N'zi Amanda M, Stevens Monica L, Eyberg Sheila M
Department of Clinical and Health Psychology, University of Florida, United States.
Department of Clinical and Health Psychology, University of Florida, United States.
Child Abuse Negl. 2016 May;55:81-91. doi: 10.1016/j.chiabu.2016.03.001. Epub 2016 Mar 21.
This pilot study used a randomized controlled trial design to examine the feasibility and explore initial outcomes of a twice weekly, 8-session Child Directed Interaction Training (CDIT) program for children living in kinship care. Participants included 14 grandmothers and great-grandmothers with their 2- to 7-year-old children randomized either to CDIT or a waitlist control condition. Training was delivered at a local, community library with high fidelity to the training protocol. There was no attrition in either condition. After training, kinship caregivers in the CDIT condition demonstrated more positive relationships with their children during behavioral observation. The caregivers in the CDIT condition also reported clinically and statistically significant decreases in parenting stress and caregiver depression, as well as fewer externalizing child behavior problems than waitlist controls. Parent daily report measures indicated significant changes in disciplining that included greater use of limit-setting and less use of critical verbal force. Results appeared stable at 3-month follow-up. Changes in child internalizing behaviors and caregiver use of non-critical verbal force were not seen until 3-month follow-up. Results of this pilot study suggest both the feasibility of conducting full scale randomized clinical trials of CDIT in the community and the promise of this approach for providing effective parent training for kinship caregivers.
这项试点研究采用随机对照试验设计,以检验为亲属照料儿童开展的每周两次、共8节次的儿童主导互动训练(CDIT)项目的可行性,并探索其初步成效。参与者包括14位祖母和曾祖母及其2至7岁的孩子,他们被随机分配到CDIT组或等待名单对照组。培训在当地社区图书馆进行,严格遵循培训方案。两组均无人员流失。培训后,在行为观察中,接受CDIT培训的亲属照料者与孩子之间表现出更积极的关系。接受CDIT培训的照料者在临床上和统计数据上也报告称,育儿压力和照料者抑郁显著降低,且与等待名单对照组相比,孩子的外化行为问题更少。家长每日报告测量结果显示,在管教方面有显著变化,包括更多地使用设定界限和更少地使用批评性言语强制手段。在3个月的随访中,结果似乎稳定。直到3个月随访时,才观察到孩子内化行为的变化以及照料者使用非批评性言语强制手段的情况。这项试点研究的结果表明,在社区中对CDIT进行全面随机临床试验是可行的,并且这种方法有望为亲属照料者提供有效的家长培训。