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Ferguson EF, Barnett ML, Goodwin JW, Vernon TW. "There is No Help:" Caregiver Perspectives on Service Needs for Adolescents and Adults with Profound Autism. J Autism Dev Disord 2024:10.1007/s10803-024-06451-x. [PMID: 38963473 DOI: 10.1007/s10803-024-06451-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2024] [Indexed: 07/05/2024]
Abstract
The underrepresentation of individuals with profound autism (who require 24/7 access to care) in autism research has resulted in limited knowledge about their service needs and a lack of evidence-based practices tailored to those needs. This study explored caregiver perspectives on service needs, barriers to accessing care, and treatment priorities to guide treatment development and improvement of service delivery. A sequential mixed-methods design integrated quantitative survey data (n = 423; Mage = 18.89 years; 26.7% female) with qualitative interviews (n = 20) with caregivers of adolescents and adults with profound autism. Quantitative findings indicated regular socialization opportunities were the most frequently endorsed unmet service need (60.3% of caregivers), followed by primary health care with autism-trained staff (59.3%), social skills instruction (55.8%), life skills instruction (51.3%), and behavioral support (47.3%). Higher likelihood of needing social activity groups was associated with elevated emotional reactivity, higher language level, minoritized ethnicity, and lower household income. Greater need for specialized primary health care was associated with lower income, while the need for social and life skills instruction was associated with increased age and elevated dysphoria. Qualitative analysis identified 10 themes that converged and expanded quantitative findings by highlighting a pervasive shortage of individualized, goal-oriented services, common barriers to care, and the priority of developing centralized treatment settings that coordinate care throughout adulthood. This study identified pressing service needs for adolescents and adults with profound autism in the United States. These insights are crucial for improving the accessibility and quality of clinical care.
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Affiliation(s)
- Emily F Ferguson
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, 401 Quarry Rd, Stanford, CA, 94305-5719, USA.
| | | | | | - Ty W Vernon
- University of California, Santa Barbara, CA, USA
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2
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Tripathi I, Moody CT, Laugeson EA. Parent perspectives on treatment: A mixed methods analysis of PEERS® for Preschoolers. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:390-402. [PMID: 37306138 PMCID: PMC10851630 DOI: 10.1177/13623613231172314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
LAY ABSTRACT Autistic children have social communication differences that can contribute to difficulties making and keeping friends, as well as poor mental health (e.g. anxiety, depression). Social skills training programs for preschoolers on the spectrum have been shown to increase social functioning and improve outcomes. Parent involvement in these programs is essential, as parents are able to use the intervention strategies outside of sessions. Teaching parents skills to help their children is also thought to reduce parenting stress through empowerment, knowledge, and social support. However, we still do not know much about how parents experience social skills treatments and whether there are specific parts that are especially helpful to them. This study examined parent perspectives on the University of California, Los Angeles Program for the Education and Enrichment of Relational Skills (PEERS®) for Preschoolers, an evidence-based, group social skills intervention for autistic young children who are struggling socially. Twenty-four parents reported on their child's progress through questionnaires and participated in semi-structured interviews that asked about their experiences and perspectives 1-5 years after completing (PEERS®) for Preschoolers. Parents reported that their children displayed increased social skills and confidence after (PEERS®) for Preschoolers, while parents described feeling more positive, supported, and having greater understanding of their child and their development. Those parents who continued to use strategies taught in (PEERS®) for Preschoolers, particularly priming and preparing their child for social activities, showed greater improvements in long-term child outcomes and parenting stress. Overall, findings show that parents had a positive experience during and after PEERS® for Preschoolers, finding the program helpful in multiple ways to both their child and to themselves as a parent.
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Affiliation(s)
- Isita Tripathi
- University of California, Los Angeles, USA
- Harvard Medical School, USA
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3
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Chan V, Albaum CS, Khanlou N, Westra H, Weiss JA. Parent Involvement in Mental Health Treatment for Autistic Children: A Grounded Theory-Informed Qualitative Analysis. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01621-x. [PMID: 37847326 DOI: 10.1007/s10578-023-01621-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/07/2023] [Indexed: 10/18/2023]
Abstract
Cognitive behavior therapy (CBT) is an effective treatment for many autistic children experiencing mental health problems, and parents are particularly involved in their psychotherapy. This study presents a conceptual framework of successful parent involvement in CBT for autistic children. Seventeen therapists (94% female) and 11 mothers were interviewed about their involvement in a CBT program for autistic children ages 8-13 years. The conceptual framework depicts how parent involvement varies depending on child, parent, and environmental factors. Parents' contributions to therapy were grouped into five main roles. Parents' beliefs and attitudes toward therapy also influenced their involvement. This is the first study to empirically investigate how parents of autistic children contribute to the therapeutic process in CBT.
