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优化行为家长培训中的参与度:迈向技术增强治疗模式的进展

Optimizing Engagement in Behavioral Parent Training: Progress Toward a Technology-Enhanced Treatment Model.

作者信息

Jones Deborah J, Loiselle Raelyn, Zachary Chloe, Georgeson Alexis R, Highlander April, Turner Patrick, Youngstrom Jennifer K, Khavjou Olga, Anton Margaret T, Gonzalez Michelle, Bresland Nicole Lafko, Forehand Rex

机构信息

University of North Carolina at Chapel Hill.

University of North Carolina at Chapel Hill.

出版信息

Behav Ther. 2021 Mar;52(2):508-521. doi: 10.1016/j.beth.2020.07.001. Epub 2020 Jul 15.

Abstract

Low-income families are more likely to have a child with an early-onset Behavior Disorder (BD); yet, socioeconomic strain challenges engagement in Behavioral Parent Training (BPT). This study follows a promising pilot to further examine the potential to cost-effectively improve low-income families' engagement in and the efficiency of BPT. Low-income families were randomized to (a) Helping the Noncompliant Child (HNC; McMahon & Forehand, 2003), a weekly, mastery-based BPT program that includes both the parent and child or (b) Technology-Enhanced HNC (TE-HNC), which includes all of the standard HNC components plus a parent mobile application and therapist web portal that provide between-session monitoring, modeling, and coaching of parent skill use with the goal of improved engagement in the context of financial strain. Relative to HNC, TE-HNC families had greater homework compliance and mid-week call participation. TE-HNC completers also required fewer weeks to achieve skill mastery and, in turn, to complete treatment than those in HNC without compromising parent satisfaction with treatment; yet, session attendance and completion were not different between groups. Future directions and clinical implications are discussed.

摘要

低收入家庭更有可能生育患有早发性行为障碍(BD)的孩子;然而,社会经济压力对参与行为父母培训(BPT)构成挑战。本研究跟踪了一项有前景的试点项目,以进一步考察以具有成本效益的方式提高低收入家庭对BPT的参与度及其效率的潜力。低收入家庭被随机分为两组:(a)帮助不听话儿童(HNC;麦克马洪和福尔汉姆,2003年),这是一个基于掌握程度的每周一次的BPT项目,包括家长和孩子;或(b)技术增强型HNC(TE-HNC),它包括所有标准的HNC组件,外加一个家长移动应用程序和治疗师网络门户,用于提供疗程间的监测、示范以及对家长技能使用的指导,目的是在经济压力背景下提高参与度。相对于HNC,TE-HNC家庭的家庭作业依从性更高,周中通话参与度也更高。与HNC组相比,TE-HNC组的完成者达到技能掌握进而完成治疗所需的周数更少,而且在不影响家长对治疗满意度的情况下;然而两组之间的疗程出席率和完成率并无差异。本文还讨论了未来的研究方向和临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f2c/7362816/c00499c20c44/gr1_lrg.jpg

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