新冠疫情期间快速全面转向虚拟 PCIT:实施与临床意义。

Rapid, Full-Scale Change to Virtual PCIT During the COVID-19 Pandemic: Implementation and Clinical Implications.

机构信息

Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA.

Duke University Center for Child and Family Policy, Coral Gables, 33146, USA.

出版信息

Prev Sci. 2021 Apr;22(3):269-283. doi: 10.1007/s11121-021-01211-0. Epub 2021 Feb 14.

Abstract

Health agencies call for the immediate mobilization of existing interventions in response to numerous child and family mental health concerns that have arisen as result of the COVID-19 pandemic. Answering this call, this pilot study describes the rapid, full-scale change from a primarily clinic-based Parent-Child Interaction Therapy (PCIT) model to a virtual service model (i.e., I-PCIT) in an academic and community-based program in Miami, Florida. First, we describe the virtual service training model our program developed and its implementation with 17 therapists (M = 32.35, 88.2% female, 47.1% Hispanic) to enable our clinic to shift from providing virtual services to a small portion of the families served (29.1%) to all of the families served. Second, we examine the effect of I-PCIT on child and caregiver outcomes during the 2-month stay-at-home period between March 16, 2020, and May 16, 2020, in 86 families (M = 4.75, 71% Hispanic). Due to the rapid nature of the current study, all active participants were transferred to virtual services, and therefore there was no comparison or control group, and outcomes represent the most recently available scores and not treatment completion. Results reveal that I-PCIT reduced child externalizing and internalizing problems and caregiver stress, and increased parenting skills and child compliance with medium to large effects even in the midst of the COVID-19 pandemic. Finally, the study examined components of our virtual service training model associated with the greatest improvements in child and caregiver outcomes. Preliminary findings revealed that locally and collaboratively developed strategies (e.g., online communities of practice, training videos and guides) had the strongest association with child and caregiver outcomes. Implications for virtual service delivery, implementation, and practice in the midst of the COVID-19 pandemic are discussed.

摘要

卫生机构呼吁立即调动现有干预措施,以应对因 COVID-19 大流行而产生的众多儿童和家庭心理健康问题。为响应这一号召,本试点研究描述了佛罗里达州迈阿密的一个学术和社区项目中,迅速将主要基于诊所的亲子互动疗法(PCIT)模式全面转变为虚拟服务模式(即 I-PCIT)的情况。首先,我们描述了我们的项目开发的虚拟服务培训模式及其在 17 名治疗师(M=32.35,88.2%为女性,47.1%为西班牙裔)中的实施情况,以使我们的诊所能够从为一小部分服务家庭(29.1%)提供虚拟服务转变为为所有服务家庭提供虚拟服务。其次,我们考察了 I-PCIT 在 2020 年 3 月 16 日至 5 月 16 日的 2 个月居家隔离期间对 86 个家庭(M=4.75,71%为西班牙裔)中儿童和照顾者结果的影响。由于当前研究的快速性质,所有活跃参与者都被转移到虚拟服务中,因此没有比较或对照组,结果代表了最近可获得的分数,而不是治疗完成情况。结果表明,I-PCIT 减少了儿童的外化和内化问题以及照顾者的压力,并且提高了育儿技能和儿童对规则的遵守,其效果为中到大,即使在 COVID-19 大流行期间也是如此。最后,该研究考察了与儿童和照顾者结果的最大改善相关的虚拟服务培训模式的组成部分。初步结果表明,本地和协作开发的策略(例如,在线实践社区、培训视频和指南)与儿童和照顾者结果的关联最强。讨论了在 COVID-19 大流行期间提供虚拟服务、实施和实践的意义。

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