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Affiliation(s)
- Victoria Chan
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada.
| | - Carly S Albaum
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada
| | | | - Henny Westra
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Jonathan A Weiss
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
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Kim T, Martinez K, Cruz BL, Huang JS, Stadnick NA. Caregiver Insights and Improvement Strategies for Youth with Autism Undergoing Gastrointestinal Endoscopy. J Autism Dev Disord 2023; 53:1476-1482. [PMID: 35217944 PMCID: PMC9402801 DOI: 10.1007/s10803-021-05346-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 11/27/2022]
Abstract
Limited guidance is available for families of youth with ASD (YASD) to prepare for invasive medical procedures. This study examined caregiver perspectives regarding YASD's gastrointestinal endoscopy (GE) experience to improve the endoscopy experience for YASD. Thirty-four caregivers of YASD, (M = 9.85 years, SD = 4.6) who underwent GE at Rady Children's Hospital, San Diego between May 2018 and July 2019 (identified via electronic health record) participated in a structured phone interview. Caregivers reported a positive experience due to the procedural team's responsiveness to the needs of YASD and appropriately answering/addressing questions/concerns. Caregivers reported a need for ASD-specific information on how to prepare for GE. Specific recommendations are discussed. Study findings offer strategies to improve the care experience of YASD undergoing GE.
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Affiliation(s)
- Tierney Kim
- Point Loma Nazarene University, San Diego, CA, USA
| | - Kassandra Martinez
- San Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
- Child & Adolescent Services Research Center, San Diego, CA, USA.
| | - Breanna Lopez Cruz
- Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Jeannie S Huang
- Dissemination and Implementation Science Center, University of California San Diego, La Jolla, CA, USA
- Division of Gastroenterology Hepatology and Nutrition, Rady Children's Hospital, San Diego, CA, USA
| | - Nicole A Stadnick
- Child & Adolescent Services Research Center, San Diego, CA, USA
- Dissemination and Implementation Science Center, University of California San Diego, La Jolla, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
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5
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Xiao N, Shinwari K, Kiselev S, Huang X, Li B, Qi J. Effects of Equine-Assisted Activities and Therapies for Individuals with Autism Spectrum Disorder: Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2630. [PMID: 36767996 PMCID: PMC9915993 DOI: 10.3390/ijerph20032630] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
Autism spectrum disorder (ASD) has become a critical public health issue that affects more than 78 million people. In many recent studies, the authors have demonstrated that equine-assisted activities and therapies (EAATs) can substantially improve the social and behavioral skills of children with ASD. However, the qualities of the studies differ, and some authors reached opposite conclusions. In this review, we systematically and objectively examined the effectiveness of EAATs for people with ASD, combining both qualitative and quantitative methods. We searched five databases (PubMed, Scopus, ERIC, ProQuest, and MEDLINE) and added relevant references, and we identified 25 articles for data extraction and analysis. According to our results, EAAT programs can substantially improve the social and behavioral functioning and language abilities of children with ASD. However, among the subdomains, the results were inconsistent. According to the meta-analyses, there were considerable improvements in the social cognition, communication, irritability, and hyperactivity domains, but not in the domains of social awareness, mannerisms, motivation, lethargy, stereotypy, or inappropriate speech. Moreover, there was a lack of sufficient comparative data to conclude that EAAT programs lead to substantial improvements in motor and sensory functioning. In addition, among the included studies, we noted the indicator of whether EAAT programs decreased parental stress and improved family functioning, and although there were four articles in which the researchers considered this aspect, we were unable to draw any conclusions because of the insufficient data and conflicting descriptive evidence. However, we need to consider the improvement in parental mental health as a factor in the effectiveness of this complementary intervention. We hope that in future studies, researchers will focus on family functioning and conduct more randomized controlled trials (RCTs) with blinded assessments using different scales and measures.
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Affiliation(s)
- Ningkun Xiao
- Department of Psychology, Institution of Humanities, Ural Federal University, Yekaterinburg 620075, Russia
| | - Khyber Shinwari
- Department of Immunochemistry, Institution of Chemical Engineering, Ural Federal University, Yekaterinburg 620075, Russia
| | - Sergey Kiselev
- Department of Psychology, Institution of Humanities, Ural Federal University, Yekaterinburg 620075, Russia
| | - Xinlin Huang
- Department of Psychology, Institution of Humanities, Ural Federal University, Yekaterinburg 620075, Russia
| | - Baoheng Li
- Engineering School of Information Technologies, Telecommunications and Control System, Ural Federal University, Yekaterinburg 620002, Russia
| | - Jingjing Qi
- Engineering School of Information Technologies, Telecommunications and Control System, Ural Federal University, Yekaterinburg 620002, Russia
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Bent CA, Pellicano E, Iacono T, Hudry K. Perspectives from parents of autistic children on participating in early intervention and associated research. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022:13623613221141540. [PMID: 36510841 DOI: 10.1177/13623613221141540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
LAY ABSTRACT Support for autistic children early in life should help them to lead flourishing lives. However, many of the early intervention programmes for young autistic children are time-consuming and costly for families. These programmes are also often conducted in settings that are not closely matched to real life. We spoke to 23 parents (of 22 autistic children) to understand their experiences of their children's involvement in early intervention. Parents told us they were grateful for the opportunity, that they had 'hit the jackpot', and their children had 'gained so much' from the programme. They seemed to value the service because it made them feel safe and secure during an uncertain time in their children's lives. Parents told us they trusted staff, felt that they weren't 'doing it alone', and this 'took that pressure off' and helped them feel empowered. They also spoke of feelings of safety from being linked to the university research programme which offered 'accountability' and 'integrity'. Parents' comments showed a strong commitment to the early intervention model and staff - but also common feelings of abandonment and disempowerment as their child's time with the programme came to an end and they went 'back to the real world' and needed to find new supports for their children. These parents' insights should help to inform the design and delivery of community supports for preschool-aged autistic children and their families, which match the reality of their lived experiences.
