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为受虐待儿童幸存者服务的临床医生的治疗信念和技术。

Treatment beliefs and techniques of clinicians serving child maltreatment survivors.

机构信息

Center for Safe and Healthy Families, Primary Children's Medical Center, Salt Lake City, UT, USA.

出版信息

Child Maltreat. 2014 Feb;19(1):49-60. doi: 10.1177/1077559513518097. Epub 2014 Jan 13.

Abstract

A significant focus in the child maltreatment field is greater dissemination and implementation of evidence-based treatments (EBTs). Research has attempted to identify attitudes toward EBTs and training experiences that predict clinicians' use of EBTs; however, these findings have yielded mixed results. This study reports on the results of a nationwide (United States) sample of 256 clinicians serving child maltreatment survivors, who completed questionnaires assessing beliefs about the clinical process, treatment technique selection, and attitudes toward EBTs. Psychometric data are presented on two new scales. The first scale examines clinicians' beliefs about two components of the clinical process: (1) the extent to which treatment should be structured/directed by the clinician and (2) children's verbal capacity to discuss traumatic events. The second scale assesses clinician-reported selection of various treatment techniques and contains four subscales: Cognitive-Behavioral, Play/Experiential, Psychodynamic, and Uncommon. Using these scales, a series of analyses were performed to determine which attitudes, beliefs, and training variables were associated with the selection of treatment techniques. After controlling for the impact of other variables, significant associations between the two clinical process beliefs and cognitive-behavioral and play/experiential techniques utilization were observed. Implications of these results for increasing implementation of EBTs with child maltreatment survivors are discussed.

摘要

儿童虐待领域的一个重要焦点是更广泛地传播和实施循证治疗 (EBT)。研究试图确定对 EBT 的态度和培训经验,以预测临床医生使用 EBT 的情况;然而,这些发现的结果喜忧参半。本研究报告了对 256 名为虐待儿童幸存者服务的临床医生进行的一项全国性(美国)样本的研究结果,这些临床医生完成了评估他们对临床过程、治疗技术选择以及对 EBT 的态度的信念的问卷。本文介绍了两个新量表的心理计量学数据。第一个量表考察了临床医生对临床过程两个组成部分的信念:(1) 治疗应该由临床医生在多大程度上进行结构化/指导;以及 (2) 儿童口头讨论创伤事件的能力。第二个量表评估了临床医生报告的各种治疗技术的选择,并包含四个子量表:认知行为、游戏/体验、心理动力学和不常见。使用这些量表,进行了一系列分析,以确定哪些态度、信念和培训变量与治疗技术的选择有关。在控制其他变量的影响后,观察到这两个临床过程信念与认知行为和游戏/体验技术的使用之间存在显著关联。讨论了这些结果对增加虐待儿童幸存者实施 EBT 的影响。

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