新常态下的新疗法:远程医疗与面对面限时亲子互动疗法的比较

IF 3.4 2区 心理学 Q2 PSYCHIATRY Behavior Therapy Pub Date : 2024-01-01 DOI:10.1016/j.beth.2023.05.002
Abigail Peskin, Alexandra Barth, W. Andrew Rothenberg, Amanda Turzi, Diana Formoso, Dainelys Garcia , Jason Jent
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引用次数: 0

摘要

针对儿童破坏性行为的远程保健治疗有可能克服获得治疗的多重障碍(如交通、治疗师的可用性)。在随机对照试验中,传统的亲子互动疗法(PCIT)已证明了通过远程医疗的疗效。目前的研究对这一研究进行了扩展,考察了基于社区的限时(即 18 周)远程健康 PCIT 的有效性,比较了远程健康 PCIT 和面对面 PCIT 的入院和治疗后儿童行为及照顾者技能。参与者主要包括不同种族、民族、语言和社会经济背景的 2 至 8 岁儿童及其照顾者。二人组(N = 380)接受了远程保健(IPCIT)或面对面 PCIT。为解决非随机样本可能造成的选择偏差,我们进行了倾向得分分析。回归分析表明,IPCIT 和面对面治疗在儿童破坏行为或依从性结果方面没有差异。不过,与接受面对面治疗的照顾者相比,接受 IPCIT 治疗的照顾者在治疗后的正面表述较少,纠正/指导性表述较多。这项研究表明,在社会经济、语言和文化多元化的人群中,有时限的 IPCIT 可以有效改善儿童的破坏性行为,这也是迄今为止通过远程医疗证明 PCIT 有效性的最大样本。未来的研究需要在更广泛的系统层面上记录干预措施的可持续性,并平衡照顾者技能学习与家庭治疗目标之间的优先次序。
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New Therapy for a New Normal: Comparing Telehealth and in-Person Time-Limited Parent-Child Interaction Therapy

Telehealth treatment for child disruptive behavior has the potential to overcome multiple barriers to access (e.g., transportation, therapist availability). Traditional Parent-Child Interaction Therapy (PCIT) has demonstrated efficacy via telehealth in randomized controlled trials. The current study extends this research by examining community-based effectiveness of time-limited (i.e., 18 week) telehealth PCIT, comparing intake and posttreatment child behavior and caregiver skills for both telehealth and in-person PCIT. Participants included predominantly racially, ethnically, linguistically, and socioeconomically diverse children aged 2 to 8 years, and their caregivers. Dyads (N = 380) received either telehealth (IPCIT) or in-person PCIT. Propensity score analyses were conducted to address potential selection bias due to the nonrandomized sample. Regression analyses revealed no difference between IPCIT and in-person treatment for child disruptive behaviors or compliance outcomes. However, caregivers who received IPCIT demonstrated fewer positive statements and greater corrective/directive statements at posttreatment than caregivers who received in-person treatment. This research demonstrated that time-limited IPCIT can effectively improve child disruptive behavior among a socioeconomically, linguistically, and culturally diverse population, and represents the largest sample to date demonstrating the effectiveness of PCIT via telehealth. Future research is warranted to document intervention sustainability on a more system-wide level, and balance prioritizing caregiver skill acquisition over family-derived treatment goals.

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来源期刊
Behavior Therapy
Behavior Therapy Multiple-
CiteScore
7.40
自引率
2.70%
发文量
113
审稿时长
121 days
期刊介绍: Behavior Therapy is a quarterly international journal devoted to the application of the behavioral and cognitive sciences to the conceptualization, assessment, and treatment of psychopathology and related clinical problems. It is intended for mental health professionals and students from all related disciplines who wish to remain current in these areas and provides a vehicle for scientist-practitioners and clinical scientists to report the results of their original empirical research. Although the major emphasis is placed upon empirical research, methodological and theoretical papers as well as evaluative reviews of the literature will also be published. Controlled single-case designs and clinical replication series are welcome.
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