St Amand Annick, Bard David E, Silovsky Jane F
Centre de recherche JEFAR, Université Laval, Quebc City, Canada.
Child Maltreat. 2008 May;13(2):145-66. doi: 10.1177/1077559508315353.
This meta-analysis of 11 treatment outcome studies evaluated 18 specific treatments of sexual behavior problems (SBP) as a primary or secondary target. Specifically, it examines relations among child characteristics, treatment characteristics (including practice elements), and short-term outcome (including sexual and general behavior problems). Utilizing pre- and postintervention results, the overall degree of change over the course of treatment was estimated at a 0.46 and 0.49 standard deviation decline in SBP and general behavior problems, respectively. As hypothesized, the caregiver practice element Parenting/Behavior Management Skills (BPT) predicted the Child Sexual Behavior Inventory (and the Child Behavior Checklist when BPT was combined with caregiver Rules about Sexual Behaviors). In contrast, practice elements that evolved from Adult Sex Offender (ASO) treatments were not significant predictors. BPT and preschool age group provided the best model fit and more strongly predicted outcome than broad treatment type classifications (e.g., Play Therapy or Cognitive Behavior Therapy). Results question current treatments for children with SBP that are based on ASO models of treatment without caregiver involvement.
这项对11项治疗结果研究的荟萃分析评估了18种作为主要或次要目标的性行为问题(SBP)的具体治疗方法。具体而言,它考察了儿童特征、治疗特征(包括实践要素)和短期结果(包括性行为和一般行为问题)之间的关系。利用干预前后的结果,治疗过程中的总体变化程度估计为SBP和一般行为问题分别下降0.46和0.49个标准差。如假设的那样,照料者实践要素育儿/行为管理技能(BPT)预测了儿童性行为量表(当BPT与照料者关于性行为的规则相结合时,还预测了儿童行为清单)。相比之下,从成年性犯罪者(ASO)治疗中演变而来的实践要素并不是显著的预测因素。BPT和学龄前年龄组提供了最佳的模型拟合,并且比宽泛的治疗类型分类(如游戏治疗或认知行为治疗)更能有力地预测结果。研究结果对当前基于无照料者参与的ASO治疗模型对患有SBP的儿童进行的治疗提出了质疑。