Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada.
Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada.
Child Abuse Negl. 2023 Dec;146:106487. doi: 10.1016/j.chiabu.2023.106487. Epub 2023 Oct 12.
Youth with severe emotional or behavioral issues who are involved with child welfare authorities are sometimes placed in intensive care services in a residential treatment program. Evidence-based psychotherapies are often used in residential treatments, but there is very little research on how to adapt psychotherapy for residential treatment.
To describe the implementation of a transdiagnostic cognitive behavioral therapy (the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children) in a residential treatment program for children.
Staff (n = 20) at a residential facility in Calgary, Canada.
A combination of qualitative interviews and focus groups were conducted before and after therapy to identify barriers and facilitators to implementation. Data were analyzed and reported using the Consolidated Framework for Implementation Research and the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies.
Modifications were made to the program including creating inclusive language, integrating relevant content targeting pediatric irritability, delivering sessions online for caregivers, and using additional staff to support youth to learn and practice the application of the content and behavioral interventions. Key barriers to implementation of the Unified Protocol included staff turnover and the difficulty of sustaining a critical mass of knowledge surrounding the Unified Protocol. The major facilitators to implementation were the perceived quality of the program and advantages of the program to children and their caregivers.
This study supports the feasibility and acceptability of providing transdiagnostic cognitive behavioral therapies for children in residential treatment and provides a template for how to implement evidence-based practice in residential treatment.
涉及儿童福利机构的有严重情绪或行为问题的青年有时会被安置在住宅治疗计划的强化护理服务中。基于证据的心理疗法经常用于住宅治疗，但对于如何适应心理疗法以适应住宅治疗，几乎没有研究。
描述在儿童情绪障碍的跨诊断认知行为治疗（统一协议）在住宅治疗计划中的实施情况。
加拿大卡尔加里的一个住宅设施的工作人员（n=20）。
在治疗前后进行了定性访谈和焦点小组，以确定实施的障碍和促进因素。使用实施研究的综合框架和对基于证据的实施策略的适应和修改的框架来分析和报告数据。
对该方案进行了修改，包括使用包容性语言、整合针对儿童易怒的相关内容、为照顾者在线提供课程、并使用额外的工作人员来支持青年学习和实践内容和行为干预的应用。实施统一协议的主要障碍包括员工更替和围绕统一协议维持足够知识量的困难。实施的主要促进因素是方案的质量和方案对儿童及其照顾者的优势。
本研究支持为住宅治疗中的儿童提供跨诊断认知行为疗法的可行性和可接受性，并为如何在住宅治疗中实施基于证据的实践提供了模板。
