Reducing Therapist Contact in Parenting Programs: Evaluation of Internet-Based Treatments for Child Conduct Problems.
Reducing Therapist Contact in Parenting Programs: Evaluation of Internet-Based Treatments for Child Conduct Problems.
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DOI：
10.1007/s10826-016-0363-3
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发表时间：
2016-06
影响因子：
2.1
通讯作者：
Kazdin AE
中科院分区：
文献类型：
--
作者：
Rabbitt SM;Carrubba E;Lecza B;McWhinney E;Pope J;Kazdin AE
这项研究评估了两个基于互联网的家长管理培训(PMT)版本，以及大大减少精神健康专业人员在治疗因行为问题而转诊的儿童方面所需联系的效果。我们感兴趣的是，减少与治疗师的接触是否会影响治疗结果、治疗联盟、父母对治疗处方的依从性以及父母对治疗程序的反应和评估。60名儿童及其照顾者被分配接受完全接触PMT(每周接触量与传统PMT相似；每周直接接触约50分钟)或减少接触PMT(通过录音提供大部分信息；每周约10分钟与治疗师接触)。两组儿童在反社会行为方面表现出显著和相似的减少，更普遍地内化和外化症状，以及整体适应功能的改善。治疗联盟在两个治疗组中也是相似的。然而，家长们认为完全接触疗法比简化接触疗法更容易接受。通过在补充分析中作为基准的非随机化配对样本进行评估，两种治疗方法在结果上与面对面治疗相似。总体而言，研究结果表明，在保持积极治疗结果的同时，治疗师的接触可以减少，但减少与治疗师的直接时间的干预可能会被客户视为不那么积极。
This study evaluated two Internet-based versions of Parent Management Training (PMT) and the effects of greatly reducing the contact required of a mental health professional on treatment of children referred for conduct problems. We were interested whether reduced contact with a therapist influenced treatment outcome, therapeutic alliance, parent adherence to treatment prescriptions, and parent reactions to and evaluations of the treatment procedures. Sixty children and their caregivers were assigned to receive either Full Contact PMT (with the amount of weekly contact similar to traditional PMT; approximately 50 minutes of direct therapist contact each week) or Reduced Contact PMT (with most information provided through recordings; approximately 10 minutes of therapist contact each week). Children in both groups showed significant and similar reductions in antisocial behaviors specifically, internalizing and externalizing symptoms more generally, and improvements in overall adaptive functioning. Therapeutic alliance also was similar across the two treatment groups. However, parents rated Full Contact treatment as more acceptable than the reduced version. Both treatments were similar in outcomes to in-person treatment as evaluated by a nonrandomized matched sample used as a benchmark in supplementary analyses. Overall, the findings indicate that therapist contact can be reduced while positive treatment outcomes are maintained but that interventions that reduce direct time with a therapist may be viewed less positively by clients.