一个基于社区的随机行为治疗与青少年多动症常规护理试验:二次结果和对并发症的影响
Margaret H Sibley1, Paulo A Graziano2, Stefany J Coxe2
1University of Washington School of Medicine, Seattle Children's Research Institute.
青少年ADHD的行为疗法在社区环境中表现有前途,特别是在经授权的临床医生提供时,减少行为问题. 没有执照的临床医生需要支持来提高实施和有效性.
科学领域:
- 儿童和青少年精神病学
- 行为心理学 行为心理学
- 实施科学 实施科学
背景情况:
- 针对青少年多动症的基于证据的行为疗法 (BT) 对社区实施和有效性的研究有限.
- 一项先前的试验 (STAND) 显示了高可接受性但可变的忠实性,有执照的治疗师改善了结果.
研究的目的:
- 报告BT针对青少年ADHD的社区试验的二次结果.
- 检查对伴随性疾病 (焦虑,抑郁,ODD,CD) 和非向性ADHD结果 (社会技能,SCT) 的影响.
- 调查治疗师执照作为治疗效果的调节者.
主要方法:
- 在~10个月的时间内,使用治疗意图和每方案线性混合模型分析了二次结果.
- 支持青少年自主日常 (STAND) 干预与常规护理 (UC) 的比较.
- 探索治疗组,时间和治疗师执照之间的相互作用.
主要成果:
- 总的来说,当社区临床医生实施时,STAND并没有超过UC.
- 一个显著的组 × 时间 × 许可互动表明,当被许可的临床医生 (d=.19.47) 交付时,STAND减少了行为问题.
- 对焦虑,抑郁,对抗性挑性障碍,社交技能或缓慢的认知速度没有观察到显著的影响.
结论:
- 青少年多动症的行为治疗在社区环境中可能是有效的,特别是对于行为问题,当被授权的专业人士提供时.
- 社区心理健康诊所应优先分配有执照的临床医生来治疗青少年多动症,并考虑心理社会方法来治疗并发性行为问题.
- 解决未经许可的临床医生实施障碍对于更广泛的有效性至关重要.
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