Department of Psychology, Queens College, City University of New York (CUNY), 65-30 Kissena Blvd, Flushing, NY 11367, USA.
J Abnorm Child Psychol. 2012 Nov;40(8):1351-62. doi: 10.1007/s10802-012-9666-z.
Behavioral parent training (BPT) is an evidence-based intervention for the treatment of attention-deficit/hyperactivity disorder (ADHD) and related disruptive behavioral disorders of childhood. Despite convincing data on effectiveness, engagement to BPT, particularly for high-risk families, has been a long standing, yet understudied, issue. Data from a clinical trial of a comprehensive BPT approach to enhance engagement and outcomes (the Strategies to Enhance Positive Parenting [STEPP] program) are presented herein. The STEPP program was compared to a traditional group-based BPT program on propensity to attend treatment, propensity to complete homework over the course of treatment, and dropout from BPT. Additionally, factors empirically related to engagement to treatment and targeted by the STEPP program were analyzed to determine whether these factors were enhanced by participation in the STEPP program. In a randomized cohort of 80 single-mothers of school-age children with ADHD, analyses demonstrated that the STEPP program lead to greater propensity to attend treatment over time and a greater propensity to complete homework over the course of treatment. Furthermore, participation in the STEPP Program was associated with a lower rate of dropout. Finally, data suggested that parents assigned to the STEPP program reported significant improvements in factors empirically related to engagement that were targeted within the STEPP program (i.e., amount and quality of social support from their group members, expectations for treatment, and perceived barriers to treatment participation). Results of the study have implications for targeting engagement throughout the process of BPT, particularly for high-risk families.
行为父母培训（BPT）是一种针对注意力缺陷/多动障碍（ADHD）和儿童相关破坏性行为障碍的循证干预措施。尽管有令人信服的有效性数据，但 BPT 的参与度，特别是对于高风险家庭而言，一直是一个长期存在但研究不足的问题。本文介绍了一项全面 BPT 方法的临床试验中的数据，旨在增强参与度和结果（增强积极育儿策略[STEPP]计划）。将 STEPP 计划与传统的基于小组的 BPT 计划进行了比较，比较了治疗的参与倾向、治疗过程中完成家庭作业的倾向以及 BPT 的辍学率。此外，还分析了与治疗参与度相关的经验因素，并针对这些因素进行了分析，以确定参与 STEPP 计划是否增强了这些因素。在一项针对 80 名患有 ADHD 的学龄期儿童的单母亲的随机队列研究中，分析表明，STEPP 计划随着时间的推移导致治疗的参与倾向增加，并且在治疗过程中完成家庭作业的倾向也增加。此外，参与 STEPP 计划与辍学率降低有关。最后，数据表明，被分配到 STEPP 计划的父母报告说，与参与该计划的目标相关的与参与度相关的经验因素有了显著改善（即，来自小组成员的社交支持的数量和质量、对治疗的期望以及对治疗参与的感知障碍）。该研究的结果对于在 BPT 过程中针对参与度具有重要意义，特别是对于高风险家庭。
