治疗师联盟建设行为与荷兰轻度智力残疾或边缘智力功能及外化问题行为儿童的治疗依从性。
Therapist alliance building behavior and treatment adherence for dutch children with mild intellectual disability or borderline intellectual functioning and externalizing problem behavior.
机构信息
Radboud University, Programme of Learning and Plasticity, Behavioural Science Institute, Nijmegen, the Netherlands.
Utrecht University, Department of Developmental Psychology, Utrecht, the Netherlands.
出版信息
Res Dev Disabil. 2022 Sep;128:104296. doi: 10.1016/j.ridd.2022.104296. Epub 2022 Jul 8.
BACKGROUND
Psychological interventions targeting children with mild intellectual disability or borderline intellectual functioning (MID-BIF) are suggested to be effective in reducing their externalizing problem behavior, but less is known about the specific treatment processes that may be associated with these effects.
AIMS
The current study investigated whether the treatment processes of observed treatment adherence (i.e., the degree to which a therapist sticks to the protocol of a treatment and provides the treatment as intended) and observed therapist alliance-building behavior (TA-BB; i.e., behavior contributing to the affective bond between the therapist and the client) predicted treatment outcomes in a group behavioral parent training combined with group child cognitive behavior therapy targeting externalizing problem behavior in children with MID-BIF.
METHODS AND PROCEDURES
Seventy-two children (aged 9-18; M = 12.1) and their parents in The Netherlands received the intervention program. They reported on children's externalizing behavior, parenting practices and the parent-child relationship by questionnaires at pre-test and post-test, and the observed treatment processes were coded by audio tapes of therapeutic sessions.
OUTCOMES AND RESULTS
The results showed high levels of both treatment adherence (M = 2.49; SD = 0.20; range 1 - 3) and TA-BB (M = 4.11; SD = 0.32; range 1 - 5). Additionally, repeated measures analyses revealed that levels of treatment adherence significantly predicted the improvement of the parent-child relationship (F(1, 66) = 5.37; p = .024) and that levels of TA-BB significantly predicted the decrease of parent reported externalizing problem behavior (F(1, 66) = 9.89; p = .002).
CONCLUSIONS AND IMPLICATIONS
The current study suggested that optimal treatment processes are important for treatment outcomes in an intervention targeting children with MID-BIF.
背景
针对轻度智力障碍或边缘智力功能（MID-BIF）儿童的心理干预被认为可以有效减少其外化问题行为，但对于可能与这些效果相关的具体治疗过程知之甚少。
目的
本研究旨在探讨观察到的治疗依从性（即治疗师遵守治疗方案并按预期提供治疗的程度）和观察到的治疗师联盟建立行为（TA-BB；即促进治疗师和客户之间情感联系的行为）治疗过程是否可以预测针对 MID-BIF 儿童外化问题行为的团体行为父母培训与团体儿童认知行为疗法相结合的治疗效果。
方法和程序
72 名儿童（年龄 9-18 岁；M = 12.1）及其父母在荷兰接受了干预计划。他们在预测试和后测试时通过问卷报告儿童的外化行为、育儿实践和亲子关系，治疗过程通过治疗会话的录音带进行编码。
结果
结果显示，治疗依从性（M = 2.49；SD = 0.20；范围 1-3）和 TA-BB（M = 4.11；SD = 0.32；范围 1-5）均处于较高水平。此外，重复测量分析表明，治疗依从性水平显著预测亲子关系的改善（F（1，66）= 5.37；p = 0.024），而 TA-BB 水平显著预测父母报告的外化问题行为的减少（F（1，66）= 9.89；p = 0.002）。
结论和意义
本研究表明，针对 MID-BIF 儿童的干预措施中，最佳治疗过程对于治疗效果很重要。
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