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7
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Stakeholder engagement to inform evidence-based treatment implementation for children’s mental health: a scoping review. Implement Sci Commun 2022; 3:82. [PMID: 35906675 PMCID: PMC9338493 DOI: 10.1186/s43058-022-00327-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 07/10/2022] [Indexed: 11/28/2022] Open
Abstract
Background There is a pervasive mental health treatment gap for children across the globe. Engaging stakeholders in child mental health evidence-based treatment (EBT) implementation projects may increase the likelihood of successful EBT implementation, thereby better addressing the treatment gap. However, little is known about the extent of stakeholder engagement to inform the implementation of child mental health EBTs. Methods We conducted a scoping review to characterize stakeholder engagement in child mental health EBT implementation projects, including what stakeholders are engaged, how they are engaged, when they are engaged, where they are engaged (i.e., location of projects), why they are engaged, and the reported impacts of stakeholder engagement. We searched seven databases: MEDLINE, PsycInfo, Embase, ERIC, CINAHL Complete, Scopus, and Web of Science Core Collection. To be included, studies had to report on some form of stakeholder engagement that was undertaken to inform or explain the implementation of a child mental health EBT. We performed data extraction and synthesis to describe key study and stakeholder characteristics, stakeholder engagement methods and rationales, reported impacts of stakeholder engagement, and quality of reporting on stakeholder engagement. Results In total, 122 manuscripts met our inclusion criteria, from which we identified a total of 103 unique child mental health EBT implementation projects. Projects spanned 22 countries, which included low-, lower-middle, upper-middle, and high-income countries. The largest number of projects was in the USA and conducted in public mental health settings. Most projects engaged EBT providers during the active implementation phase and with limited depth, often gathering information from stakeholders without sharing decision-making power in implementation efforts. Across projects, impacts of stakeholder engagement spanned all of Proctor and colleague’s implementation outcomes. Conclusions Given that stakeholder engagement is often shallow and with limited shared decision-making, additional effort should be made to increase engagement to preempt challenges to EBT implementation and ensure implementation success. Such efforts may ensure the just distribution of power in EBT implementation efforts. Trial registration All procedures were pre-registered on the Open Science Framework prior to conducting the literature search (DOI 10.17605/OSF.IO/GR9AP). Supplementary Information The online version contains supplementary material available at 10.1186/s43058-022-00327-w.
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8
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Chlebowski C, Lind T, Ganger W, Brookman-Frazee L. Are we on the same page? Therapist and caregiver agreement on therapist evidence-based strategy use in youth mental health. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2022; 9:87-102. [PMID: 38694790 PMCID: PMC11060707 DOI: 10.1080/23794925.2022.2148310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Affiliation(s)
- Colby Chlebowski
- UC San Diego, Department of Psychiatry, Child and Adolescent Services Research Center, 9500 Gilman Drive #0812, La Jolla CA 92093-0603
| | - Teresa Lind
- San Diego State University, Department of Child and Family Development, Child and Adolescent Services Research Center, San Diego, CA
| | - William Ganger
- San Diego State University Research Foundation, Child and Adolescent Services Research Center, San Diego, CA
| | - Lauren Brookman-Frazee
- UC San Diego, Department of Psychiatry, Child and Adolescent Services Research Center, Autism Discovery Institute at Rady Children's Hospital-San Diego, San Diego, CA
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9
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Warner K, Keville S, Hockley J, Ludlow A. Experiences of equine assisted therapy for females with autism spectrum disorders. ADVANCES IN AUTISM 2022. [DOI: 10.1108/aia-10-2021-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This research indicates females with autism spectrum disorders (ASDs) have a diverse clinical presentation compared to males. Furthermore, females with ASD are often diagnosed later and typically experience greater levels of mental health difficulties. Evidence suggests that clinic-based verbal interventions for ASD have limited efficacy; therefore, alternative therapies, such as equine-assisted therapies (EATs), are gaining recognition. The purpose of this study was to directly explore the experiences of females with an ASD who have undertaken EAT.
Design/methodology/approach
Five female participants with a diagnosis of ASD were recruited from two equine therapy centres. Participants were aged between 15 and 30 years and undertook semi-structured interviews, which were analysed using interpretative phenomenological analysis.
Findings
Three superordinate themes emerged: the difficult experience of the social world, the process of EAT and the emotional impact of horses.
Originality/value
Directly exploring the experiences of females with ASD highlights benefits from engaging therapeutically with horses, building confidence and independence to transferring this into more effective social communication with other people. Offering emotion-focused therapeutic complementary interventions for females with ASD should be forefronted to help remediate the impact of difficult and sometimes traumatic earlier experiences in the social world. This requires increased funding for EAT, combined with larger-scale research projects to evaluate this.
