Henggeler S W, Rowland M D, Pickrel S G, Miller S L, Cunningham P B, Santos A B, Schoenwald S K, Randall J, Edwards J E
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29425, USA.
J Clin Child Psychol. 1997 Sep;26(3):226-33. doi: 10.1207/s15374424jccp2603_1.
The development and validation of family-based alternatives to out-of-home placements for children is an important goal in the mental health services field. The rigorous evaluation of such alternatives, however, can be difficult to accomplish. The purpose of this article is to describe initial barriers experienced during the pilot study of a randomized trial, funded by the National Institute of Mental Health, conducted in a field setting, and the strategies that were used to overcome these barriers. The randomized trial is examining home-based multisystemic therapy as an alternative to the psychiatric hospitalization of youths presenting psychiatric emergencies. The pilot study illuminated the interface of treatment and services research issues, prompting significant changes in the project's clinical procedures, organization, and supervisory processes, as well as in the project's interface with existing community resources for serving youths with serious emotional disturbances.
为儿童开发并验证基于家庭的替代户外安置方式是心理健康服务领域的一个重要目标。然而，对这类替代方式进行严格评估可能很难实现。本文旨在描述在一项由美国国立精神卫生研究所资助、在实地环境中进行的随机试验的试点研究期间遇到的初步障碍，以及为克服这些障碍所采用的策略。该随机试验正在研究以家庭为基础的多系统疗法，作为对出现精神紧急情况的青少年进行精神病住院治疗的替代方案。试点研究揭示了治疗与服务研究问题的交叉点，促使该项目在临床程序、组织和监督流程方面发生重大变化，以及在该项目与现有社区资源为患有严重情绪障碍的青少年提供服务的接口方面发生重大变化。
