Empirically Guided Coordination of Multiple Evidence-Based Treatments: An Illustration of Relevance Mapping in Children's Mental Health Services
Empirically Guided Coordination of Multiple Evidence-Based Treatments: An Illustration of Relevance Mapping in Children's Mental Health Services
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DOI：
10.1037/a0023982
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发表时间：
2011-08-01
影响因子：
5.9
通讯作者：
Daleiden, Eric L.
中科院分区：
文献类型：
--
作者：
Chorpita, Bruce F.;Bernstein, Adam;Daleiden, Eric L.
目的：尽管在心理健康的发展和识别的心理社会循证治疗（EBT）取得了重大进展，有最小的经验指导，选择一套最佳的EBT最大限度地适用和推广到选定的服务样本。相关性映射是一种建议的方法，解决这个问题，通过结构化的比较服务样本中的客户端特征的参与者特征的EBT的研究。方法：作者使用来自全州精神卫生系统的1，781名青少年的数据和包括437项随机临床试验的研究数据集证明了相关性映射的可行性。相关性映射（a）揭示了在研究参与者和客户之间的不同匹配定义下，任何EBT“可覆盖”的人，以及（B）确定了在定义治疗操作的不同分析水平上，为最大数量的客户提供服务所需的最小治疗集。结果如下：在插图样本中，当匹配仅要求客户与EBT研究参与者有相同的问题时，研究数据集审查针对的所有问题都是完全可覆盖的。在另一个极端，当匹配还需要年龄，性别，种族和环境时，在这个样本中，不可覆盖的年轻人的比例增加到86%。确定了两套最小的只有8个EBT，当添加到该系统中已经存在的一个EBT时，在匹配所需问题，年龄和性别时，覆盖了100%的可覆盖青年。结论：这种方法为经验指导的EBT选择和协调提供了希望，从而解决了知识与实践之间差距的一个方面。
Objective: Despite substantial progress in the development and identification of psychosocial evidence-based treatments (EBTs) in mental health, there is minimal empirical guidance for selecting an optimal set of EBTs maximally applicable and generalizable to a chosen service sample. Relevance mapping is a proposed methodology that addresses this problem through structured comparison of client characteristics in a service sample to participant characteristics from studies of EBTs. Method: The authors demonstrate the feasibility of relevance mapping using data from 1,781 youths in a statewide mental health system and a study data set including 437 randomized clinical trials. Relevance mapping (a) reveals who is "coverable" by any EBT, under different definitions of matches between study participants and clients, and (b) identifies minimum sets of treatments needed to serve maximum numbers of clients, across different levels of analysis for defining treatment operations. Results: In the illustration sample, all problems targeted by the study data set review were fully coverable when matching only required clients to have the same problem as EBT study participants. At the other extreme, when matching also required age, gender, ethnicity, and setting, the percentage of noncoverable youths increased to 86% in this sample. Two minimal sets of only 8 EBTs were identified that, when added to the one EBT already in place in that system, covered 100% of coverable youths when matching required problem, age, and gender. Conclusions: This methodology offers promise for the empirically guided selection and coordination of EBTs, thereby addressing one aspect of the gap between knowledge and practice.