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儿童及家庭的远程心理治疗:从二十年转化研究中汲取的经验教训

Telepsychotherapy With Children and Families: Lessons Gleaned From Two Decades of Translational Research.

作者信息

Wade Shari L, Gies Lisa M, Fisher Allison P, Moscato Emily L, Adlam Anna R, Bardoni Alessandra, Corti Claudia, Limond Jennifer, Modi Avani C, Williams Tricia

机构信息

Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, and Department of Psychology and Department of Pediatrics, College of Medicine, University of Cincinnati.

Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, and Department of Psychology, University of Cincinnati.

出版信息

J Psychother Integr. 2020 Jun;30(2):332-347. doi: 10.1037/int0000215.

Abstract

The novel coronavirus, COVID-19, has led to sweeping changes in psychological practice and the concomitant rapid uptake of telepsychotherapy. Although telepsychotherapy is new to many clinical psychologists, there is considerable research on telepsychotherapy treatments. Nearly 2 decades of clinical research on telepsychotherapy treatments with children with neurological conditions has the potential to inform emerging clinical practice in the age of COVID-19. Toward that end, we synthesized findings from 14 clinical trials of telepsychotherapy problem-solving and parent-training interventions involving more than 800 children and families with diverse diagnoses, including traumatic brain injury, epilepsy, brain tumors, congenital heart disease, and perinatal stroke. We summarize efficacy across studies and clinical populations and report feasibility and acceptability data from the perspectives of parents, children, and psychotherapists. We describe adaptation for international contexts and strategies for troubleshooting technological challenges and working with families of varying socioeconomic strata. The extensive research literature reviewed and synthesized provides considerable support for the utility of telepsychotherapy with children with neurological conditions and their families and underscores its high level of acceptability with both diverse clinical populations and providers. During this period of heightened vulnerability and stress and reduced access to usual supports and services, telepsychotherapy approaches such as online family problem-solving treatment and online parenting skills training may allow psychologists to deliver traditional evidence-based treatments virtually while preserving fidelity and efficacy.

摘要

新型冠状病毒COVID-19给心理治疗实践带来了全面变革,同时远程心理治疗也迅速兴起。尽管远程心理治疗对许多临床心理学家来说是新事物,但关于远程心理治疗的研究却相当多。近20年来针对患有神经疾病儿童的远程心理治疗临床研究,有可能为COVID-19时代新兴的临床实践提供参考。为此,我们综合了14项远程心理治疗解决问题和家长培训干预临床试验的结果,这些试验涉及800多名患有各种疾病的儿童和家庭,包括创伤性脑损伤、癫痫、脑肿瘤、先天性心脏病和围产期中风。我们总结了各项研究和临床群体的疗效,并从家长、儿童和心理治疗师的角度报告了可行性和可接受性数据。我们描述了针对国际环境的调整方法,以及解决技术挑战和与不同社会经济阶层家庭合作的策略。经过回顾和综合的大量研究文献,为针对患有神经疾病儿童及其家庭的远程心理治疗的效用提供了相当多的支持,并强调了其在不同临床群体和提供者中的高度可接受性。在这段脆弱性和压力加剧、获得常规支持和服务减少的时期,诸如在线家庭问题解决治疗和在线育儿技能培训等远程心理治疗方法,可能使心理学家能够在保持保真度和疗效的同时,以虚拟方式提供传统的循证治疗。

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