Hibbs E D, Clarke G, Hechtman L, Abikoff H B, Greenhill L L, Jensen P S
Child and Adolescent Disorders Research Branch, NIMH, Rockville, MD 20857, USA.
Psychopharmacol Bull. 1997;33(4):619-29.
There has been a proliferation of treatment manuals in the past decade as part of an effort to operationalize treatment applications and standardize treatments across subjects, settings, and therapists. In this article we present the essential elements needed to develop manuals for the psychosocial and psychopharmacological treatments of child and adolescent disorders, using one modality or in multimodal treatment trials. We delineate how to integrate various treatment components for psychosocial and psychopharmacological manuals, as well as those for control conditions. We also examine the therapist variable as it concerns training and adherence to the structured or flexible scripted manuals. Finally, we discuss the advantages and disadvantages of manuals in terms of how they may affect outcome, recommending that treatments be both empirically grounded and clinically meaningful.
在过去十年中，治疗手册大量涌现，这是将治疗应用付诸实践并使跨对象、场景和治疗师的治疗标准化的努力的一部分。在本文中，我们介绍了为儿童和青少年疾病的心理社会治疗及心理药物治疗编写手册所需的基本要素，这些手册可用于单一治疗方式或多模式治疗试验。我们阐述了如何将心理社会治疗手册、心理药物治疗手册以及对照条件手册的各种治疗成分整合起来。我们还探讨了治疗师变量，涉及到他们对结构化或灵活脚本化手册的培训及遵循情况。最后，我们从手册可能如何影响治疗结果的角度讨论了手册的优缺点，建议治疗既要基于实证依据，又要有临床意义。
