Intervention format and therapist-child agreement associated with therapeutic alliance and outcomes.
Intervention format and therapist-child agreement associated with therapeutic alliance and outcomes.
复制标题
与治疗联盟和结果相关的干预形式和治疗师-儿童协议。
DOI：
10.1037/ccp0000841
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发表时间：
2024
影响因子：
5.9
通讯作者：
Qu,Lixin
中科院分区：
文献类型：
--
作者：
Lochman,JohnE;Laird,RobertD;McDaniel,HeatherL;Boxmeyer,CarolineL;Braun,SummerS;Powell,NicoleP;Qu,Lixin
目的本研究考察了治疗联盟（TA、关系纽带、任务协作）对外化行为结果的影响，当儿童在单独和小组会议中被观察时，TA的作用是如何不同的，以及治疗师-儿童在TA的看法上的分歧如何影响结果。方法选取20所小学四年级教师认定的攻击行为发生率高的儿童360名（年龄9.2 ~ 11.8岁，男性占65%，黑人占78.1%），随机分为小组和个人两组进行认知行为干预“应对能力”。使用儿童治疗联盟量表在干预中期和结束时收集儿童和治疗师的TA评分。采用儿童行为评估系统，在干预前和干预后1年随访时收集教师对儿童外化和内化行为问题的评分。结果单独接受干预的儿童报告的任务协作的类特质水平显著高于小组儿童。与干预形式无关，较高的治疗师评定的纽带和任务协作类特质水平预示着外化问题水平的降低，而较高的儿童和治疗师评定的任务协作类特质水平和治疗师评定的纽带类特质水平预示着内化问题水平的降低。治疗师和儿童报告之间的差异预示着群体中儿童内化行为的减弱程度较弱。结论通过对有攻击行为问题的儿童进行中期干预，特别是在小群体中发现攻击行为问题的儿童时，培训治疗师开发和评估TA是必要的，并确定治疗师是否可能误解TA的强度。（PsycInfo数据库记录(c) 2024 APA，版权所有）
ObjectiveThe study examined the effects of therapeutic alliance (TA; relational bond, task collaboration) on externalizing behavior outcomes, how TA can operate differently when children are seen in individual versus group sessions, and how therapist–child disagreement in perceptions of TA affects outcomes.MethodThree hundred sixty children (Ages 9.2–11.8; 65% male; 78.1% Black) identified as having high rates of aggressive behavior by the fourth-grade teachers, and their 20 elementary schools were randomized to group versus individual delivery of the cognitive behavioral intervention, Coping Power. TA ratings were collected from children and therapists at mid and end of intervention using the Therapeutic Alliance Scale for Children. Teacher ratings of children’s externalizing and internalizing behavior problems were collected prior to intervention and at 1-year follow-up after intervention using the Behavior Assessment System for Children.ResultsChildren receiving the intervention individually reported significantly higher trait-like levels of task collaboration than did children seen in groups. Independent of intervention format, higher trait-like levels of therapist-rated bond and task collaboration predicted reduced levels of externalizing problems, and higher trait-like levels of child-and therapist-rated task-collaboration and therapist-rated bond predicted reduced levels of internalizing problems. Differences between therapist and child reports of bond predicted weaker reductions in internalizing behavior for children seen in groups.ConclusionsIt is essential to train therapists to develop and assess for TA by midintervention with children with aggressive behavior problems, especially if they are seen in small groups, and to determine if therapists may misperceive the strength of TA.(PsycInfo Database Record (c) 2024 APA, all rights reserved)