描述儿童和青少年治疗中的变化机制：方法学问题与研究建议。
Delineating mechanisms of change in child and adolescent therapy: methodological issues and research recommendations.
作者信息
Kazdin Alan E, Nock Matthew K
机构信息
Child Study Center, Yale University School of Medicine, New Haven, Connecticut 06520-7900, USA.
出版信息
J Child Psychol Psychiatry. 2003 Nov;44(8):1116-29. doi: 10.1111/1469-7610.00195.
BACKGROUND
Mechanisms of therapeutic change are rarely studied in child and adolescent therapy. Our central thesis is that the study of mechanisms of treatment is an excellent investment for improving clinical practice and patient care. Indeed, extending treatment trials to clinical settings, without complementary research that studies why and how treatment works, could have great limitations.
METHOD
In this article, we discuss the importance of studying mechanisms, the logical and methodological requirements, and why almost no studies to date provide evidence for why or how treatment works. Standard statistical practices (tests of mediation) and designs (randomized controlled clinical trials) contribute greatly to outcome research but have little to say about mechanisms given the way they are commonly used.
CONCLUSIONS
The article ends with recommendations to guide research on mechanisms of therapeutic change.
背景
儿童和青少年心理治疗中治疗改变的机制很少被研究。我们的核心论点是，对治疗机制的研究是改善临床实践和患者护理的一项极佳投资。事实上，如果没有对治疗为何起作用以及如何起作用进行补充研究，将治疗试验扩展到临床环境可能会有很大局限性。
方法
在本文中，我们讨论了研究机制的重要性、逻辑和方法要求，以及为何迄今为止几乎没有研究能提供治疗为何起作用或如何起作用的证据。标准的统计方法（中介检验）和设计（随机对照临床试验）对结果研究有很大贡献，但就其常用方式而言，对机制几乎没有涉及。
结论
本文最后给出了指导治疗改变机制研究的建议。
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