Department of Psychiatry, University of California, San Diego, CA, USA.
Child and Adolescent Services Research Center (CASRC), 3020 Children's Way, MC 5033, San Diego, CA, 92123, USA.
J Autism Dev Disord. 2019 Mar;49(3):924-934. doi: 10.1007/s10803-018-3795-3.
Publicly funded mental health services play an important role in serving children with autism spectrum disorder (ASD). Previous research indicates a high likelihood of adaptations when therapists deliver evidence based practices to non-ASD populations, though less is known about therapists' use of adaptations for children with ASD receiving mental health services. The current study uses a mixed quantitative and qualitative approach to characterize the types and reasons therapists adapted a clinical intervention [An Individualized Mental Health Intervention for Children with ASD (AIM HI)] for delivery with clinically complex children with ASD served in publicly funded mental health settings and identify therapist characteristics that predict use of adaptations. The most common adaptations were characterized as augmenting AIM HI and were done to individualize the intervention to fit with therapeutic style, increase caregiver participation, and address clients' and caregivers' needs and functioning. No therapist characteristics emerged as significant predictors of adaptations. Results suggest that therapists' adaptations were largely consistent with the AIM HI protocol while individualizing the model to address the complex needs of youth with ASD.
公共资助的心理健康服务在为自闭症谱系障碍（ASD）儿童提供服务方面发挥着重要作用。先前的研究表明，治疗师在向非 ASD 人群提供循证实践时，很可能会进行调整，尽管对于接受心理健康服务的 ASD 儿童的治疗师使用调整的情况了解较少。本研究采用混合定量和定性方法，描述了在公共资助的心理健康环境中为临床复杂的 ASD 儿童提供服务的治疗师对临床干预[自闭症儿童个体化心理健康干预（AIM HI）]进行调整的类型和原因，并确定了预测调整使用的治疗师特征。最常见的调整被描述为增强 AIM HI，并对干预措施进行个性化，以适应治疗风格，增加照顾者的参与度，并满足客户和照顾者的需求和功能。没有治疗师特征被确定为调整的显著预测因素。研究结果表明，治疗师的调整在很大程度上与 AIM HI 方案一致，同时对该模型进行了个性化，以满足 ASD 青少年的复杂需求。
