Therapist Reports of EBP Client Engagement Challenges in Sessions with Diverse Youth and Families in Community Mental Health Settings
Therapist Reports of EBP Client Engagement Challenges in Sessions with Diverse Youth and Families in Community Mental Health Settings
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DOI：
10.1007/s10566-018-9472-z
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发表时间：
2019-02-01
影响因子：
1.8
通讯作者：
Lau, A. S.
中科院分区：
文献类型：
--
作者：
Gellatly, R.;Brookman-Frazee, L.;Lau, A. S.
背景循证实践(EBPs)在社区环境中的实施似乎导致相对于对照试验的益处减少。这种结果的差异可能部分归因于治疗师在向低收入少数民族青年和家庭提供EBPS时遇到的敬业度挑战。目的本研究试图确定与治疗师报告的治疗师在治疗会话中的敬业度挑战相关的治疗师、客户和会话特征，以及两种类型的客户参与度挑战和治疗师自我报告的在公共儿童心理健康服务系统驱动的实施中提供EBP的能力之间的关联。方法103名治疗师报告了两种类型的客户参与度挑战有限的客户参与度，并在702次与274名客户的会话中表达了客户关注度。结果表明，治疗师报告在与男性客户的会话和有年轻人在场的会话中，治疗师报告的有限客户参与度的频率更高，以及案例工作量较小的治疗师。没有显著预测客户所表达的担忧的变量。这两种类型的敬业度挑战与治疗师报告的他们在同一会话中执行预期活动的能力呈负相关。结论研究结果表明，治疗师可以从学习策略中受益，以解决在社区环境中与不同家庭实施EBPS时遇到的这两种不同类型的敬业度挑战。
BackgroundThe implementation of evidence-based practices (EBPs) in community settings appears to result in reduced benefit relative to controlled trials. This difference in outcomes may be attributable in part to engagement challenges therapists encounter when delivering EBPs to low-income ethnic minority youth and families.ObjectiveThe current study sought to identify therapist, client, and session characteristics associated with therapist-reported engagement challenges in therapy sessions, as well the associations between two types of client engagement challenges and therapists' self-reported ability to deliver the EBP in sessions within a system-driven implementation in public children's mental health services.MethodOne hundred and three therapists reported on two types of engagement challengesLimited Client Engagement and Expressed Client Concernsin 702 sessions with 274 clients.ResultsResults indicated that therapists reported a higher frequency of Limited Client Engagement in sessions with male clients and in sessions where the youth was present, and by therapists with smaller caseloads. No variables significantly predicted Expressed Client Concerns. Both types of engagement challenges were negatively associated with therapists' report of their ability to carry out intended activities in the same session.ConclusionsFindings suggest that therapists may benefit from learning strategies to address these two distinct types of engagement challenges encountered in implementation of EBPs with diverse families in community settings.