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10
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Dreiling NG, Cook ML, Lamarche E, Klinger LG. Mental health Project ECHO Autism: Increasing access to community mental health services for autistic individuals. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:434-445. [PMID: 34218685 PMCID: PMC8814946 DOI: 10.1177/13623613211028000] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
LAY ABSTRACT Although many autistic individuals have additional mental health conditions, most have a hard time getting services from mental health providers. One reason why these services can be hard to access is that many mental health providers do not feel confident in their ability to provide services to autistic individuals. To share autism expertise with local community providers and boost their confidence in working with autistic individuals, we created a mental health version of the Extension for Community Healthcare Outcomes (Project ECHO) Autism virtual teleconsultation program. In this pilot study, we recruited 51 community mental health providers to participate in Project ECHO Autism. During each biweekly session, providers received information from autism experts about how to tailor mental health interventions (e.g. attention-deficit hyperactivity disorder or anxiety interventions) for use with autistic individuals. They also had the opportunity to ask questions and get advice on their current cases. At the end of the 6-month study, mental health providers showed improvements in their confidence, in their knowledge of autism, and in their problem-solving skills. Nearly half (45%) of these providers participated from rural counties, suggesting that the Project ECHO Autism teleconsultation model was able to reach mental health providers who might not have been able to get training otherwise. This study supports the feasibility of using Project ECHO Autism to share autism knowledge with mental health providers, consequently expanding mental health service options for autistic individuals with co-occurring mental health conditions.
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Affiliation(s)
- Nicole Ginn Dreiling
- Nicole Ginn Dreiling, TEACCH Autism Program, University of North Carolina at Chapel Hill, CB#7180, Chapel Hill, NC 27599-7180, USA.
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11
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Seibel LF, Peth-Pierce R, Hoagwood KE. Revisiting caregiver satisfaction with children's mental health services in the United States. Int J Ment Health Syst 2021; 15:71. [PMID: 34454565 PMCID: PMC8403344 DOI: 10.1186/s13033-021-00493-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/05/2021] [Indexed: 11/18/2022] Open
Abstract
Nearly four decades ago, Unclaimed Children documented the gaps in the United States between mental health programs and caregivers’ perspectives about those services for their children. This absence of attention to parent or caregiver perspectives, including their satisfaction with these services, was a key finding of the report, which detailed system failure in caring for youth with mental health needs. Since then, the focus on caregiver satisfaction with children’s mental health services has been largely overlooked in research, and when examined has been mostly included as an indicator of the feasibility of program implementation. In striking contrast, overall healthcare system reforms have highlighted the importance of improving consumer’s direct experience of care. However, caregiver satisfaction remains largely disconnected to these overall health system reforms, even as reforms focus increasingly on value-based, coordinated and integrated care. In this paper, we review literature from 2010 to 2020, revisit the measurement of caregiver satisfaction, identify how and when it is being measured, and delineate a research agenda to both realign it with health system improvements, refine its focus on expectancies and appropriateness, and root it more firmly in the principles of user experience (UX) and human-centered design (HCD).
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Affiliation(s)
- Lauren F Seibel
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, 1 Park Ave, 7th Floor, New York, NY, 10016, USA.
| | - Robin Peth-Pierce
- Public Health Communications Consulting, LLC, 16678 State Rd., North Royalton, OH, 44133, USA
| | - Kimberly E Hoagwood
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, 1 Park Ave, 7th Floor, New York, NY, 10016, USA
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12
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Dickson KS, Chlebowski C, Haine-Schlagel R, Ganger B, Brookman-Frazee L. Impact of Therapist Training on Parent Attendance in Mental Health Services for Children with ASD. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 51:230-241. [PMID: 32816564 DOI: 10.1080/15374416.2020.1796682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The current study explored the impact of training therapists in a mental health intervention for children with autism spectrum disorder (ASD) on parent attendance in their children's therapy sessions. We also examined family, therapist, and program factors as potential moderators. METHOD Data were drawn from a cluster-randomized community effectiveness trial of "An Individualized Mental Health Intervention for ASD (AIM HI)". Participants included 168 therapists yoked with 189 children recruited from publicly-funded mental health services. Data included family (caregiver strain, parent sense of competence, race/ethnicity), therapist (background, experience), and program (service setting) characteristics, and parent session attendance. Multilevel models were used to evaluate the effectiveness of AIM HI therapist training on caregiver attendance and identify moderators of training effects on parent attendance. RESULTS Parents attended a higher percentage of sessions in the AIM HI training condition compared to the Usual Care condition. Program service setting moderated the effect of AIM HI training, with higher parent attendance in non-school (mostly outpatient) settings compared to school settings and a significantly smaller difference between the settings in the AIM HI condition. CONCLUSIONS Effective strategies to promote parent engagement, especially in service settings such as schools, are warranted. Findings support the effectiveness of AIM HI training in promoting parent attendance across multiple publicly-funded mental health service settings. The larger effect in school-based programs supports the utility of training in evidence-based interventions such as AIM HI to increase the feasibility of parent attendance in such services.
