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社区提供的婴儿-父母心理治疗可改善母亲的敏感育儿:密歇根婴儿心理健康家访模式的评估。

Community-delivered infant-parent psychotherapy improves maternal sensitive caregiving: Evaluation of the Michigan model of infant mental health home visiting.

机构信息

Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.

University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio.

出版信息

Infant Ment Health J. 2020 Mar;41(2):178-190. doi: 10.1002/imhj.21840. Epub 2020 Apr 3.

Abstract

The current study evaluated the effectiveness of a home-based psychotherapeutic Infant Mental Health Home Visiting (IMH-HV) intervention for enhancing parenting sensitivity; a secondary aim was to evaluate whether the use of video feedback was associated with greater treatment response. Participants were N = 78 mothers and their children (age at entry ranged from prebirth to 24-month old (M = 9.8, SD = 8.4), who were initiating IMH-HV services with community mental health-based therapists (N = 51). Dyads were assessed during extended home visits via standardized interviews and observational and questionnaire methods within the first month of treatment (baseline), and again 6 and 12 months thereafter. Following each of these extended home visits, study evaluators completed a standard Q-sort to capture observations of maternal sensitivity during the visit. Therapists completed fidelity checklists used to derive the total number of IMH-HV sessions received (i.e., dosage) and frequency with which therapists provided video feedback. Results indicated a dose-response relationship between number of sessions and maternal sensitivity, and that video review with parents independently contributed to improved maternal sensitivity. Discussion focuses on the effectiveness of this community-based psychotherapeutic home visiting model for enhancing parenting, as well as the value of video feedback as a specific therapeutic strategy.

摘要

本研究评估了一种基于家庭的心理治疗性婴儿心理健康家访(IMH-HV)干预措施在增强育儿敏感性方面的有效性;次要目的是评估视频反馈的使用是否与更大的治疗反应相关。参与者为 N=78 名母亲及其子女(入组时的年龄从出生前到 24 个月不等(M=9.8,SD=8.4),他们正在与社区心理健康为基础的治疗师一起接受 IMH-HV 服务(N=51)。在治疗的第一个月内(基线),通过标准化访谈以及观察和问卷调查方法,在延长的家访期间对双生子进行了评估,此后 6 个月和 12 个月后再次进行评估。在每次家访结束后,研究评估员都会完成一项标准的 Q 分类,以捕捉家访过程中母亲敏感性的观察结果。治疗师完成了用于确定接受的 IMH-HV 疗程总数(即剂量)以及治疗师提供视频反馈频率的可信度检查表。结果表明,疗程数与母亲敏感性之间存在剂量反应关系,并且父母的视频审查独立有助于提高母亲敏感性。讨论重点关注这种基于社区的心理治疗性家访模式在增强育儿方面的有效性,以及视频反馈作为一种特定治疗策略的价值。

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