Integrating Computer-Assisted Parent Training Therapy into Community Mental Health Clinic Practice

将计算机辅助家长培训治疗融入社区心理健康诊所实践

• 批准号: 9750808
• 负责人: Jennifer Christine Wolff
• 金额: $ 24.15万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-25 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9750808
• 关键词: Accountability; Address; Adolescent; Affect; Aftercare; Ambulatory Care; Attitude; Behavior; Behavioral; Caring; Child; Child Rearing; Client; Clinic; Clinical; Code; Communities; Community Practice; Competence; Computer Assisted; Conduct Disorder; Consumer Satisfaction; Data; Development; Disruptive Behavior Disorder; Effectiveness; Effectiveness of Interventions; Evidence based practice; Family; Feedback; Financial Hardship; Goals; Health Services Research; Intervention; Interview; Logic; Measures; Mental Health; Mental Health Services; Modeling; Modification; National Institute of Mental Health; Oppositional Defiant Disorder; Outcome; Outpatients; Parent-Child Relations; Parents; Partnership Practice; Phase; Problem behavior; Process; Protocols documentation; Provider; Psychotherapy; Questionnaires; Randomized; Research; Self Efficacy; Services; Speed; Strategic Planning; Structure; Techniques; Technology; Testing; Therapeutic; Therapeutic Effect; Time; Training; Use Effectiveness; Withdrawal; Youth; base; behavioral outcome; clinical practice; community intervention; community setting; computer assisted patient care; computerized; cost; effective therapy; evidence base; follow-up; implementation research; improved; innovation; lower income families; portability; practice setting; programs; randomized trial; response; service delivery; skills; treatment as usual; uptake

Project Summary/Abstract Disruptive behavior disorders (DBDs) including oppositional defiant disorder (ODD) and conduct disorder (CD) are among the most common mental health referrals for children and adolescents. Despite the overwhelming evidence that parents are an essential component in effective treatments for youth behavior problems, there is still a gap in the use of these techniques in community mental health clinics (CMHCs). The use of technology may facilitate the delivery of parent training and broaden the availability of these approaches to improve the integrity of community treatment and meet the needs of families in a more timely and efficient manner. Computerized interventions can be delivered at a lower cost, with less demand on staff time for training, increased protocol fidelity, portability, and ease of use. This would greatly increase the scalability and dissemination potential of such approaches. Despite the apparent logic in using these programs to augment services, there may be barriers to the use of computerized programs by clinicians and parents. Understanding and addressing barriers to the implementation of such approaches has the potential to improve the use of these approaches to meet the needs of underserved youth in CMHCs. This project involves adapting a computerized parenting intervention (Parenting Wisely; PW) that has established efficacy in improving parenting skills and reducing youth behavior problems to a community outpatient treatment facility. The project aims to 1) obtain implementation level data on the acceptability and feasibility of the protocol for parents and providers; 2) provide data on therapeutic mechanisms including therapist fidelity and competency as well as parenting skills and self-efficacy; 3) identify factors that promote or hinder the use and effectiveness of the computer-assisted parent training protocol for providers and parents.; and 4) examine the efficacy of PW compared to treatment as usual on disruptive behavior disorders. An open trial (N=10) will be conducted and modifications to treatment will be made using an iterative process based on interviews with parents and providers. Second, a 2 group randomized trial with 50 parents, 25 in each condition, will compare PW to treatment as ususal (TAU). Follow-up interviews will be conducted at the end of treatment and 3 and 6 months post-treatment. The use of a low-cost, low-intensity electronic intervention aligns with RFA objectives to: 1) conduct “research on interventions with previously demonstrated efficacy, for use … in broader community settings”; 2) conduct “innovative services research directions that require preliminary testing or development”; 3)“address the mechanism by which the adapted intervention or augmentation will enhance outcomes'; and 4) has the potential to inform practice-relevant questions including “improvement in response rate, speed of response …or uptake in community/practice.”

项目总结/摘要 破坏性行为障碍（DBD），包括对立违抗性障碍（ODD）和行为 精神疾病（CD）是儿童和青少年最常见的精神健康转诊。 尽管有压倒性的证据表明，父母是有效治疗的重要组成部分， 青少年行为问题，在社区心理健康中使用这些技术仍有差距 诊所（CMHC）。利用技术可以促进家长培训的提供，并扩大 这些方法的可用性，以提高社区治疗的完整性，并满足 以更及时、更有效的方式帮助家庭。计算机化干预可以以较低的成本提供， 成本，对员工培训时间的需求更少，增加了协议的保真度，便携性和易用性。 这将大大提高这些方法的可扩展性和推广潜力。尽管 使用这些程序来增强服务的明显逻辑，可能会存在使用障碍， 临床医生和家长的计算机程序。了解和解决在实现可持续发展方面的障碍 这些方法的实施有可能改善这些方法的使用， CMHC中服务不足的青年的需求。 该项目涉及采用计算机化的育儿干预（育儿明智; PW）， 在提高育儿技能和减少青少年行为问题方面取得了成效， 社区门诊治疗设施。该项目的目的是：（1）获得关于 方案对父母和提供者的可接受性和可行性; 2）提供治疗数据 心理治疗师的忠诚度和胜任力以及育儿技巧和自我效能等机制; 确定促进或阻碍使用计算机辅助父母及其有效性的因素 提供者和家长的培训协议。和4）检查PW与治疗相比的疗效 破坏性行为障碍将进行一项开放试验（N=10）， 将根据与家长和提供者的访谈，采用迭代过程进行治疗。 其次，一项2组随机试验，50名父母，每种情况25人，将比较PW与治疗 如通常（TAU）。随访访谈将在治疗结束时以及3个月和6个月进行 后处理。使用低成本、低强度的电子干预与RFA目标一致 （1）开展“关于先前证明有效的干预措施的研究，以便.在更广泛的领域使用”。 社区环境”; 2）进行“需要初步测试的创新服务研究方向 （3）“解决适应性干预或增强将 提高成果”; 4）有可能告知实践相关问题，包括 “提高回应率、回应速度.或在社区/实践中的吸收”。