A Comparison of Interactions Among Children, Parents, and Therapists in Cognitive Behavior Therapy for Anxiety Disorders in Australia and Japan
A Comparison of Interactions Among Children, Parents, and Therapists in Cognitive Behavior Therapy for Anxiety Disorders in Australia and Japan
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DOI：
10.1016/j.beth.2021.05.008
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发表时间：
2022-01-10
期刊：
影响因子：
3.7
通讯作者：
Hudson, Jennifer L.
中科院分区：
文献类型：
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作者：
Ishikawa, Shin-ichi;Romano, Mia;Hudson, Jennifer L.
尽管越来越多的人关注儿童和青少年的文化适应性认知行为治疗（CBT）项目的疗效，但对于治疗师如何调整原始治疗方案以适应特定文化的客户，仍然很少有经验和实用的信息。目前的研究旨在比较两种不同文化群体的CBT治疗相互作用。我们开发了一个观察编码系统来检查在澳大利亚和日本对患有焦虑症的儿童进行CBT治疗期间，儿童、父母和治疗师表现出的行为。我们的研究结果表明，两国在儿童的治疗准备程度、治疗期间父母和儿童的谈话比例、治疗师的笑声、第一次治疗期间的沉默时间以及父母的适应指数等方面存在显著差异。随着时间的推移（即从第一次到最后一次CBT治疗），两国的父母在最后一次CBT治疗期间往往会说得更多，而只有澳大利亚的治疗师随着时间的推移会说得更少。在日语课程中，沉默的比例随着时间的推移而减少，而在澳大利亚课程中，父母打断孩子的比例随着时间的推移而增加。最后，我们的探索性分析表明，许多行为观察与治疗后的焦虑治疗结果相关。这项研究表明，在CBT过程中，儿童、父母和治疗师之间的互动可能会受到CBT发生的文化的影响，这可能会对CBT项目的文化适应性产生影响。
Despite growing attention to the efficacy of culturally adapted cognitive-behavioral treatment (CBT) programs for children and adolescents, there is still little empirical and practical information available to therapists who adapt original treatment protocols to suit clients of a specific culture. The current study aimed to compare therapeutic interactions across CBT treatment delivered with two different cultural groups. We developed an observational coding system to examine behaviors exhibited by child, parent, and therapist during CBT sessions conducted in Australia and Japan for children with anxiety disorders. Our results demonstrated significant differences between the two countries with respect to the treatment readiness of children, the proportion of talking during the sessions by parents and children, therapists' laughter, length of silence during the first session, and parent indices of accommodation. In terms of transitions over time (i.e., first to last CBT session), parents in both countries tended to talk more during the last CBT session, whereas only Australian therapists talked less over time. The proportion of silence decreased over time during the Japanese sessions, and the amount of interruptions by parents increased over time for Australian sessions. Finally, our exploratory analyses demonstrated that a number of behavioral observations were correlated with anxiety treatment outcome at posttreatment. This study suggests that interactions between a child, parent, and therapist during CBT sessions may be affected by the culture in which the CBT session occurs, which could have implications for culturally adapted CBT programs.