Andrade Brendan F, Browne Dillon T, Naber Alex R
Centre for Addiction and Mental Health; University of Toronto.
Ontario Institute for Studies in Education, University of Toronto.
Behav Ther. 2015 May;46(3):365-78. doi: 10.1016/j.beth.2015.01.004. Epub 2015 Feb 8.
Parent management training programs for parents of children with disruptive behaviors are efficacious treatments; however, in order to maximize efficiency it is necessary to develop approaches to understand which parents are most likely to participate in treatment. Accordingly, the present study used a person-centered methodology to determine clinically relevant parenting profiles that capture the breadth of parents' readiness to engage in parenting treatment, and their self-reported parenting skills. Further, identified profiles were compared on the severity of children's behavior problems and used to predict participation in parent management training.
One hundred and forty-three parents completed assessments at an urban children's mental health clinic. Parents were given measures to assess personal readiness to participate in parenting treatment, parenting skills, and child behavior. A subset of these parents participated in parent management training.
Three profiles emerged that differed in parents' treatment readiness and level of skills. Forty-one percent of parents were classified as "ready." They showed relatively higher rates of inconsistent discipline, but also somewhat higher levels of positive parenting. Thirty-nine percent of parents were classified as "less in need." These parents reported relatively less inconsistent discipline and poor supervision skills and greater positive parenting. Finally, approximately 20% of parents were classified as "almost ready." They showed high levels of inconsistent discipline and poor supervision skills, and low levels of positive parenting. Almost ready and ready parents reported the most problems with their children's behavior. Further, parents classified as less in need participated in the fewest treatment sessions.
Consideration of parent readiness and skills, in addition to symptom severity, may inform clinical decision making and screening procedures.
针对有破坏性行为儿童的家长开展的家长管理培训项目是有效的治疗方法;然而,为了最大限度地提高效率,有必要开发一些方法来了解哪些家长最有可能参与治疗。因此,本研究采用以人为主的方法来确定具有临床相关性的育儿模式,这些模式能够体现家长参与育儿治疗的意愿程度以及他们自我报告的育儿技能。此外,还根据儿童行为问题的严重程度对确定的模式进行了比较,并用于预测家长参与家长管理培训的情况。
143名家长在一家城市儿童心理健康诊所完成了评估。家长们接受了评估个人参与育儿治疗意愿、育儿技能和儿童行为的测评。这些家长中的一部分参加了家长管理培训。
出现了三种模式,它们在家长的治疗意愿和技能水平方面存在差异。41%的家长被归类为“有意愿”。他们表现出相对较高的不一致管教率,但积极育儿水平也略高。39%的家长被归类为“需求较低”。这些家长报告的不一致管教和监督技能较差的情况相对较少,积极育儿程度较高。最后,约20%的家长被归类为“几乎有意愿”。他们表现出高水平的不一致管教和较差的监督技能,积极育儿水平较低。几乎有意愿和有意愿的家长报告的孩子行为问题最多。此外,被归类为需求较低的家长参加的治疗课程最少。
除了症状严重程度外,考虑家长的意愿和技能可能有助于临床决策和筛查程序。