Sibley Margaret H, Comer Jonathan S, Gonzalez Jaife
Department of Psychiatry and Behavioral Health, Florida International University, Miami, FL.
Department of Psychology, Florida International University, Miami, FL.
J Psychopathol Behav Assess. 2017 Sep;39(3):467-485. doi: 10.1007/s10862-017-9598-6. Epub 2017 Mar 20.
Adolescents with ADHD demonstrate notoriously poor treatment utilization. Barriers to access have been partially addressed through tailored therapy content and therapist delivery style; yet, additional challenges to engaging this population remain. To leverage modern technology in support of this aim, the current study investigates parent-teen therapy for ADHD delivered over a videoconferencing format. In this preliminary feasibility study, teens and parents (20) received an empirically supported dyadic therapy that incorporates skills-based modules with motivational interviewing. The videoconferencing interface was deemed feasible with nearly all families completing treatment. Acceptable therapeutic alliance was reported and key mechanisms of change were engaged (i.e., adolescent motivation to meet goals, parent strategy implementation). Families reported high satisfaction, despite minor disturbances associated with delivering therapy via videoconferencing. Treatment integrity and fidelity were acceptable, though slightly reduced compared to clinic-based trials of the same protocol. Therapists perceived that videoconferencing enhanced treatment for 50% of families. Reductions in participant ADHD symptoms and organization, time management, and planning problems from baseline to post-treatment were noted by parents and teachers. However, open trial results of this study should be interpreted with caution due to their uncontrolled and preliminary nature.
患有注意力缺陷多动障碍(ADHD)的青少年在治疗利用率方面表现出极差的情况。通过量身定制的治疗内容和治疗师的授课方式,获取治疗的障碍已得到部分解决;然而,吸引这一人群参与治疗仍面临其他挑战。为利用现代技术来支持这一目标,本研究调查了通过视频会议形式提供的针对ADHD的亲子治疗。在这项初步可行性研究中,青少年及其父母(共20对)接受了一种基于实证的二元治疗,该治疗结合了基于技能的模块和动机性访谈。几乎所有家庭都完成了治疗,视频会议界面被认为是可行的。报告显示治疗联盟可接受,且关键的改变机制得以启动(即青少年实现目标的动机、父母策略的实施)。尽管通过视频会议进行治疗存在一些小干扰,但家庭报告的满意度很高。治疗的完整性和忠诚度是可接受的,不过与基于诊所的相同方案试验相比略有降低。治疗师认为视频会议对50%的家庭的治疗有促进作用。父母和教师指出,从基线到治疗后,参与者的ADHD症状以及组织、时间管理和计划问题都有所减少。然而,由于本研究的开放试验结果具有非控制性和初步性,应谨慎解读。