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培训社区心理健康治疗师实施 ASD 循证干预的效果:在门诊和学校心理健康服务中进行的混合有效性-实施试验的结果。

The effectiveness of training community mental health therapists in an evidence-based intervention for ASD: Findings from a hybrid effectiveness-implementation trial in outpatient and school-based mental health services.

机构信息

University of California, San Diego, USA.

Rady Children's Hospital-San Diego, USA.

出版信息

Autism. 2022 Apr;26(3):678-689. doi: 10.1177/13623613211067844. Epub 2022 Jan 5.

Abstract

Publicly funded mental health services play an important role in caring for school-age children with autism spectrum disorder (ASD); however, therapists report a lack of specialized ASD training, which families identity as a barrier in obtaining mental health services for their children. (AIM HI) was developed in collaboration with community stakeholders to respond to identified needs of children and community therapists. The current study examined the effects of therapist training in AIM HI on the changes in therapist practice, including therapists' use of evidence-based intervention strategies in session. Data were collected from a study conducted in community outpatient and school based mental health programs randomly assigned to receive AIM HI therapist training or observation of routine care. Therapist and child clients were enrolled from participating programs. Therapists in AIM HI training received training and consultation for 6 months while delivering the AIM HI intervention to a participating client; therapists in usual care delivered routine care. Both groups of therapists video recorded psychotherapy sessions which were scored by trained raters. Differences between training groups were examined using multilevel modeling. Therapists trained in AIM HI were observed to use more extensive active teaching strategies with caregivers, engagement strategies with children, strategies promoting continuity of care, and had more structured sessions with more effective pursuit of caregiver and children skill teaching. Therapist licensure moderated some training outcomes.

摘要

公共资助的心理健康服务在照顾学龄自闭症谱系障碍(ASD)儿童方面发挥着重要作用;然而,治疗师报告说,他们缺乏专门的 ASD 培训,而这是家庭获得儿童心理健康服务的障碍之一。(AIM HI) 是与社区利益相关者合作开发的,以满足儿童和社区治疗师的需求。本研究考察了治疗师在 AIM HI 培训中实践的变化,包括治疗师在治疗过程中使用循证干预策略的情况。数据来自一项在社区门诊和学校心理健康项目中进行的研究,这些项目被随机分配接受 AIM HI 治疗师培训或观察常规护理。来自参与项目的治疗师和儿童客户都被录取。接受 AIM HI 培训的治疗师在 6 个月内接受培训和咨询,同时为一名参与的客户提供 AIM HI 干预;常规护理组的治疗师提供常规护理。两组治疗师都对心理治疗过程进行了录像,由经过培训的评估员进行评分。使用多层建模检查了培训组之间的差异。接受 AIM HI 培训的治疗师被观察到与照顾者更多地使用广泛的主动教学策略,与儿童更多地使用参与策略,促进护理连续性的策略,以及更具结构性的治疗会议,更有效地促进照顾者和儿童技能教学。治疗师的执照在一定程度上影响了培训结果。

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