Feasibility of Online Parent Training for the Treatment of Conduct Problems

描述（由申请人提供）：该项目测试了两种在线版本的家长管理培训（PMT），这是一种基于证据的治疗（EBT），适用于有反抗、攻击和反社会行为的儿童。尽管存在有效的干预措施，如经前治疗，但估计有70%需要服务的儿童没有得到这些服务。实际和后勤问题可能使前往诊所接受亲自治疗成为不可能。在线治疗提供了解决这一困境的办法，它大大扩大了获得必要护理的机会，并惠及那些没有得到标准当面治疗服务的家庭。目前的项目旨在评估两种版本的在线PMT在减少因CD和ODD就诊的不同种族儿童（6-12岁）临床功能障碍方面的可行性和初步疗效。这些小组在治疗师接触的类型上有所不同。一组（全接触PMT）的结构与标准的面对面PMT相同，但使用视频会议程序来提供治疗，而不需要面对面的治疗。虽然他们不会在同一个物理位置，但家庭和他们的治疗师将会实时地看到、听到和互动。第二组（减少接触PMT）的家庭没有与治疗师面对面的交流。相反，他们通过一个综合的PMT网站获得PMT，该网站有书面材料、视频剪辑和可下载的表格。除了儿童的治疗变化外，该项目还评估了治疗联盟，干扰治疗可接受性的感知障碍，以及对治疗的参与。将对后一种领域进行评估，因为它们已被证明可以缓和治疗变化，并且在不同版本的在线治疗（可能与传统的面对面的PMT不同）中可能会有不同的操作。这项研究的结果将为在线PMT有效性的大规模随机对照试验提供信息和指导，并将促进研究项目的长期目标，即在美国（和其他地方）和服务不完善的地理区域（如农村地区）更广泛地传播ebt。这些发现也将对其他涉及使用互联网和远程精神病学/心理学的治疗在治疗过程、易用性和患者反应方面产生重要影响。

DESCRIPTION (provided by applicant): The project tests two online versions of parent management training (PMT), an evidence-based treatment (EBT) for children referred for oppositional, aggressive, and antisocial behavior. Despite the existence of effective interventions, such as PMT, an estimated 70% of children in need of services do not receive them. Practical and logistical problems can make traveling to a clinic to receive in-person treatment impossible. Online treatment offers a solution to this dilemma by significantly expanding access to necessary care and reaching families who are not being served by standard, in-person treatment. The current project seeks to evaluate the feasibility and initial efficacy of two versions of online PMT in reducing clinical dysfunction in a sample of ethnically diverse children (ages 6-12 years) referred for CD and ODD. The groups will vary in the type of therapist contact. One group (Full- contact PMT) is structured identically to standard, in-person PMT but uses a videoconference program to deliver treatment instead of requiring in-person sessions. Although they will not be in the same physical location, families and their therapists will see, hear, and interact with each other in real time. Families in the second group (Reduced-contact PMT) do not have face-to-face interactions with a therapist. Instead, they receive PMT through a comprehensive PMT website with written materials, video clips, and downloadable forms. In addition to therapeutic change in the children, the project evaluates the therapeutic alliance, perceived barriers that interfere with treatment acceptability, and participation in treatment. These latter domains will be evaluated because they have been shown to moderate therapeutic change and may operate differently in the different versions of online treatment (which may differ from traditional, in-person PMT). Findings from this study will inform and guide a large-scale RCT on the efficacy of online PMT and will facilitate longer-term objectives of the research program, namely, wider dissemination of EBTs to underserved populations in the United States (and elsewhere) and geographic areas that are not well served (e.g., rural areas). The findings will also have important implications for other treatments involving the use of the Internet and telepsychiatry/psychology in terms of therapeutic processes, ease of use, and client reactions.