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将简短战略家庭治疗从实验室应用到实际:跨转化阶段的证据生成

Taking Brief Strategic Family Therapy from Bench to Trench: Evidence Generation Across Translational Phases.

作者信息

Horigian Viviana E, Anderson Austen R, Szapocznik José

机构信息

Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL.

出版信息

Fam Process. 2016 Sep;55(3):529-42. doi: 10.1111/famp.12233. Epub 2016 Jul 14.

Abstract

In this article, we review the research evidence generated over 40 years on Brief Strategic Family Therapy illustrating the NIH stages of intervention development and highlighting the translational process. Basic research (Stage 0) led to the discovery of the characteristics of the population and the nature of the problems that needed to be addressed. This step informed the selection of an intervention model that addressed the problems presented by the population, but in a fashion that was congruent with the population's culture, defined in terms of its value orientations. From this basic research, an intervention that integrated structural and strategic elements was selected and refined through testing (Stage I). The second stage of translation (Stage II) included efficacy trials of a specialized engagement module that responded to challenges to the provision of services. It also included several other efficacy trials that documented the effects of the intervention, mostly in research settings or with research therapists. Stages III/IV in the translational process led to the testing of the effectiveness of the intervention in real-world settings with community therapists and some oversight from the developer. This work revealed that an implementation/organizational intervention was required to achieve fidelity and sustainability of the intervention in real-world settings. The work is currently in Stage V in which new model development led to an implementation intervention that can ensure fidelity and sustainability. Future research will evaluate the effectiveness of the current implementation model in increasing adoption, fidelity, and long-term sustainability in real-world settings.

摘要

在本文中,我们回顾了40多年来关于简短策略式家庭治疗的研究证据,阐述了美国国立卫生研究院干预发展的各个阶段,并突出了转化过程。基础研究(0阶段)促成了对目标人群特征以及需要解决的问题本质的发现。这一步为选择一种干预模式提供了依据,该模式能够解决目标人群所呈现的问题,并且在价值取向所定义的文化层面上与目标人群相契合。基于这项基础研究,一种整合了结构和策略元素的干预措施被选定,并通过测试进行完善(I阶段)。转化的第二阶段(II阶段)包括针对提供服务所面临挑战的一个专门参与模块的疗效试验。它还包括其他几项疗效试验,这些试验记录了该干预措施的效果,大多是在研究环境中或由研究治疗师进行的。转化过程中的III/IV阶段导致在现实环境中由社区治疗师对该干预措施的有效性进行测试,并由开发者进行一定监督。这项工作表明,在现实环境中要实现该干预措施的保真度和可持续性,需要实施一种组织干预。目前这项工作处于V阶段,在此阶段新的模式开发促成了一种能够确保保真度和可持续性的实施干预。未来的研究将评估当前实施模式在现实环境中提高采用率、保真度和长期可持续性方面的有效性。

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