Barnett Miya L, Niec Larissa N, Peer Samuel O, Jent Jason F, Weinstein Allison, Gisbert Patricia, Simpson Gregory
a Center for Children, Families and Communities , Central Michigan University.
b University of Miami, Miller School of Medicine.
J Clin Child Adolesc Psychol. 2017 Nov-Dec;46(6):895-902. doi: 10.1080/15374416.2015.1063428. Epub 2015 Oct 14.
Although behavioral parent training is considered efficacious treatment for childhood conduct problems, not all families benefit equally from treatment. Some parents take longer to change their behaviors and others ultimately drop out. Understanding how therapist behaviors impact parental engagement is necessary to improve treatment utilization. This study investigated how different techniques of therapist in vivo feedback (i.e., coaching) influenced parent attrition and skill acquisition in parent-child interaction therapy (PCIT). Participants included 51 parent-child dyads who participated in PCIT. Children (age: M = 5.03, SD = 1.65) were predominately minorities (63% White Hispanic, 16% African American or Black). Eight families discontinued treatment prematurely. Therapist coaching techniques during the first session of treatment were coded using the Therapist-Parent Interaction Coding System, and parent behaviors were coded with the Dyadic Parent-Child Interaction Coding System, Third Edition. Parents who received more responsive coaching acquired child-centered parenting skills more quickly. Therapists used fewer responsive techniques and more drills with families who dropped out of treatment. A composite of therapist behaviors accurately predicted treatment completion for 86% of families. Although group membership was correctly classified for the treatment completers, only 1 dropout was accurately predicted. Findings suggest that therapist in vivo feedback techniques may impact parents' success in PCIT and that responsive coaching may be particularly relevant.
尽管行为家长培训被认为是治疗儿童行为问题的有效方法，但并非所有家庭都能从治疗中平等受益。一些家长改变行为的时间更长，另一些家长最终会退出治疗。了解治疗师的行为如何影响家长的参与度对于提高治疗利用率至关重要。本研究调查了治疗师现场反馈（即指导）的不同技巧如何影响亲子互动疗法（PCIT）中的家长退出率和技能习得。参与者包括51对参与PCIT的亲子二元组。儿童（年龄：M = 5.03，SD = 1.65）主要是少数族裔（63%为西班牙裔白人，16%为非裔美国人或黑人）。八个家庭过早中断治疗。使用治疗师-家长互动编码系统对治疗第一阶段的治疗师指导技巧进行编码，并用《二元亲子互动编码系统（第三版）》对家长行为进行编码。接受更多响应性指导的家长更快地获得了以儿童为中心的育儿技能。治疗师对退出治疗的家庭使用的响应性技巧较少，而使用的训练较多。治疗师行为的综合指标准确预测了86%家庭的治疗完成情况。虽然治疗完成者的组别分类正确，但仅准确预测了1名退出者。研究结果表明，治疗师现场反馈技巧可能会影响家长在PCIT中的治疗效果，而响应性指导可能尤为重要。
