Transportability of multisystemic therapy: evidence for multilevel influences.
Transportability of multisystemic therapy: evidence for multilevel influences.
复制标题
DOI：
10.1023/a:1026229102151
复制
发表时间：
2003-12-01
期刊：
影响因子：
--
通讯作者：
Liao, Jason G
中科院分区：
文献类型：
--
作者：
Schoenwald, Sonja K;Sheidow, Ashli J;Liao, Jason G
本研究探讨了与多系统治疗（MST）的实施和短期结果相关的因素，MST是一种针对青少年严重反社会行为的强化，短期，以家庭和社区为基础的治疗方法。参与者是666名儿童和家庭，由39个地点的217名治疗师提供服务。治疗前（T1）至治疗后即刻（T2）儿童问题和功能的差异与MST随机试验中发现的差异幅度相似。随机效应回归的结果支持治疗师的依从性，组织气氛和结构在基线上直接治疗后的儿童结果的直接影响。然而，组织因素无关的坚持，因此，一个假设的调解模型，组织气候和结构影响的结果，通过治疗师坚持MST不支持。此外，一些组织气候变量和结果之间的关联方向与预期相反。事后适度分析澄清了这些发现，治疗过程中治疗师坚持的水平不同，组织效果。以证据为基础的心理治疗转移到通常的护理实践设置的青年的影响进行了讨论。
This study examines factors associated with the implementation and short-term outcomes in dissemination sites of Multisystemic Therapy (MST), an intensive, short-term, family- and community-based treatment for serious antisocial behavior in youth. Participants were 666 children and families served by 217 therapists in 39 sites. Pre- (T1) to immediate posttreatment (T2) differences in child problems and functioning were similar in magnitude to those found in randomized trials of MST. Results of random effects regression supported direct effects of therapist adherence, organizational climate, and structure at baseline on immediate posttreatment child outcomes. However, organizational factors were unrelated to adherence; thus, a hypothesized mediation model in which organizational climate and structure affect outcomes through therapist adherence to MST was not supported. Furthermore, the direction of associations between some organizational climate variables and outcomes countered expectations. Post hoc moderation analyses clarify these findings, with organizational effects differing by level of therapist adherence during treatment. Implications for the transfer of evidence-based psychosocial treatments for youth to usual care practice settings are discussed.