Does Parent Training Format Affect Treatment Engagement? A Randomized Study of Families at Social Risk
Does Parent Training Format Affect Treatment Engagement? A Randomized Study of Families at Social Risk
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DOI：
10.1007/s10826-017-0984-1
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发表时间：
2018-05-01
影响因子：
2.1
通讯作者：
Uveges, Melissa K.
中科院分区：
文献类型：
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作者：
Gross, Deborah;Belcher, Harolyn M. E.;Uveges, Melissa K.
我们研究了在城市心理健康诊所为学龄前儿童寻求行为治疗的经济条件较差的家庭样本中，父母参与家长培训（PT）的方式（以家长小组为基础的视频辅导与以掌握为基础的孩子单独辅导）是否存在差异。父母（N = 159, 76.1%为母亲，69.8%为非裔美国人，73%为低收入者）被随机分为两组：芝加哥家长计划（家长组+视频；CPP）或亲子互动治疗（个性化的基于掌握的指导；PCIT）。家长参与指标比较了PT出勤率和完成率，参与质量和家长满意度。预测PT损耗的风险因素（父母抑郁、心理逆境、儿童行为问题严重程度、开始PT的等待时间长度）也被比较，以确定它们是否更有可能影响一种PT形式与另一种PT形式的参与。不同形式的PT出勤率和完成率无显著差异。临床医生对家长参与PCIT的评价高于CPP，而家长对CPP的满意度高于PCIT。从未参加过PT的CPP患者有更多的社会心理逆境和外化行为问题，PCIT患者有更高的基线抑郁。心理社会逆境较多、基线抑郁程度较高的父母完成PCIT的可能性较小。没有任何危险因素可以区分CPP完成者和非完成者。PCIT比CPP延迟治疗时间更长。讨论了每种方案的优点和局限性，因为它们与生活在城市贫困中的家庭的需要和现实有关。
We examined whether parent engagement in parent training (PT) differed based on PT format (parent group-based with video versus mastery-based individual coaching with child) in an economically disadvantaged sample of families seeking behavioral treatment for their preschool children in an urban mental health clinic. Parents (N = 159; 76.1% mothers, 69.8% African American, 73% low-income) were randomized to one of two interventions, Chicago Parent Program (parent group + video; CPP) or Parent-Child Interaction Therapy (individualized mastery-based coaching; PCIT). Parent engagement indicators compared were PT attendance and completion rates, participation quality, and parent satisfaction. Risk factors predictive of PT attrition (parent depression, psychosocial adversity, child behavior problem severity, length of wait time to start PT) were also compared to determine whether they were more likely to affect engagement in one PT format versus the other. No significant differences were found in PT attendance or completion rates by format. Clinicians rated parents' engagement higher in PCIT than in CPP while satisfaction with PT was rated higher by parents in CPP compared to PCIT. Never attending PT was associated with more psychosocial adversity and externalizing behavior problems for CPP and with higher baseline depression for PCIT. Parents with more psychosocial adversities and higher baseline depression were less likely to complete PCIT. None of the risk factors differentiated CPP completers from non-completers. Delay to treatment start was longer for PCIT than CPP. Strengths and limitations of each PT format are discussed as they relate to the needs and realities of families living in urban poverty.