Background/Objectives: Evidence supports the efficacy of Behavioral Parent Training (BPT) interventions such as Parent–Child Interaction Therapy (PCIT) for treating child behavior problems; however, ...treatment engagement and outcomes vary across ethnic groups. Risk for poor treatment engagement and outcomes may be attributed in part to misalignment between parent explanatory model components (PEMs) and the traditional BPT model, including treatment expectations, etiological explanations, parenting styles, and family support for treatment. The present study aims to examine whether personalized treatment adaptations addressing these PEM–BPT misalignments reduce risk for poor treatment engagement and outcomes. Methods: The authors previously utilized the PersIn framework to develop a personalized version of PCIT (MY PCIT) that assesses these PEMs in order to identify families at risk for poor treatment engagement and outcomes. Families were identified as high risk (due to PEM–BPT misalignment) and low risk (meaning those without identified PEM–BPT misalignment) for specific PEMs. Families at elevated risk then received tailored treatment materials designed to improve alignment between the parental explanatory model and the PCIT treatment explanatory model. A recent pilot trial of MY PCIT demonstrated positive treatment outcomes; however, the extent to which adaptations were successful in reducing the underlying risk factors has not yet been examined. Results: Findings demonstrate that the personalization approach was effective in reducing indicators of risk, and that families who were initially at high and low risk during pre-treatment reported similar levels of treatment engagement and outcomes by post-treatment. Conclusions: The findings suggest that this personalized approach has the potential to reduce risk associated with poor treatment engagement and outcomes for culturally diverse families.
Client-therapist consensus has been hypothesized to be an important element of culturally competent care. However, little is known about the relationship between explanatory model agreement and ...treatment engagement, particularly for services involving adolescents, where both parent and youth perspectives may need to be considered. This longitudinal study collected youth, parent, and therapist survey data on etiological beliefs as well as therapist-rated treatment engagement related to a culturally diverse sample of 285 outpatient mental health service-using youth (aged 12-18, M = 14.06 at Time 1 interview; 40% female). Youth-therapist and parent-therapist agreement on beliefs about the etiology of the youth's mental health problems were examined in relationship to later treatment engagement. Although parent-therapist agreement was unrelated to parent engagement, youth-therapist coendorsement of etiological beliefs predicted overall youth treatment engagement. In addition, youth-therapist agreement significantly predicted specific aspects of youth engagement: client-therapist interaction, communication/openness, and client's perceived usefulness of treatment. Results speak to the importance of agreement between therapist and youth upon key issues related to the youth's problems in mental health treatment settings and support facilitation of consensus as a component of culturally competent care. Differences between findings for youth and parents suggest that therapeutic relationships may vary for different stakeholders, indicating a need to consider individual perspectives and contributions separately.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Previous research has demonstrated the association between child maltreatment and household composition, with increased maltreatment risk generally present in single mother households. However, ...existing research does not fully examine the complexity and configuration of single mother households. In particular, less is known about important variants of single parent family structures, such as grandparents residing in the home, and the extent to which household compositions change across time.
The present study examines rates of maltreatment allegations across various household compositions in a sample of single biological mother households. Participants and Setting: Youth participants (N = 417) were part of the larger multi-site Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) study.
Participants completed longitudinal assessments of household composition and maltreatment allegations from ages 4 to 10. Results: The present study illustrates substantial variability in the rate of maltreatment allegations across different types of single mother household compositions. In particular, the presence of non-relatives, especially unrelated males, demonstrated an increased risk for maltreatment allegations in the home. Conversely, single mother homes with two or more adult relatives, especially grandmothers, were at reduced risk for child maltreatment allegations.
This study highlights variability in maltreatment allegations among single mother homes, including how maltreatment allegations vary across different household configurations, across child age periods and across different risk levels.
Therapist-client cognitive match upon key constructs such as treatment goals is purported to be an important component of culturally competent care. For adolescent clients, treatment may involve both ...youths and their parents, suggesting the need to consider both youth-therapist and parent-therapist perspectives. This longitudinal study examined broadband youth-therapist and parent-therapist treatment goal matching and mismatching in relationship to treatment engagement in a culturally diverse sample of 245 outpatient mental health service-using youth. Although goal matching/mismatching did not uniformly predict treatment engagement as measured by a total score, youth-therapist internalizing goal matching predicted better youth engagement, and parent-therapist externalizing goal mismatch marginally predicted worse parent engagement. When selected post hoc analyses examined relationships to four individual engagement dimensions, youth-therapist internalizing goal matches positively predicted youth Client-therapist interaction, Communication/Openness, Client's perceived usefulness of therapy, and Collaboration with treatment, while parent-therapist externalizing goal mismatch negatively predicted parent Collaboration with treatment. Findings support the importance of cognitive match on treatment goals as well as the consideration of both parent and youth perspectives, matched and mismatched goals, internalizing and externalizing goals, and examining individual dimensions in addition to total scores of engagement.
