De Los Reyes Andres, Talbott Elizabeth, Power Thomas J, Michel Jeremy J, Cook Clayton R, Racz Sarah J, Fitzpatrick Olivia
University of Maryland at College Park, United States of America.
William and Mary, United States of America.
Clin Psychol Rev. 2022 Mar;92:102114. doi: 10.1016/j.cpr.2021.102114. Epub 2021 Dec 21.
Over 60 years of research reveal that informants who observe youth in clinically relevant contexts (e.g., home, school)-typically parents, teachers, and youth clients themselves-often hold discrepant views about that client's needs for mental health services (i.e., informant discrepancies). The last 10 years of research reveal that these discrepancies reflect the reality that (a) youth clients' needs may vary within and across contexts and (b) informants may vary in their expertise for observing youth clients within specific contexts. Accordingly, collecting and interpreting multi-informant data comprise "best practices" in research and clinical care. Yet, professionals across settings (e.g., health, mental health, school) vary in their use of multi-informant data. Specifically, professionals differ in how or to what degree they leverage multi-informant data to determine the goals of services designed to meet youth clients' needs. Further, even when professionals have access to multiple informants' reports, their clinical decisions often signal reliance on one informant's report, thereby omitting reports from other informants. Together, these issues highlight an understudied research-to-practice gap that limits the quality of services for youth. We advance a framework-the Needs-to-Goals Gap-to characterize the role of informant discrepancies in identifying youth clients' needs and the goals of services to meet those needs. This framework connects the utility of multi-informant data with the reality that services often target an array of needs within and across contexts, and that making decisions without accurately integrating multiple informants' reports may result in suboptimal care. We review evidence supporting the framework and outline directions for future research.
60多年的研究表明，在临床相关环境（如家庭、学校）中观察青少年的信息提供者——通常是父母、教师和青少年客户本人——对于该客户的心理健康服务需求往往持有不同的观点（即信息提供者差异）。过去10年的研究表明，这些差异反映了以下现实：（a）青少年客户的需求可能在不同环境中以及跨环境存在差异；（b）信息提供者在特定环境中观察青少年客户的专业能力可能各不相同。因此，收集和解读多信息提供者数据构成了研究和临床护理中的“最佳实践”。然而，不同领域（如健康、心理健康、学校）的专业人员在使用多信息提供者数据方面存在差异。具体而言，专业人员在如何或在多大程度上利用多信息提供者数据来确定旨在满足青少年客户需求的服务目标方面存在差异。此外，即使专业人员能够获取多个信息提供者的报告，他们的临床决策往往表明依赖于某一个信息提供者的报告，从而忽略了其他信息提供者的报告。这些问题共同凸显了一个研究较少的研究与实践之间的差距，该差距限制了为青少年提供的服务质量。我们提出了一个框架——需求到目标差距——来描述信息提供者差异在识别青少年客户需求以及满足这些需求的服务目标方面所起的作用。这个框架将多信息提供者数据的效用与以下现实联系起来：服务通常针对不同环境中以及跨环境的一系列需求，并且在没有准确整合多个信息提供者报告的情况下做出决策可能会导致护理效果不佳。我们回顾了支持该框架的证据，并概述了未来研究的方向。
