Cohen J A, Mannarino A P
Medical College of Pennsylvania, Pittsburgh, USA.
J Am Acad Child Adolesc Psychiatry. 1996 Jan;35(1):42-50. doi: 10.1097/00004583-199601000-00011.
Treatment outcome for sexually abused preschool-age children and their parents was assessed, comparing the effectiveness of a cognitive-behavioral intervention to nondirective supportive treatment.
Sixty-seven sexually abused preschool children and their parents were randomly assigned to either (1) cognitive-behavioral therapy adapted for sexually abused preschool children (CBT-SAP) or (2) nondirective supportive therapy (NST). Treatment consisted of 12 individual sessions for both the child and parent, monitored for integrity with the therapeutic model through intensive training and supervision, use of treatment manuals, and rating of audiotaped sessions. Parents completed the Child Behavior Checklist, the Child Sexual Behavior Inventory, and the Weekly Behavior Report to measure a variety of emotional and behavioral symptoms.
Within-group comparison of pretreatment and posttreatment outcome measures demonstrated that while the NST group did not change significantly with regard to symptomatology, the CBT-SAP group had highly significant symptomatic improvement on most outcome measures. Repeated-measures analyses of variance demonstrated group x time interactions on some variables as well. Clinical findings also supported the effectiveness of the CBT-SAP intervention over NST.
Findings provide strong preliminary evidence for the effectiveness of a specific cognitive-behavioral treatment model for sexually abused preschool children and their parents.
评估遭受性虐待的学龄前儿童及其父母的治疗效果，比较认知行为干预与非指导性支持性治疗的有效性。
将67名遭受性虐待的学龄前儿童及其父母随机分为两组：（1）针对遭受性虐待的学龄前儿童的认知行为疗法（CBT-SAP）；（2）非指导性支持性疗法（NST）。治疗包括为儿童和父母各安排12次个体治疗课程，通过强化培训和监督、使用治疗手册以及对录音课程进行评分来监控治疗与治疗模式的一致性。父母完成儿童行为清单、儿童性行为量表和每周行为报告，以测量各种情绪和行为症状。
治疗前和治疗后结果测量的组内比较表明，虽然NST组在症状方面没有显著变化，但CBT-SAP组在大多数结果测量上有非常显著的症状改善。重复测量方差分析也表明在一些变量上存在组×时间交互作用。临床结果也支持CBT-SAP干预比NST更有效。
研究结果为一种针对遭受性虐待的学龄前儿童及其父母的特定认知行为治疗模式的有效性提供了有力的初步证据。
