Children's Mental Health Services Research Center.
Psychiatr Rehabil J. 2012 Sep;35(5):369-375. doi: 10.1037/h0094495.
Treatment adherence, defined as the degree to which practitioners implemented prescribed program principles and activities and avoided proscribed activities, has been an area of growing interest in mental health services for children with severe emotional and behavioral disorders. This study evaluated the reliability and validity of a treatment adherence measure for child psychiatric rehabilitation (CPSR).
Parents of children receiving CPSR (n = 79) or psychotherapy (n = 27) completed the Children's Psychosocial Rehabilitation Treatment Adherence Measure (CTAM) and a measure of 2-week session impact. Psychiatric rehabilitation (PSR) supervisors identified PSR practitioners with reputations for high or low adherence to the model. The CTAM's discriminant validity was assessed by using known-groups procedures and predictive validity by examining its relationship to 2-week session impact.
The CTAM demonstrated excellent internal consistency (α = .92), discriminant validity (p = .002, d = .72; p = .021, d = .59), and predictive validity (B = 2.24, SE = .31, p < .001), accounting for 28% of the child-level variance in 2-week session impact.
Findings suggest the CTAM is a reliable and valid measure of treatment adherence for CPSR programs with a skill-teaching focus. Providers and agencies should take steps to enhance treatment adherence because it may be an important predictor of children's short-term response to CPSR.
治疗依从性，即从业者实施规定的方案原则和活动并避免规定的活动的程度，已成为儿童严重情绪和行为障碍的精神卫生服务中日益关注的领域。本研究评估了儿童精神病康复（CPSR）治疗依从性测量的信度和效度。
接受 CPSR（n=79）或心理治疗（n=27）的儿童的父母完成了儿童心理社会康复治疗依从性量表（CTAM）和为期两周的疗程影响量表。精神病康复（PSR）主管根据对模型的高度或低度依从性来确定 PSR 从业者。使用已知组程序评估 CTAM 的判别有效性，并通过检查其与两周疗程影响的关系来评估其预测有效性。
CTAM 表现出极好的内部一致性（α=.92）、判别有效性（p=.002，d=.72；p=.021，d=.59）和预测有效性（B=2.24，SE=.31，p<.001），占儿童两周疗程影响的 28%。
研究结果表明，CTAM 是具有技能教学重点的 CPSR 计划治疗依从性的可靠和有效衡量标准。提供者和机构应采取措施提高治疗依从性，因为它可能是儿童对 CPSR 短期反应的重要预测因素。
