Stadnick Nicole A, Drahota Amy, Brookman-Frazee Lauren
San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA. Child and Adolescent Services Research Center, Rady Children's Hospital-San Diego, San Diego, CA, USA.
J Child Fam Stud. 2013 Apr 1;22(3):414-422. doi: 10.1007/s10826-012-9594-0.
Research suggests that improvements to community mental health (CMH) care for children with autism spectrum disorders (ASD) are needed. Recent research examining the feasibility of training CMH therapists to deliver a package of evidence-based practice intervention strategies (EBPs) targeting challenging behaviors for school-age children with ASD offers initial support for such efforts to improve care. Specifically, quantitative data from a recent pilot study indicate that CMH therapists with limited ASD experience can deliver an EBP intervention with fidelity and perceive it as useful to their practice. Further, client attendance is high and children demonstrate improvement on standardized measures. To further understand the feasibility and impact of training CMH therapists to deliver EBPs, this mixed-methods study examined parent perspectives of the process and impact of outpatient psychotherapy for 13 parents of children ages 5-13 with ASD whose therapists were trained to deliver the EBP intervention. Results complement and expand previously reported quantitative data on psychotherapy process indicating that parents are highly involved in treatment for their children, perceive a strong therapeutic alliance with their children's therapist, and highlight that treatment was different once therapists began delivering the intervention. Results also indicate themes related to parents' perceptions of positive child and parent outcomes that provide important details on the specific gains that were observed during treatment. Study findings underscore the importance of parent perspectives in understanding the process and impact of implementing EBPs in CMH settings for families of children with ASD.
研究表明,自闭症谱系障碍(ASD)儿童的社区心理健康(CMH)护理需要改进。最近一项研究探讨了培训CMH治疗师提供一套针对ASD学龄儿童挑战行为的循证实践干预策略(EBP)的可行性,为改善护理的此类努力提供了初步支持。具体而言,最近一项试点研究的定量数据表明,ASD经验有限的CMH治疗师能够忠实地实施EBP干预,并认为这对他们的实践有用。此外,服务对象的出勤率很高,儿童在标准化测评中也有进步。为了进一步了解培训CMH治疗师实施EBP的可行性和影响,这项混合方法研究调查了13名5至13岁ASD儿童家长对门诊心理治疗过程和影响的看法,这些儿童的治疗师接受过实施EBP干预的培训。研究结果补充并扩展了先前报告的关于心理治疗过程的定量数据,表明家长高度参与孩子的治疗,认为与孩子的治疗师建立了强大的治疗联盟,并强调一旦治疗师开始实施干预,治疗就有所不同。结果还表明了与家长对儿童和家长积极治疗结果的看法相关的主题,这些主题提供了治疗期间观察到的具体收获的重要细节。研究结果强调了家长观点在理解为ASD儿童家庭在CMH环境中实施EBP的过程和影响方面的重要性。