Division of Child and Adolescent Psychiatry, Department of Psychiatry & Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa.
Judge Baker Children's Center, Harvard Medical School, Boston, MA 02115, USA.
Int J Environ Res Public Health. 2022 Apr 7;19(8):4450. doi: 10.3390/ijerph19084450.
There is a large assessment and treatment gap in child and adolescent mental health services, prominently so in low- and middle-income countries, where 90% of the world's children live. There is an urgent need to find evidence-based interventions that can be implemented successfully in these low-resource contexts. This pre-pilot study aimed to explore the barriers and facilitators to implementation as well as overall feasibility of Parent-Child Interaction Therapy (PCIT) in South Africa. A reflective and consensus building workshop was used to gather South African PCIT therapist (N = 4) perspectives on barriers, facilitators, and next steps to implementation in that country. Caregiver participants (N = 7) receiving the intervention in South Africa for the first time were also recruited to gather information on overall feasibility. Facilitators for implementation, including its strong evidence base, manualisation, and training model were described. Barriers relating to sustainability and scalability were highlighted. Largely positive views on acceptability from caregiver participants also indicated the promise of PCIT as an intervention in South Africa. Pilot data on the efficacy of the treatment for participating families are a next step. These initial results are positive, though research on how implementation factors contribute to the longer-term successful dissemination of PCIT in complex, heterogeneous low-resource settings is required.
在儿童和青少年心理健康服务中，存在着大量的评估和治疗差距，尤其是在中低收入国家，全世界 90%的儿童都生活在这些国家。迫切需要找到基于证据的干预措施，可以在这些资源匮乏的环境中成功实施。本预试验研究旨在探索南非实施亲子互动治疗（PCIT）的障碍和促进因素，以及整体可行性。采用反思和共识建立研讨会的方法，收集南非 4 名 PCIT 治疗师的观点，了解在该国实施的障碍、促进因素和下一步措施。还招募了首次在南非接受该干预措施的照顾者参与者，以收集有关整体可行性的信息。描述了实施的促进因素，包括其强大的证据基础、手册化和培训模式。强调了与可持续性和可扩展性相关的障碍。照顾者参与者对可接受性的看法大多是积极的，这也表明 PCIT 作为南非的一种干预措施具有前景。参与家庭治疗效果的初步试点数据是下一步。这些初步结果是积极的，但需要研究实施因素如何促进 PCIT 在复杂、异质的资源匮乏环境中的长期成功传播。