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Affiliation(s)
- Kelsey S Dickson
- Department of Child and Family Development, San Diego State University.,Child and Adolescent Services Research Center
| | - Colby Chlebowski
- Child and Adolescent Services Research Center.,Department of Psychiatry, University of California San Diego
| | - Rachel Haine-Schlagel
- Department of Child and Family Development, San Diego State University.,Child and Adolescent Services Research Center
| | - Bill Ganger
- Child and Adolescent Services Research Center.,San Diego State University Research Foundation
| | - Lauren Brookman-Frazee
- Child and Adolescent Services Research Center.,Department of Psychiatry, University of California San Diego.,Autism Discovery Institute at Rady Children's Hospital San Diego
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13
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Strang JF, Knauss M, van der Miesen A, McGuire JK, Kenworthy L, Caplan R, Freeman A, Sadikova E, Zaks Z, Pervez N, Balleur A, Rowlands DW, Sibarium E, Willing L, McCool MA, Ehrbar RD, Wyss SE, Wimms H, Tobing J, Thomas J, Austen J, Pine E, Griffin AD, Janssen A, Gomez-Lobo V, Brandt A, Morgan C, Meagher H, Gohari D, Kirby L, Russell L, Powers MD, Anthony LG. A Clinical Program for Transgender and Gender-Diverse Neurodiverse/Autistic Adolescents Developed through Community-Based Participatory Design. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 50:730-745. [DOI: 10.1080/15374416.2020.1731817] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- John F. Strang
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
- George Washington University School of Medicine, George Washington University
| | - Megan Knauss
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
- Alliance of Community Health Plans
| | - Anna van der Miesen
- Department of Child and Adolescent Psychiatry, Center of Expertise on Gender Dysphoria, VU University Medical Center
| | - Jenifer K. McGuire
- Department of Family Social Science, University of Minnesota
- National Center for Gender Spectrum Health, University of Minnesota
| | - Lauren Kenworthy
- George Washington University School of Medicine, George Washington University
- Center for Autism Spectrum Disorders, Children’s National Health System
| | | | | | - Eleonora Sadikova
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
| | - Zosia Zaks
- Hussman Center for Adults with Autism, Towson University
| | | | | | | | | | - Laura Willing
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
- George Washington University School of Medicine, George Washington University
| | - Marissa A. McCool
- Queer Indigenous and People of Color (QIPOC), Augsburg University
- V-Day, University of Pennsylvania
| | | | - Shannon E. Wyss
- Gender and Sexuality Education and Advocacy Program, Children’s National Medical Center
- Transgender Leadership Initiative, AIDS United
| | - Harriette Wimms
- Youth Gender Care Services, The Village Family Support Center of Baltimore
| | | | - John Thomas
- Transgender and Autism Services, Falls Church Counseling
| | | | - Elyse Pine
- LGBT Health Resource Center, Chase Brexton Health Care
| | | | - Aron Janssen
- Gender and Sexuality Service, Child Study Center, New York University Medical School
| | - Veronica Gomez-Lobo
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
- Division of Pediatric Gynecology, Children’s National Health System
| | - Abigail Brandt
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
- Division of Hearing and Speech, Children’s National Health System
| | - Colleen Morgan
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
- Division of Hearing and Speech, Children’s National Health System
| | - Haley Meagher
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
| | - Dena Gohari
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
| | - Laura Kirby
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
| | - Laura Russell
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
| | - Meredith D. Powers
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System
| | - Laura G. Anthony
- Department of Psychiatry, Pediatric Mental Health Institute, Children’s Hospital of Colorado, University of Colorado School of Medicine
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Dickson KS, Aarons GA, Anthony LG, Kenworthy L, Crandal BR, Williams K, Brookman-Frazee L. Adaption and pilot implementation of an autism executive functioning intervention in children's mental health services: a mixed-methods study protocol. Pilot Feasibility Stud 2020; 6:55. [PMID: 32699642 PMCID: PMC7371471 DOI: 10.1186/s40814-020-00593-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 04/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Youth with autism spectrum disorder (ASD) represent a growing population with significant service needs. Prominent among these needs are high rates of co-occurring psychiatric conditions that contribute to increased functional impairments and often necessitate mental health services. Executive functioning deficits are associated with ASD as well as common co-occurring conditions (e.g., attention-deficit/hyperactivity disorder) and an evidence-based intervention has been developed and tested to address executive functioning within the school context. There is an urgent need to implement indicated evidence-based interventions for youth with ASD receiving care in community mental health settings. Interventions that optimally "fit" the mental health services context as well as the complex and co-occurring mental health needs of these youth have the potential to improve key clinical outcomes for this high priority population. METHODS This mixed-methods developmental study will apply the Exploration, Preparation, Implementation, Sustainment implementation framework and a community-academic partnership approach to systematically adapt and test an evidence-based executive functioning intervention for youth with ASD for delivery in community mental health settings. Specific aims are to (1) conduct a need and context assessment to inform the systematic adaptation an executive functioning evidence-based intervention; (2) systematically adapt the clinical intervention and develop a corresponding implementation plan, together entitled "Executive Functioning for Enhancing Community-based Treatment for ASD," (EFFECT for ASD); and (3) conduct a feasibility pilot test of EFFECT for ASD in community mental health settings. DISCUSSION Tailoring evidence-based interventions for delivery in community-based mental health services for youth with ASD has the potential to increase quality of care and improve child outcomes. Results from the current study will serve as the foundation for large-scale hybrid implementation and effectiveness trials and a generalizable approach for different service systems of care and clinical populations. TRIAL REGISTRATION Clinicaltrials.gov, NCT04295512.
