Murray Maureen M, Southerland Dannia, Farmer Elizabeth M, Ballentine Kess
Department of Psychiatry, Duke University Medical Center, DUMC Box 3454, Durham, NC 27710.
J Child Fam Stud. 2010;19(4):393-403. doi: 10.1007/s10826-009-9310-x.
Evidence-based practices to improve outcomes for children with severe behavioral and emotional problems have received a great deal of attention in children's mental health. Therapeutic Foster Care (TFC), a residential intervention for youth with emotional or behavioral problems, is one of the few community-based programs that is considered to be evidence-based. However, as for most treatment approaches, the vast majority of existing programs do not deliver the evidence-based version. In an attempt to fill this gap and improve practice across a wide range of TFC agencies, we developed an enhanced model of TFC based on input from both practice and research. It includes elements associated with improved outcomes for youth in "usual care" TFC agencies as well as key elements from Chamberlain's evidence-based model. The current manuscript describes this "hybrid" intervention - Together Facing the Challenge - and discusses key issues in implementation. We describe the sample and settings, highlight key implementation strategies, and provide "lessons learned" to help guide others who may wish to change practice in existing agencies.
改善有严重行为和情绪问题儿童的治疗效果的循证实践在儿童心理健康领域受到了广泛关注。治疗性寄养照料（TFC）是针对有情绪或行为问题青少年的一种寄宿干预措施，是少数被认为基于循证的社区项目之一。然而，与大多数治疗方法一样，绝大多数现有项目并未采用循证模式。为了填补这一空白并改善众多TFC机构的实践，我们基于实践和研究的意见，开发了一种强化的TFC模式。它包括与“常规照料”TFC机构中青少年改善治疗效果相关的要素，以及张伯伦循证模式的关键要素。当前的论文描述了这种“混合”干预措施——“共同面对挑战”，并讨论了实施过程中的关键问题。我们描述了样本和环境，突出了关键的实施策略，并提供了“经验教训”，以帮助指导那些可能希望改变现有机构实践的人。
