Potential Treatment Mechanisms of Counseling for Children in Burundi: A Series of n=1 Studies
Potential Treatment Mechanisms of Counseling for Children in Burundi: A Series of n=1 Studies
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DOI：
10.1111/j.1939-0025.2012.01171.x
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发表时间：
2012-07-01
影响因子：
3.3
通讯作者：
De Jong, Joop T. V. M.
中科院分区：
文献类型：
--
作者：
Jordans, Mark J. D.;Komproe, Ivan H.;De Jong, Joop T. V. M.
人们对低收入国家社会心理咨询的影响和治疗过程知之甚少。本研究旨在对布隆迪咨询的关键工作机制提出假设。作者进行了11项基于经验的n = 1研究，对1114岁的儿童进行了抑郁和焦虑筛查，并接受了咨询。作者使用定量（症状量表）和定性工具（治疗内容和认知）。每周分别在干预前（4个时间点）、干预期间（810个时间点）和干预后（4个时间点）进行测量。五种治疗机制持续出现与结果轨迹相关：以病人为中心、治疗联盟、积极解决问题、创伤暴露和家庭参与。较高的水平似乎与更好的结果相关。相反，没有变化的案例的特点分别是高度关注辅导员规范、遏制和自我控制、非结构化复述和明确回避、以建议为导向的问题解决和不包括家庭成员。作者发现每个治疗师的结果趋势有明显的聚类。研究结果表明，综合咨询将普遍的治疗师变量与积极使用特定治疗技术和系统观点相结合，可能是治疗布隆迪儿童心理健康症状的适当策略。
Little is known about the impact and treatment processes of psychosocial counseling in low-income countries. This study aimed to generate hypotheses on key working mechanisms of counseling in Burundi. The authors carried out 11 empirically grounded n = 1 studies with children (1114 years) screened for depression and anxiety who received counseling. The authors used quantitative (symptom scales) and qualitative instruments (treatment content and perceptions). Weekly measurements were taken preintervention (4 time points), during the intervention period (810 time points), and postintervention (4 time points). Five treatment mechanisms continua appeared associated with outcome trajectories: client centeredness, therapeutic alliance, active problem solving, trauma-focused exposure, and family involvement. Higher levels appeared associated with better outcomes. Contrarily, cases that demonstrated no change were characterized by a heavy focus on counselors norms, containment and self-control, unstructured retelling and explicit avoidance, advice-oriented problem solving, and noninclusion of family members, respectively. The authors found a distinct clustering of outcome trends per therapist. The findings suggest that integrative counseling, which combines universal therapist variables with active use of specific therapeutic techniques and a systemic perspective, may be an adequate strategy to treat mental health symptoms of children in Burundi.