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Affiliation(s)
- Kelsey S. Dickson
- San Diego State University, San Diego, CA USA
- Child and Adolescent Services Research Center, San Diego, CA USA
| | - Gregory A. Aarons
- Child and Adolescent Services Research Center, San Diego, CA USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA USA
| | - Laura Gutermuth Anthony
- University of Colorado School of Medicine, Aurora, CO USA
- Children’s Hospital of Colorado, Aurora, CO USA
| | - Lauren Kenworthy
- Center for Autism Spectrum Disorders, Children’s National, Washington, DC USA
| | | | - Katherine Williams
- Department of Psychiatry, University of California San Diego, La Jolla, CA USA
- Rady Children’s Hospital-San Diego, San Diego, CA USA
| | - Lauren Brookman-Frazee
- Child and Adolescent Services Research Center, San Diego, CA USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA USA
- Autism Disovery Institute at Rady Children’s Hospital, San Diego, CA USA
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Bejarano-Martín Á, Canal-Bedia R, Magán-Maganto M, Fernández-Álvarez C, Cilleros-Martín MV, Sánchez-Gómez MC, García-Primo P, Rose-Sweeney M, Boilson A, Linertová R, Roeyers H, Van der Paelt S, Schendel D, Warberg C, Cramer S, Narzisi A, Muratori F, Scattoni ML, Moilanen I, Yliherva A, Saemundsen E, Loa Jónsdóttir S, Efrim-Budisteanu M, Arghir A, Papuc SM, Vicente A, Rasga C, Rogé B, Guillon Q, Baduel S, Kafka JX, Poustka L, Kothgassner OD, Kawa R, Pisula E, Sellers T, Posada de la Paz M. Early Detection, Diagnosis and Intervention Services for Young Children with Autism Spectrum Disorder in the European Union (ASDEU): Family and Professional Perspectives. J Autism Dev Disord 2019; 50:3380-3394. [DOI: 10.1007/s10803-019-04253-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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16
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Ong JJ. Parental satisfaction and perception of Progress in influencing the Practice of complementary health approaches in children with autism: a cross sectional survey from Negeri Sembilan, Malaysia. Altern Ther Health Med 2019; 19:250. [PMID: 31500611 PMCID: PMC6734321 DOI: 10.1186/s12906-019-2672-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 09/03/2019] [Indexed: 11/10/2022]
Abstract
Background Parents’ use of complementary health approaches (CHA) for children with autism spectrum disorder (ASD) are common despite the uncertain evidence of its benefit. Parents often adopt CHA due to dissatisfaction with conventional treatment. This study aimed to examine parents’ satisfaction with ASD treatment and their perception of progress in their child’s development. Parents’ use of CHA among children with ASD and the factors related were also evaluated. Methods Self-administered questionnaires were completed by 48 parents of children with ASD at a single tertiary referral hospital in Malaysia. Correlation analysis was used to explore associations between parental satisfaction scores, perception of progress scores and use of CHA. Results Use of CHA was reported by parents for 35.4% of children with ASD in the sample. Parents who were less satisfied with conventional treatment and parents who perceived poorer progress in their child’s development were more likely to use CHA. Strong positive relationship was found between parent satisfaction with ASD treatment scores and parent perception of progress scores, which indicates that parents who were satisfied with treatment were more likely to perceive greater progress in their child’s development. Improvement in child’s progress was most appreciated by parents in their child’s behavior (85.5%), social skills (83.3%) and motor skills (77.1%). Conclusion The use of CHA was common among children with ASD. Parents were more likely to practice CHA when they were less satisfied with conventional treatment and perceived poorer progress. A larger multicenter study is required to further explore the practice of CHA among children with ASD throughout Malaysia.
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Affiliation(s)
- Jun Jean Ong
- Pediatric Department, Clinical Campus Seremban, International Medical University (IMU), Jalan Rasah, 70300 Seremban, Seri Menanti, Negeri Sembilan, Malaysia.
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17
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Brookman-Frazee L, Roesch S, Chlebowski C, Baker-Ericzen M, Ganger W. Effectiveness of Training Therapists to Deliver An Individualized Mental Health Intervention for Children With ASD in Publicly Funded Mental Health Services: A Cluster Randomized Clinical Trial. JAMA Psychiatry 2019; 76:574-583. [PMID: 30840040 PMCID: PMC6551846 DOI: 10.1001/jamapsychiatry.2019.0011] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Publicly funded mental health services play an important role in addressing co-occurring mental health problems in children with autism spectrum disorder (ASD); however, therapists report lacking training to effectively serve this complex population. OBJECTIVE To test the effectiveness of training community therapists in An Individualized Mental Health Intervention for ASD (AIM HI) on challenging behaviors across 18 months among children with ASD and identify moderators and mediators of any intervention effects. DESIGN, SETTING, AND PARTICIPANTS Cluster randomized trial conducted in 29 publicly funded outpatient and school-based mental health programs in southern California from 2012 to 2017. Programs were randomized to receive immediate AIM HI training or provide usual care followed by receipt of AIM HI training. Therapist participants were recruited from enrolled programs, and child participants were recruited from participant therapists' caseloads. Data were analyzed from 202 children with ASD who were aged 5 to 13 years. INTERVENTIONS The AIM HI protocol is a package of parent-mediated and child-focused strategies aimed to reduce challenging behaviors in children with ASD who are 5 to 13 years old. It was designed for delivery in publicly funded mental health services based on a systematic assessment of therapist training needs and child clinical needs. The therapist training and consultation process takes approximately 6 months and includes an introductory workshop, 11 structured consultation meetings as the therapist delivers AIM HI with a current client, and case-specific performance feedback from trainers. MAIN OUTCOMES AND MEASURES Child participants were assessed for challenging behaviors using the Eyberg Child Behavior Inventory (ECBI) and Social Skills Improvement System (SSIS) Competing Problem Behaviors scales based on parent report at baseline and at 6-month intervals for 18 months. Outcomes were analyzed using intent-to-treat models. RESULTS In total, 202 children with ASD (mean [SD] age, 9.1 [2.4] years; 170 [84.2%] male; 121 [59.9%] Latinx) were eligible, enrolled, and included in the analyses. Statistically significant group by time interactions for the ECBI Intensity (B = -0.38; P = .02) and ECBI Problem (B = -1.00; P = .005) scales were observed, with significantly larger decreases in ECBI Intensity scores in the AIM HI group (B = -1.36; P < .001) relative to the usual care group (B = -0.98; P < .001) and a significantly larger decrease in ECBI Problem scores in the AIM HI group (B = -1.22; P < .001) relative to the usual care group (B = -0.20; P = .29). Therapist fidelity moderated these intervention effects. CONCLUSIONS AND RELEVANCE The present findings support the effectiveness of training therapists to deliver the AIM HI model to children with ASD receiving publicly funded mental health services. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02416323.
