Child and Family Research Group, and Brain, Behaviour and Mental Health Research Group, Western Australia, School of Psychology, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, QLD, 4072, Australia.
Clin Child Fam Psychol Rev. 2019 Mar;22(1):129-145. doi: 10.1007/s10567-019-00284-2.
Evidence-based psychotherapies or programs (EBPs) exist for most mental health disorders that occur in childhood; however, the majority of children with a mental health disorder do not receive such treatments. This research-practice gap has been attributed to a range of factors that complicate the delivery of EBPs in everyday practice. While most suggestions to bridge this gap have focused on how to develop EBPs that will have a better fit for the clinical settings in which they will ultimately be deployed, a useful adjunct is to enhance practitioners' capacity to flexibly deliver EBPs to manage these factors. We propose that the extent to which a practitioner is able to change their own behaviour in response to cues and information about the current needs of their clients, and do so while maintaining the integrity of an EBP, may be a function of practitioners' self-regulatory capacity. In this conceptual paper, we describe a model of self-regulation that can be applied to child and family practitioners. We argue that practitioners with greater self-regulatory capacity are more likely to take up EBPs, sustain their use of them and have superior outcomes with clients. We draw on our experience in disseminating a system of parenting support to illustrate how practitioners' self-regulatory capacity can be enhanced while simultaneously receiving training in an EBP. Advantages and disadvantages of a self-regulatory approach to training are discussed and directions for future research are offered.
针对大多数发生于儿童时期的精神健康障碍,均存在循证心理疗法或项目(EBPs);然而,大多数患有精神健康障碍的儿童并未接受此类治疗。这一研究与实践之间的差距归因于一系列使 EBPs 在日常实践中难以实施的因素。尽管大多数弥合这一差距的建议侧重于如何开发更符合 EBPs 最终部署的临床环境的疗法,但一个有用的辅助手段是增强从业者灵活提供 EBPs 以管理这些因素的能力。我们提出,从业者根据有关客户当前需求的线索和信息来改变自身行为的程度,同时保持 EBPs 的完整性,可能是从业者自我监管能力的一个函数。在本概念性论文中,我们描述了一个可应用于儿童和家庭从业者的自我监管模型。我们认为,自我监管能力较强的从业者更有可能采用 EBPs,持续使用它们,并为客户带来更好的效果。我们借鉴了在传播育儿支持系统方面的经验,来说明如何在接受 EBPs 培训的同时增强从业者的自我监管能力。本文讨论了自我监管方法在培训方面的优缺点,并提出了未来研究的方向。