Schoenwald Sonja K, Sheidow Ashli J, Chapman Jason E
Family Services Research Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
J Consult Clin Psychol. 2009 Jun;77(3):410-21. doi: 10.1037/a0013788.
This nonexperimental study used mixed-effects regression models to examine relations among supervisor adherence to a clinical supervision protocol, therapist adherence, and changes in the behavior and functioning of youths with serious antisocial behavior treated with an empirically supported treatment (i.e., multisystemic therapy [MST]) 1 year posttreatment. Participants were 1,979 youths and families treated by 429 clinicians across 45 provider organizations in North America. Four dimensions of clinical supervision were examined. Mixed-effects regression model results showed that one dimension, supervisor focus on adherence to treatment principles, predicted greater therapist adherence. Two supervision dimensions, Adherence to the Structure and Process of Supervision and focus on Clinician Development, predicted changes in youth behavior. Conditions required to test hypothesized mediation by therapist adherence of supervisor adherence effects on youth outcomes were not met. However, direct effects of supervisor and therapist adherence were observed in models including both of these variables.
这项非实验性研究使用混合效应回归模型，来检验在接受经验证支持的治疗（即多系统治疗[MST]）一年后，主管对临床督导协议的依从性、治疗师的依从性，以及有严重反社会行为的青少年的行为和功能变化之间的关系。参与者是北美45个服务提供机构中429名临床医生所治疗的1979名青少年及其家庭。研究考察了临床督导的四个维度。混合效应回归模型结果显示，其中一个维度，即主管对治疗原则依从性的关注，预示着治疗师更高的依从性。另外两个督导维度，即对督导结构和过程的依从性以及对临床医生发展的关注，预示着青少年行为的变化。通过治疗师依从性来检验主管依从性对青少年结果的假设性中介作用所需的条件未得到满足。然而，在包含这两个变量的模型中观察到了主管和治疗师依从性的直接效应。
