Silver School of Social Work, New York University, New York, NY, USA.
McSilver Institute for Poverty Policy and Research, Silver School of Social Work, New York University, New York, NY, USA.
Trials. 2022 May 23;23(1):432. doi: 10.1186/s13063-022-06354-1.
Child maltreatment recidivism substantially increases the likelihood of adverse life outcomes, but there is little evidence that family preservation services are effective at reducing recidivism. Mothers in child welfare have very high rates of trauma exposure; maternal post-traumatic stress disorder (PTSD) is an intervention target that has the potential to reduce abuse and neglect. The Safe Mothers, Safe Children (SMSC) intervention program involves the delivery of an innovative combination of interventions, including Skills Training in Affective and Interpersonal Regulation (STAIR) and Parent-Child Interaction Therapy (PCIT). The combined intervention, Parenting-STAIR (P-STAIR), targets maternal PTSD and comorbid depression symptoms to reduce the adverse effects of PTSD on parenting, improve positive parenting skills, and prevent maltreatment recidivism.
This study is a two-arm randomized controlled trial: P-STAIR (23 sessions) versus supportive counseling (23 sessions). Participants are mothers receiving child welfare family preservation services (FPS), with a child in the age range of 1-8 years old and meeting diagnostic criteria for PTSD (with/without depression). Clinical assessment occurs at pre-treatment (baseline), two in-treatment assessments (mid-assessment #1 after module 9 and mid-assessment #2 after module 15), post-treatment, and at a 6-month follow-up. Recidivism will be measured using the New York State Child Welfare Registry (NYSCWR). We will enroll a total of 220 participants over 4 years: half (N = 110) randomly assigned to the P-STAIR condition and half (N = 110) to the supportive counseling condition.
This is the first RCT to investigate the efficacy of P-STAIR. The findings for the trial have the potential to contribute to the expansion of evidence-based practices for maternal PTSD, maltreatment, and child welfare.
儿童虐待复发大大增加了不良生活结果的可能性，但几乎没有证据表明家庭保护服务能有效减少复发。儿童福利中的母亲遭受创伤的比率很高；母亲创伤后应激障碍（PTSD）是一个干预目标，有潜力减少虐待和忽视。安全母亲、安全儿童（SMSC）干预计划涉及提供创新的干预措施组合，包括情感和人际调节技能培训（STAIR）和亲子互动疗法（PCIT）。联合干预，养育-STAIR（P-STAIR），针对母亲 PTSD 和共病抑郁症状，以减少 PTSD 对养育的负面影响，提高积极养育技能，并防止虐待复发。
这是一项两臂随机对照试验：P-STAIR（23 节）与支持性咨询（23 节）。参与者是接受儿童福利家庭保护服务（FPS）的母亲，其孩子年龄在 1-8 岁之间，符合 PTSD（伴/不伴抑郁）的诊断标准。临床评估在治疗前（基线）、两次治疗中评估（模块 9 后第 1 次中期评估和模块 15 后第 2 次中期评估）、治疗后和 6 个月随访时进行。复发将使用纽约州儿童福利登记处（NYSCWR）进行衡量。我们将在 4 年内共招募 220 名参与者：一半（N = 110）随机分配到 P-STAIR 组，另一半（N = 110）分配到支持性咨询组。
这是第一项研究 P-STAIR 疗效的 RCT。试验结果有可能为扩大母亲 PTSD、虐待和儿童福利的循证实践做出贡献。
