A Combined Motivation and Parent-Child Interaction Therapy Package Reduces Child Welfare Recidivism in a Randomized Dismantling Field Trial
A Combined Motivation and Parent-Child Interaction Therapy Package Reduces Child Welfare Recidivism in a Randomized Dismantling Field Trial
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DOI：
10.1037/a0021227
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发表时间：
2011-02-01
影响因子：
5.9
通讯作者：
Gurwitch, Robin
中科院分区：
文献类型：
--
作者：
Chaffin, Mark;Funderburk, Beverly;Gurwitch, Robin
目的：与常规服务（SAU）相比，先前在实验室试验中发现了一套亲子互动治疗（PCIT）结合自我激励（SM）取向可以减少儿童虐待再犯。本研究的目的是在实地机构而不是在实验室环境中测试有效性，并拆除SM与SAU取向和PCIT与SAU教养的成分效应。方法：研究对象为192名儿童福利机构的父母，平均有6次转介，大多数父母的孩子都被带走了。遵循2 × 2顺序随机实验设计，父母被随机分配到取向条件（SM vs. SAU），然后被随机分配到养育条件（PCIT vs. SAU）。儿童福利再犯案件的跟踪时间中位数为904天。一种基于归因的方法被用于估计再犯存活率，并伴有与治疗相关的儿童回家时间和频率的显著差异。结果：倾向于SM + PCIT组合的取向条件对减少未来儿童福利报告有显著的影响，且这种影响在儿童早回家比晚回家时更强。结论：研究结果表明，以前的实验室结果可以在现场实施环境中复制，也可以在有慢性和严重儿童福利史的父母中复制，支持SM + PCIT的协同效益。分析儿童福利事件历史数据复杂的差异风险剥夺的方法学考虑也被强调。
Objective: A package of parent child interaction therapy (PCIT) combined with a self-motivational (SM) orientation previously was found in a laboratory trial to reduce child abuse recidivism compared with services as usual (SAU). Objectives of the present study were to test effectiveness in a field agency rather than in a laboratory setting and to dismantle the SM versus SAU orientation and PCIT versus SAU parenting component effects. Method: Participants were 192 parents in child welfare with an average of 6 prior referrals and most with all of their children removed. Following a 2 X 2 sequentially randomized experimental design, parents were randomized first to orientation condition (SM vs. SAU) and then subsequently randomized to a parenting condition (PCIT vs. SAU). Cases were followed for child welfare recidivism for a median of 904 days. An imputation-based approach was used to estimate recidivism survival complicated by significant treatment-related differences in timing and frequency of children returned home. Results: A significant orientation condition by parenting condition interaction favoring the SM + PCIT combination was found for reducing future child welfare reports, and this effect was stronger when children were returned to the home sooner rather than later. Conclusions: Findings demonstrate that previous laboratory results can be replicated in a field implementation setting and among parents with chronic and severe child welfare histories, supporting a synergistic SM + PCIT benefit. Methodological considerations for analyzing child welfare event history data complicated by differential risk deprivation are also emphasized.