Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, USA.
Am Psychol. 2010 Feb-Mar;65(2):85-97. doi: 10.1037/a0017784.
Improving outcomes for children and adolescents with mental health needs demands a broad meta-systemic orientation to overcome persistent problems in current service systems. Improving outcomes necessitates inclusion of current and emerging evidence about effective practices for the diverse population of youth and their families. Key components of the meta-system for children with emotional or behavioral needs include families, cultural norms and values, and service sectors such as schools, pediatric health centers, specialty mental health systems, juvenile justice systems, child protection services, and substance use treatment systems. We describe each component of the meta-system, noting challenges to the provision of evidence-based practice (EBP) and highlighting ways to optimize outcomes. Our focus is on the inclusion of evidence-based assessment and interventions, including prevention, within a developmentally driven and culturally responsive contextual model. Recommendations for addressing disparities in research funding and essential steps to foster communication and coordination of EBP across settings are provided.
改善有心理健康需求的儿童和青少年的结果需要对当前服务系统中存在的持续问题进行广泛的元系统定向，以克服这些问题。要改善结果，就必须纳入关于不同青少年及其家庭的有效实践的当前和新兴证据。有情感或行为需求的儿童的元系统的关键组成部分包括家庭、文化规范和价值观以及服务部门，如学校、儿科保健中心、专业精神卫生系统、少年司法系统、儿童保护服务和药物使用治疗系统。我们描述了元系统的每个组成部分，指出了提供基于证据的实践（EBP）的挑战，并强调了优化结果的方法。我们的重点是在发展驱动和文化响应的背景模型中纳入基于证据的评估和干预措施，包括预防措施。我们还提供了解决研究资金差距的建议以及促进跨环境 EBP 沟通和协调的基本步骤。
