Lyon Aaron R, Budd Karen S
University of Washington, Psychiatry and Behavioral Sciences, 6200 NE 74 St., Suite 100, Seattle, Washington 98115.
J Child Fam Stud. 2010 Oct 1;19(5):654-668. doi: 10.1007/s10826-010-9353-z.
Parent-Child Interaction Therapy (PCIT) has been identified as an evidence-based practice in the treatment of externalizing behavior among preschool-aged youth. Although considerable research has established its efficacy, little is known about the effectiveness of PCIT when delivered in a community mental health setting with underserved youth. The current pilot study investigated an implementation of PCIT with primarily low-socioeconomic status, urban, ethnic minority youth and families. The families of 14 clinically referred children aged 2-7 years and demonstrating externalizing behavior completed PCIT initial assessment, and 12 began treatment. Using standard PCIT completion criteria, 4 families completed treatment; and these families demonstrated clinically significant change on observational and self-report measures of parent behavior, parenting stress, and child functioning. Although treatment dropouts demonstrated more attenuated changes, observational data and parent-reported problems across sessions indicated some improvements with lower doses of intervention. Attendance and adherence data, referral source, barriers to treatment participation, and treatment satisfaction across completers and dropouts are discussed to highlight differences between the current sample and prior PCIT research. The findings suggest that PCIT can be delivered successfully in an underserved community sample when families remain in treatment, but that premature dropout limits treatment effectiveness. The findings suggest potential directions for research to improve uptake of PCIT in a community service setting.
亲子互动疗法(PCIT)已被确认为治疗学龄前儿童外化行为的循证实践方法。尽管大量研究已证实其疗效,但对于在社区心理健康环境中为服务不足的青少年提供PCIT时的效果,人们了解甚少。当前的试点研究调查了主要针对社会经济地位较低、居住在城市的少数民族青少年及其家庭实施PCIT的情况。14名年龄在2至7岁、表现出外化行为且经临床转诊的儿童的家庭完成了PCIT初始评估,其中12个家庭开始接受治疗。按照PCIT标准完成标准,4个家庭完成了治疗;这些家庭在父母行为、育儿压力和儿童功能的观察及自我报告测量方面显示出具有临床意义的变化。尽管退出治疗的家庭变化较小,但观察数据以及父母报告的各阶段问题表明,较低剂量的干预也有一些改善。文中讨论了出勤和依从性数据、转诊来源、治疗参与障碍以及完成治疗者和退出治疗者的治疗满意度,以突出当前样本与之前PCIT研究之间的差异。研究结果表明,当家庭持续接受治疗时,PCIT可以在服务不足的社区样本中成功实施,但过早退出会限制治疗效果。研究结果为在社区服务环境中提高PCIT的接受度的研究提供了潜在方向。