Neuropsychological research has been limited in the representation of cultural diversity due to various issues, raising questions regarding the applicability of findings to diverse populations. ...Nonetheless, culture-dependent differences in fundamental psychological processes have been demonstrated. One of the most basic of these, self-construal (individualism, collectivism), is central to how many other differences are interpreted. Self-construals may have possible consequences on social interactions, emotions, motivation, and cognition. This study aimed to evaluate the impact of self-construal on neurocognitive functions in older adults. A total of 86 community-dwelling older adults 60 years and older were assessed with three common self-report measures of self-construal along individualism and collectivism (IC). A cognitive battery was administered to assess verbal and non-verbal fluency abilities. Latent profile analysis (LPA) was used to categorize individuals according to IC, and one-way analyses of covariance (ANCOVA), including relevant covariates (e.g., ethnicity, gender, linguistic abilities), were used to compare neurocognitive functions between individualists and collectivists. Collectivists outperformed individualists on left frontally-mediated measures of verbal fluency (action, phonemic) after controlling for relevant covariates,
= 6.942,
= 0.010,
= 0.061. Groups did not differ on semantic fluency, non-verbal fluency, or attention/working memory (all
s > 0.05). These findings suggest a cognitive advantage in collectivists for verbal processing speed with an additional contribution of left frontal processes involved in lexicosemantic retrieval. Self-construal may provide a meaningful descriptor for diverse samples in neuropsychological research and may help explain other cross-cultural differences.
This study compared the effectiveness of a culturally modified version of Parent-Child Interaction Therapy (PCIT), called Guiando a Niños Activos (GANA), to the effectiveness of standard PCIT and ...Treatment as Usual (TAU) for young Mexican Amerian children with behavior problems. Fifty-eight Mexican Amerian families whose 3- to 7-year-old child had a clinically significant behavior problems were randomly assigned to GANA, standard PCIT, or TAU. All three treatment approaches produced significant pre-post improvement in conduct problems across a wide variety of parent-report measures. GANA produced results that were significantly superior to TAU across a wide variety of both parent report and observational indices; however, GANA and PCIT did not differ significantly from one another. PCIT was superior to TAU on two of the parent report indices and almost all of the observational indices. There were no significant differences between the three groups on treatment dropout, and families were more satisfied with both GANA and PCIT than with TAU.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Parent-youth agreement on the youth's functional impairment may have important implications for mental health service utilization, assessment, therapy goal development, and treatment engagement for ...adolescents. The present study examines parent-youth agreement on their perceptions of youth functional impairment in a predominantly racial/ethnic minority sample of adolescents utilizing outpatient mental health services. Parent and youth functional impairment ratings were compared, and agreement was estimated in multiple ways. On average, parents indicated higher levels of youth functional impairment compared to youth in their overall scores, and when differences existed between parents and youth at the functioning domain and item level. Although there was similarity in the proportion of parents and youth who reported total impairment above the clinical cut-off, actual agreement between parent-youth pairs was only slight. There appeared to be substantial variation in agreement levels when identifying problems in functional impairment at the domain and item levels, and some areas of strong consensus were identified. These findings highlight the need to consider parent-youth agreement in perceptions of functional impairment and the complexities that may underlie this agreement.
Culture-specific versions of evidence-based interventions are critically important to meeting the needs of underserved and minoritized populations but may also face significant barriers to ...large-scale implementation when there are settings with multiple cultural groups and within-group heterogeneity. The PersIn framework is a proposed approach for personalizing an evidence-based intervention to facilitate cultural responsiveness concurrent with fidelity to the original intervention, flexibility in individual implementation, and administration that is standardized, feasible, and replicable. This study describes pilot feasibility outcomes for MY PCIT (n = 32), a personalized version of Parent-Child Interaction Therapy for culturally diverse families that was developed as a proof-of-concept of the PersIn framework. This application of the PersIn framework was designed to enhance cultural responsiveness by increasing alignment between parent explanatory models and the presentation and delivery of PCIT. MY PCIT produced both statistically and clinically significant changes in pre-to post-treatment child outcomes and parent outcomes. Child behavior change outcomes were comparable to those reported by three benchmark studies, supporting the potential of this approach.
•An approach is proposed for personalizing evidence-based interventions to increase cultural responsiveness.•A personalized version of an evidence-based intervention was developed and pilot-tested in a culturally-diverse sample.•A personalized version of an evidence-based treatment produced significant changes in child and parent outcomes in a culturally-diverse sample.•A personalized version of an evidence-based intervention resulted in changes in child behavior that were comparable to those reported in other relevant studies of the original intervention.
The present study evaluated whether families receiving Parent–Child Interaction Therapy (PCIT) experienced significant improvements in both parent and child internalizing symptoms, and if so, whether ...the relationship between improvement in child externalizing symptoms and internalizing symptoms was mediated by reductions in parenting stress and parent depressive symptoms. Participants were an ethnically diverse sample of 72 families with 2–7-year-old children experiencing clinically significant externalizing symptoms who were assigned to receive a version of PCIT in one of two previously conducted clinical trials designed to evaluate culturally modified versions of PCIT. Analyses revealed that parent-reported child internalizing symptoms, parenting stress, and parent depressive symptoms improved significantly from pre to post treatment in PCIT. Additionally, the relation between child externalizing improvement and internalizing improvement was mediated through reduction in parenting stress, but not parent depressive symptoms. These findings suggest that ethnically diverse children are likely to experience significant improvement in co-occurring externalizing and internalizing symptoms following PCIT. Furthermore, decreases in parenting stress may play a role in the improvement of child internalizing symptoms.
Highlights
Both parent-reported child in- and externalizing symptoms decreased significantly after PCIT.
Parenting stress and parent depressive symptoms decreased significantly after PCIT.
Improvements in parenting stress mediated the relation between improvements in child externalizing and internalizing symptoms.
Improvement in parent depressive symptoms did not mediate the relation between improvements in child externalizing and internalizing symptoms.
PDF
