国人（19%），非西班牙裔白人（30%），或其他（4%）民族/种族背景。分析控制是否存在临床症状升高对结果变量的影响。临床结果在治疗开始后的基线、5个月和12个月进行测量。外化行为高于临床阈值的客户在BOOST条件下与SAU条件下的问题行为显著减少。低于阈值的客户对条件的反应没有差异。BOOST的主管对FFT模型有更多的经验；因此，观察到的结果可能是主管经验的结果。BOOST监督与高于临床阈值的问题行为的改善结果相关。研究结果表明，在自然环境下的实施研究中处理客户案例组合的重要性。
This study examined the effects of observation-based supervision Building Outcomes with Observation-Based Supervision of Therapy (BOOST therapists = 26, families = 105), versus supervision as usual (SAU therapists = 21, families = 59) on (a) youth externalizing behavior problems and (b) the moderating effects of changes in family functioning on youth externalizing behaviors for adolescents receiving Functional Family Therapy (FFT). Exploratory analyses examined the impact of supervision conditions on youth internalizing problems. In 8 community agencies, experienced FFT therapists (M = 1.4 years) received either BOOST or SAU supervision in a quasi-experimental design. Male (59%) or female (41%) adolescents were referred for the treatment of behavior problems (e.g., delinquency, substance use). Clients were Hispanic (62%), African American (19%), Non-Hispanic White (12%), or Other (7%) ethnic/racial origins. Therapists (female, 77%) were Hispanic 45%, African American (19%), White Non-Hispanic (30%), or other (4%) ethnic/racial backgrounds. Analyses controlled for the presence or absence of clinically elevated symptoms on outcome variables. Clinical outcomes were measured at baseline, 5 months, and 12 months after treatment initiation. Clients with externalizing behavior above clinical thresholds had significantly greater reductions in problem behaviors in the BOOST versus the SAU conditions. Clients below thresholds did not respond differentially to conditions. Supervisors in BOOST had more experience with the FFT model; as such, the observed results may be a result of supervisor experience. The BOOST supervision was associated with improved outcomes on problem behaviors that were above clinical thresholds. The findings demonstrate the importance of addressing client case mix in implementation studies in natural environments.