Shared Decision-Making with Latinx Caregivers During Community Implemented Evidence-Based Practices: Determinants and Associations with Alliance.

IF 4.2 1区 心理学 Q1 PSYCHOLOGY, CLINICAL
Blanche Wright, Lauren Brookman-Frazee, Bryce D McLeod, Ashley Flores, Margarita Alegría, David A Langer, Denise Chavira, Anna S Lau
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Abstract

Objective: The current observational study examined shared decision-making (SDM) with caregivers of Latinx youth within the delivery of multiple evidence-based practices (EBPs) in community mental health services. The aims of the study were to (1) Identify therapist and client factors associated with increased SDM within EBP sessions and (2) Examine the association between SDM and therapeutic alliance between community therapists and Latinx caregivers.

Method: The Observing Patient Involvement in Decision-Making (OPTION) instrument measured SDM in 210 audio-recorded therapy sessions with 62 community therapists (91.94% female; 69.35% Latinx) and 109 Latinx caregivers (91.43% female) of youth who were an average age of 8.26 years (SD = 3.59). We used the Therapy Process Observational Coding System for Child Psychotherapy-Alliance scale to measure the caregiver-therapist alliance observationally. Multilevel linear regressions were conducted to examine research questions.

Results: Greater SDM was observed within sessions where therapists targeted conduct problems versus trauma (B = -8.79, 95% CI[-14.09, -3.49], p = .001). There was a trend that SDM was higher in English-language sessions compared to Spanish. We found that the global measurement of SDM (B = .04, 95% CI[.01, .08], p = .03) and the OPTION item Integrate Preferences (B = .69, 95% CI[.07, 1.32], p = .03) were positively associated with alliance.

Conclusions: SDM may help foster Latinx caregiver engagement within EBP delivery. Provider training in SDM may be warranted with consideration of the specific clinical contexts (e.g., by presenting problem) that are appropriate for collaborative treatment planning. More research is needed to further establish the benefits of SDM in youth psychotherapy.

在社区实施循证实践过程中与拉美裔护理人员共同决策:决定因素以及与联盟的关联。
研究目的本观察性研究考察了在社区心理健康服务中提供多种循证实践(EBPs)的过程中,拉美裔青少年的照顾者与治疗师共同决策(SDM)的情况。该研究的目的是:(1)确定在 EBP 课程中增加 SDM 的相关治疗师和客户因素;(2)研究 SDM 与社区治疗师和拉美裔照顾者之间的治疗联盟之间的关联:观察患者参与决策(OPTION)工具测量了平均年龄为 8.26 岁(SD = 3.59)的 62 名社区治疗师(91.94% 为女性;69.35% 为拉丁裔)和 109 名拉丁裔照顾者(91.43% 为女性)在 210 次录音治疗过程中的 SDM 情况。我们使用儿童心理治疗过程观察编码系统(Therapy Process Observational Coding System for Child Psychotherapy-Alliance scale)来观察测量照顾者与治疗师之间的联盟关系。我们对研究问题进行了多层次线性回归:在治疗师针对行为问题和心理创伤进行治疗的疗程中,观察到的 SDM 更高(B = -8.79,95% CI[-14.09, -3.49],p = .001)。有一种趋势表明,与西班牙语相比,英语疗程中的 SDM 更高。我们发现,SDM 的整体测量(B = .04,95% CI[.01,.08],p = .03)和 OPTION 项目整合偏好(B = .69,95% CI[.07,1.32],p = .03)与联盟呈正相关:结论:SDM 可能有助于促进拉美裔护理人员参与 EBP 的实施。对提供者进行 SDM 培训时,可能需要考虑到适合合作治疗计划的特定临床环境(如出现的问题)。需要进行更多的研究,以进一步确定 SDM 在青少年心理治疗中的益处。
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来源期刊
CiteScore
9.70
自引率
4.80%
发文量
58
期刊介绍: The Journal of Clinical Child and Adolescent Psychology (JCCAP) is the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association. It publishes original contributions on the following topics: (a) the development and evaluation of assessment and intervention techniques for use with clinical child and adolescent populations; (b) the development and maintenance of clinical child and adolescent problems; (c) cross-cultural and sociodemographic issues that have a clear bearing on clinical child and adolescent psychology in terms of theory, research, or practice; and (d) training and professional practice in clinical child and adolescent psychology, as well as child advocacy.
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