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Affiliation(s)
- Lauren Brookman-Frazee
- Department of Psychiatry, University of California, San Diego, La Jolla,Child and Adolescent Services Research Center, San Diego, California,Rady Children’s Hospital–San Diego, University of California San Diego School of Medicine, La Jolla
| | - Scott Roesch
- Department of Psychology, San Diego State University, San Diego, California
| | - Colby Chlebowski
- Department of Psychiatry, University of California, San Diego, La Jolla,Child and Adolescent Services Research Center, San Diego, California
| | - Mary Baker-Ericzen
- Child and Adolescent Services Research Center, San Diego, California,Rady Children’s Hospital–San Diego, University of California San Diego School of Medicine, La Jolla
| | - William Ganger
- Child and Adolescent Services Research Center, San Diego, California,San Diego State University Research Foundation, San Diego, California
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Tan VXL, Simmonds JG. Parent Perceptions of Psychosocial Outcomes of Equine-Assisted Interventions for Children with Autism Spectrum Disorder. J Autism Dev Disord 2019; 48:759-769. [PMID: 29196865 DOI: 10.1007/s10803-017-3399-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This research explored parents' perceptions of the psychosocial outcomes of their children's experience of receiving equine-assisted interventions (EAI). Participants were the parents of six children (aged 3-14) diagnosed with autism spectrum disorder. Five semi-structured interviews were conducted and the transcript data was analysed using Interpretative phenomenological analysis. Four super-ordinate themes emerged from the analysis: (1) child's improved self-concept and enhanced emotional well-being, (2) child's improved self-regulatory ability, (3) social benefits for the child, and (4) unexpected outcomes. EAI was perceived by the parents as having several levels of psychosocial benefits for their children. These benefits may also extend to parents and family through ecopsychological and "flow on" effects associated with the children's involvement in EAI programs.
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Affiliation(s)
- Vanessa Xue-Ling Tan
- Psychology Programs, Faculty of Education, Monash University, Melbourne, VIC, Australia
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Guler J, de Vries PJ, Seris N, Shabalala N, Franz L. The importance of context in early autism intervention: A qualitative South African study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 22:1005-1017. [PMID: 28914083 PMCID: PMC5832543 DOI: 10.1177/1362361317716604] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The majority of individuals with autism spectrum disorder live in low- and middle-income countries and receive little or no services from health or social care systems. The development and validation of autism spectrum disorder interventions has almost exclusively occurred in high-income countries, leaving many unanswered questions regarding what contextual factors would need to be considered to ensure the effectiveness of interventions in low- and middle-income countries. This study qualitatively explored contextual factors relevant to the adaptation of a caregiver-mediated early autism spectrum disorder intervention in a low-resource South African setting. We conducted four focus groups and four in-depth interviews with 28 caregivers of young children with autism spectrum disorder and used thematic analysis to identify key themes. Eight contextual factors including culture, language, location of treatment, cost of treatment, type of service provider, support, parenting practices, and stigma emerged as important. Caregivers reported a preference for an affordable, in-home, individualized early autism spectrum disorder intervention, where they have an active voice in shaping treatment goals. Distrust of community-based health workers and challenges associated with autism spectrum disorder-related stigma were identified. Recommendations that integrate caregiver preferences with the development of a low-cost and scalable caregiver-mediated early autism spectrum disorder intervention are included.
