D'Angelo Eugene J, Llerena-Ouinn Roxana, Shapiro Rachel, Colon Frances, Rodriguez Paola, Gallagher Katie, Beardslee William R
Division of Psychology, Department of Psychiatry, Children's Hospital, 300 Longwood Avenue, Boston, MA 02110, USA.
Fam Process. 2009 Jun;48(2):269-91. doi: 10.1111/j.1545-5300.2009.01281.x.
This paper describes the process for and safety/feasibility of adapting the Beardslee Preventive Intervention Program for Depression for use with predominantly low income, Latino families. Utilizing a Stage I model for protocol development, the adaptation involved literature review, focus groups, pilot testing of the adapted manual, and open trial of the adapted intervention with 9 families experiencing maternal depression. Adaptations included conducting the intervention in either Spanish or English, expanding the intervention to include the contextual experience of Latino families in the United States with special attention to cultural metaphors, and using a strength-based, family-centered approach. The families completed preintervention measures for maternal depression, child behavioral difficulties, global functioning, life stresses, and an interview that included questions about acculturative stressors, resiliency, and family awareness of parental depression. The postintervention interview focused on satisfaction, distress, benefits of the adapted intervention, and therapeutic alliance. The results revealed that the adaptation was nonstressful, perceived as helpful by family members, had effects that seem to be similar to the original intervention, and the preventionists could maintain fidelity to the revised manual. The therapeutic alliance with the preventionists was experienced as quite positive by the mothers. A case example illustrates how the intervention was adapted.
本文描述了将比尔德斯利预防抑郁症干预计划应用于以低收入为主的拉丁裔家庭的过程及其安全性/可行性。利用第一阶段的方案开发模型,改编过程包括文献综述、焦点小组、改编手册的试点测试,以及对9个有母亲抑郁症的家庭进行改编干预的开放试验。改编内容包括用西班牙语或英语进行干预,扩大干预范围以纳入美国拉丁裔家庭的背景经历,并特别关注文化隐喻,以及采用基于优势、以家庭为中心的方法。这些家庭完成了关于母亲抑郁症、儿童行为困难、整体功能、生活压力的干预前测量,以及一次访谈,访谈问题包括文化适应压力源、复原力和家庭对父母抑郁症的认知。干预后的访谈重点关注满意度、痛苦程度、改编干预的益处以及治疗联盟。结果显示,改编没有造成压力,家庭成员认为改编很有帮助,其效果似乎与原干预相似,而且预防人员能够忠实执行修订后的手册。母亲们对与预防人员的治疗联盟体验非常积极。一个案例说明了干预是如何改编的。