Treating Child Disruptive Behavior in High-Risk Families: A Comparative Effectiveness Trial from a Community-Based Implementation.
Treating Child Disruptive Behavior in High-Risk Families: A Comparative Effectiveness Trial from a Community-Based Implementation.
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治疗高风险家庭中的儿童破坏性行为：基于社区实施的比较有效性试验。
DOI：
10.1007/s10826-015-0322-4
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发表时间：
2016
影响因子：
2.1
通讯作者：
Lindauer RJ
中科院分区：
文献类型：
--
作者：
Abrahamse ME;Junger M;van Wouwe MA;Boer F;Lindauer RJ
家长管理培训计划已被证明是治疗儿童行为问题的最有效方法。本研究报告的有效性试验，以社区为基础的实施亲子互动疗法（PCIT）相比，荷兰开发的家庭创造性治疗（FCT）。45名年龄在32至102个月（M = 67.7，SD = 15.9）之间的儿童（58%为男孩）被转诊接受治疗，他们及其父母被随机分配到PCIT或FCT组。治疗效果主要通过儿童行为问题的改善程度来衡量，使用Eyberg儿童行为量表。次要结果包括家长和教师的报告数据和独立的观察育儿技巧和儿童行为。试验期间，治疗交叉（从FCT至PCIT）违反了随机化。意向治疗分析显示，在6个月随访时，主要结局无显著差异，但交叉影响了解释。随后的治疗收到的分析显示，时间和治疗条件之间的显着的相互作用的影响，更大的改善，儿童行为和育儿技能的PCIT家庭相比，FCT家庭。对完全完成PCIT方案的家庭进行的分析也显示，随访时的治疗维持率较高。接受治疗的分析表明，PCIT在治疗高危人群中幼儿破坏性行为问题的有效性方面取得了可喜的结果。然而，鉴于本研究的设计困难，在概括结论时需要谨慎。建议在日常实践中提高治疗交付，并指出临床意义。
Parent management training programs have proven the most effective way to treat child behavior problems. This study reports on an effectiveness trial of a community-based implementation of Parent–Child Interaction Therapy (PCIT) in comparison with the Dutch-developed Family Creative Therapy (FCT). Forty-five children (58 % boys) aged between 32 and 102 months (M = 67.7, SD = 15.9) were referred for treatment, and they and their parent(s) were randomly assigned to PCIT or FCT. Treatment effectiveness was measured primarily by the degree of improvement on child behavior problems, using the Eyberg Child Behavior Inventory. Secondary outcomes included parent and teacher report data and independent observations of parenting skills and child behavior. During the trial, randomization was violated by treatment crossovers (from FCT to PCIT). Intention-to-treat analyzes revealed no significant differences in the primary outcome at 6-month follow-up, but interpretation was hampered by the crossovers. Subsequent treatment-received analyzes revealed significant interaction effects between time and treatment condition, with greater improvements in child behavior and parenting skills for PCIT families compared to FCT families. Analyzes on families that fully completed the PCIT protocol also showed higher treatment maintenance at follow-up. The treatment-received analyzes indicated promising results for the effectiveness of PCIT in treating young children’s disruptive behavior problems in a high-risk population. However, caution in generalizing the conclusions is needed in view of the design difficulties in this study. Suggestions are made for enhancing treatment delivery in daily practice, and clinical implications are noted.