Treatment of Child Physical Abuse: Effectiveness Trial

儿童身体虐待的治疗：有效性试验

• 批准号: 7093415
• 负责人: DAVID KOLKO
• 金额: $ 59.12万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7093415
• 关键词: behavioral /social science research tag; child abuse; child welfare; clinical research; clinical trials; cognitive behavior therapy; community; family structure /dynamics; health care personnel education; health care personnel performance; human subject; human therapy evaluation; longitudinal human study; mental health personnel; relapse /recurrence; training

DESCRIPTION (provided by applicant): This revised application is being submitted in response to RFA PA-02-131, entitled "Dissemination and Implementation Research in Mental Health". Child physical abuse (CPA) is both common and associated with significant psychosocial and health problems. With the emergence of a few promising interventions for this population, efforts to transport empirically based treatments (EBT) to community settings have been strongly encouraged. In this application, we propose to evaluate the effectiveness of one intervention for CPA, recently described as Abuse-Focused Cognitive-Behavioral Therapy (AF-CBT; Kolko & Swenson, 2002), that has been identified as a "best practice" worthy of dissemination (Office of Victims of Crime, National Child Traumatic Stress Network; Kauffman Foundation Project). AF-CBT integrates complementary individual and family CBT protocols whose materials have recently been adapted by community practitioners to facilitate transportability and efficient application. Practitioners from seven community agencies in two counties will be randomized to one of two intervention conditions: 1) AF-CBT (6 agencies), or 2) Treatment-as-usual (TAU; 3 agencies). We project sample sizes of 100 practitioners and 333 families with at least one eligible perpetrator of physical abuse within the past 6 months and who is in regular contact with the abused child (aged 5-15 years). Treatment may vary in duration but generally will last approximately three to six months. Treatment adherence will be assessed using research staff observations of session audiotapes and self-reports from both supervisors and practitioners. Data collection across four timepoints will be directed towards the evaluation of two sets of effectiveness outcomes: 1) the impact of training in AF-CBT on practitioner repertoire/practices (pre-training assessment, post-training assessment, 1-year and 2-year follow-ups), and 2) the impact of AF-CBT on client (child, parent, family) mental health functioning and reabuse rates (pre-treatment assessment, post-treatment assessment, 1-year and 2-year follow-ups). The client effectiveness component will begin after practitioner training has been completed. Additional analyses seek to identify predictors of both practitioner adherence and adoption of AF-CBT, and client improvement through follow-up. This study will provide initial data on the transportability and adoption of EBTs in community settings serving the child welfare system.

描述（由申请人提供）：本修订后的申请是为了响应 RFA PA-02-131 提交的，题为“心理健康领域的传播和实施研究”。儿童身体虐待 (CPA) 很常见，并且与严重的社会心理和健康问题相关。随着针对该人群的一些有希望的干预措施的出现，大力鼓励将基于经验的治疗（EBT）转移到社区环境中。在本申请中，我们建议评估一种 CPA 干预措施的有效性，最近被称为以虐待为中心的认知行为疗法（AF-CBT；Kolko & Swenson，2002），该疗法已被确定为值得传播的“最佳实践”（犯罪受害者办公室、国家儿童创伤应激网络；考夫曼基金会项目）。 AF-CBT 整合了互补的个人和家庭 CBT 协议，其材料最近已被社区从业者改编，以促进可移植性和高效应用。来自两个县七个社区机构的从业者将被随机分配到两种干预条件之一：1）AF-CBT（6 个机构），或 2）照常治疗（TAU；3 个机构）。我们预测了 100 名从业者和 333 个家庭的样本量，这些家庭在过去 6 个月内至少有一名符合资格的身体虐待施暴者，并且与受虐待儿童（5-15 岁）经常接触。治疗的持续时间可能会有所不同，但通常会持续大约三到六个月。将使用研究人员对会议录音带的观察以及主管和从业者的自我报告来评估治疗依从性。四个时间点的数据收集将用于评估两组有效性结果：1）AF-CBT 培训对从业者技能/实践的影响（培训前评估、培训后评估、1 年和 2 年随访），以及 2）AF-CBT 对客户（儿童、父母、家庭）心理健康功能和重用率的影响（治疗前评估、治疗后评估、 1年和2年随访）。客户有效性部分将在从业者培训完成后开始。其他分析旨在确定从业者依从性和采用 AF-CBT 的预测因素，以及通过随访来改善客户的情况。这项研究将提供有关 EBT 在服务于儿童福利系统的社区环境中的可转移性和采用情况的初步数据。