Diamond Gary M, Diamond Guy S, Hogue Aaron
Ben-Gurion University of the Negev, Israel.
J Marital Fam Ther. 2007 Apr;33(2):177-91. doi: 10.1111/j.1752-0606.2007.00015.x.
This study examined the fidelity of attachment-based family therapy (ABFT) for depressed adolescents. Trained observers used the therapist behavior rating scale (3rd version) to code therapist behaviors in 45 sessions of ABFT and 45 sessions each from two empirically based treatments for adolescent substance abusers: multidimensional family therapy (MDFT) and cognitive-behavioral therapy (CBT). Results indicate that ABFT therapists employed essential ABFT interventions, such as focusing on vulnerable affect, highlighting attachment-related themes, and promoting adolescent-parent reattachment through in-session enactments. In accordance with the sequential nature of the treatment, these interventions were used more extensively during the early stage of treatment, when there is a greater focus on reattachment. ABFT was perfectly discriminable from CBT, with ABFT therapists using more restructuring and reattachment interventions and CBT therapists using more signature CBT interventions, such as cognitive monitoring and homework. ABFT was also discriminable from MDFT, with ABFT therapists placing a greater emphasis on reattachment. These results suggest that ABFT is a viable and differentiated treatment. Together with prior findings supporting its efficacy, ABFT should be considered a promising new approach for working with depressed adolescents and their families.
本研究考察了基于依恋的家庭治疗（ABFT）对抑郁青少年的治疗保真度。经过培训的观察员使用治疗师行为评定量表（第3版）对45次ABFT治疗以及针对青少年药物滥用者的两种实证治疗方法（多维度家庭治疗（MDFT）和认知行为疗法（CBT））各45次治疗中的治疗师行为进行编码。结果表明，ABFT治疗师采用了基本的ABFT干预措施，例如关注脆弱情感、突出与依恋相关的主题，以及通过治疗过程中的互动促进青少年与父母的重新依恋。根据治疗的顺序性质，这些干预措施在治疗早期使用得更为广泛，因为此时更注重重新依恋。ABFT与CBT完全可区分，ABFT治疗师使用更多的重构和重新依恋干预措施，而CBT治疗师使用更多典型的CBT干预措施，如认知监测和家庭作业。ABFT也与MDFT可区分，ABFT治疗师更强调重新依恋。这些结果表明ABFT是一种可行且有区别的治疗方法。连同先前支持其疗效的研究结果，ABFT应被视为治疗抑郁青少年及其家庭的一种有前景的新方法。
