King Gillian, Schwellnus Heidi, Keenan Sarah, Chiarello Lisa A
a Bloorview Research Institute and Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Ontario , Canada.
b Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada.
Phys Occup Ther Pediatr. 2018;38(5):527-547. doi: 10.1080/01942638.2017.1405864. Epub 2018 Jan 5.
Client engagement is assumed to affect therapy outcomes. This study examined service providers' perceptions of youth engagement in solution-focused coaching sessions focusing on participation-oriented goals for youth with cerebral palsy.
Service providers completed the Pediatric Rehabilitation Intervention Measure of Engagement-Service Provider version (PRIME-SP) at the end of each session of the brief solution-focused coaching intervention (3-5 sessions) for 10 youth.
Youth engagement was high yet fluctuated over the sessions. Service providers noted a range of components of engagement/disengagement (affective, cognitive, and behavioral) and related factors, including client states, components of behavior change (success or nonsuccess between therapy sessions, and pleasure with success), and service provider strategies. Four preliminary patterns involving engagement, client-reported success, and goal difficulty (personally achievable or dependent on others) appeared to be meaningfully related to quantitative measures of youth outcomes.
The study provides insights into the highly engaging nature of solution-focused coaching and the relational, co-constructed nature of the therapeutic interaction. The study indicates the utility of the PRIME-SP as a tool for recording observations of components of engagement and related factors that may be useful for clinical decisions about the use of engagement strategies and for general reflections on practice.
假定客户参与会影响治疗效果。本研究考察了服务提供者对以解决为导向的辅导课程中青少年参与情况的看法，这些课程聚焦于为患有脑瘫的青少年设定的以参与为导向的目标。
对于10名青少年，服务提供者在简短的以解决为导向的辅导干预（3 - 5节课程）的每节课程结束时，完成《青少年康复干预参与度测量 - 服务提供者版》（PRIME - SP）。
青少年的参与度较高，但在各课程期间有所波动。服务提供者指出了参与/不参与的一系列组成部分（情感、认知和行为方面）以及相关因素，包括客户状态、行为改变的组成部分（课程之间的成功或不成功，以及对成功的愉悦感）和服务提供者策略。涉及参与度、客户报告的成功以及目标难度（个人可实现或依赖他人）的四种初步模式似乎与青少年治疗效果的量化指标有显著关联。
该研究深入了解了以解决为导向的辅导的高度参与性本质以及治疗互动的关系性、共同构建的本质。该研究表明PRIME - SP作为一种工具，可用于记录对参与组成部分和相关因素的观察，这对于关于使用参与策略的临床决策以及对实践的总体反思可能是有用的。