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Affiliation(s)
- Jessy Guler
- Clinical Child Psychology Program, University of Kansas, USA
| | - Petrus J de Vries
- Division of Child & Adolescent Psychiatry, University of Cape Town, South Africa
| | - Noleen Seris
- Division of Child & Adolescent Psychiatry, University of Cape Town, South Africa
- Department of Psychology, University of Cape Town, South Africa
| | - Nokuthula Shabalala
- Division of Child & Adolescent Psychiatry, University of Cape Town, South Africa
- Department of Psychology, University of Cape Town, South Africa
| | - Lauren Franz
- Department of Psychiatry and Behavioral Sciences and Global Health, Duke University, USA
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20
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Lee HS, Kim SJ, Kwon JY. Parents' Perspectives and Clinical Effectiveness of Cranial-Molding Orthoses in Infants With Plagiocephaly. Ann Rehabil Med 2018; 42:737-747. [PMID: 30404423 PMCID: PMC6246855 DOI: 10.5535/arm.2018.42.5.737] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/15/2018] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the clinical effectiveness of and parents' perspectives on cranial-molding orthotic treatment. METHODS Medical charts were reviewed for 82 infants treated for plagiocephaly with cranial-molding orthoses in our clinic from April 2012 to July 2016 retrospectively. Infants who were clinically diagnosed with positional plagiocephaly and had a Cranial Vault Asymmetry Index (CVAI) of more than 3.5% were included. Pre- and post-treatment CVAI was obtained by three-dimensional head-surface laser scan. Parents' perceptions of good outcome (satisfaction) were evaluated with the Goal Attainment Scale (GAS). The GAS score assessed how much the parent felt that his or her initial goal for correcting the skull asymmetry was achieved after the treatment. RESULTS The compliance with cranial-molding orthoses was 90.2% (74 of 82 infants). There were 53 infants (65% of the 82 infants) who had adverse events with the cranial-molding orthoses during the study. Heat rash was found in 29 cases (35.4%) and was the most common adverse event. The mean GAS T-score was 51.9±10.2. A GAS T-score of 0 or more was identified for 71.6% of parents. The GAS T-score was significantly related to the age (p<0.001), the initial CVAI, and the difference of CVAI during the treatment (p<0.001). CONCLUSION Parents' perception of good outcome was correlated with the anthropometric improvement in cranialmolding orthotic treatment in infants with plagiocephaly. A high percentage of parents felt that the treatment met their initial goals in spite of a high occurrence of adverse events.
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Affiliation(s)
- Hyo Sun Lee
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Jun Kim
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong-Yi Kwon
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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21
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Mental Health Service Use Among Youth with Autism Spectrum Disorder: A Comparison of Two Age Groups. J Dev Behav Pediatr 2018; 39:20-27. [PMID: 29286984 DOI: 10.1097/dbp.0000000000000500] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Although youth with autism have elevated rates of mental health problems compared to typically developing youth, little is known about the mental health services that they receive. The current study examines predisposing, enabling, and clinical need factors as they relate to mental health service use in youth with autism. METHODS The current study surveyed parents of 2337 children and adolescents with autism, compared their access to behavioral management and mental health treatment (MHT), and isolated the correlates of such receipt. RESULTS Children used behavioral management more than adolescents, whereas the opposite was true for MHT. Mental health treatment receipt was associated with caregiver-related and mental health problems in both age groups, with routine health service use in children and with behavioral problems in adolescents. Behavioral management was correlated with caregiver-related services and behavioral problems in both age groups, and with sex and intellectual disability in adolescents. CONCLUSION Clinical needs and caregiver service use are consistently associated with mental health care across ages, whereas the role of youth characteristics is particularly relevant when considering service use for adolescents.
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22
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Postorino V, Sharp WG, McCracken CE, Bearss K, Burrell TL, Evans AN, Scahill L. A Systematic Review and Meta-analysis of Parent Training for Disruptive Behavior in Children with Autism Spectrum Disorder. Clin Child Fam Psychol Rev 2017; 20:391-402. [DOI: 10.1007/s10567-017-0237-2] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Stahmer AC, Aranbarri A, Drahota A, Rieth S. Toward a more collaborative research culture: Extending translational science from research to community and back again. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 21:259-261. [DOI: 10.1177/1362361317692950] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Aubyn C Stahmer
- Department of Psychiatry and Behavioral Sciences, The MIND Institute, University of California Davis, CA, USA
| | - Aritz Aranbarri
- Department of Psychiatry and Behavioral Sciences, The MIND Institute, University of California Davis, CA, USA
| | - Amy Drahota
- Department of Psychology, Michigan State University, MI, USA
| | - Sarah Rieth
- Department of Child and Family Development, San Diego State University, CA, USA
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Therapist perspectives on training in a package of evidence-based practice strategies for children with autism spectrum disorders served in community mental health clinics. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2015; 41:114-25. [PMID: 23086499 DOI: 10.1007/s10488-012-0441-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Therapist perspectives regarding delivery of evidence-based practice (EBP) strategies are needed to understand the feasibility of implementation in routine service settings. This qualitative study examined the perspectives of 13 therapists receiving training and delivering a package of EBPs to children with autism spectrum disorders (ASDs) in community mental health clinics. Therapists perceived the training and intervention delivery as effective at improving their clinical skills, the psychotherapy process, and child and family outcomes. Results expand parent pilot study findings, and add to the literature on training community providers and limited research on training providers to deliver EBPs to children with ASD.
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Accurso EC, Hawley KM, Garland AF. Psychometric properties of the Therapeutic Alliance Scale for Caregivers and Parents. Psychol Assess 2013; 25:244-52. [PMID: 23088205 PMCID: PMC3647370 DOI: 10.1037/a0030551] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examined the psychometric properties of the Therapeutic Alliance Scale for Caregivers and Parents (TASCP) in a sample of 209 caregivers whose children (4-13 years of age) presented with disruptive behavior problems to a publicly funded outpatient mental health clinic in San Diego County. Information about therapeutic alliance was collected from caregivers, children, and their therapists across the course of therapy (up to 16 months). Results support the reliability, temporal stability, convergent validity, and discriminant validity of scores on the TASCP. The multilevel factor structure of this new measure was consistent with the parallel child-report version, with 2 within-level factors and 1 between-level factor. Furthermore, predictive validity was strong, with stronger caregiver-reported alliance associated with less treatment dropout, more sessions attended, and greater satisfaction with perceived improvement.
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Affiliation(s)
- Erin C Accurso
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, 5841 South Maryland Avenue, MC 3077, Chicago, IL 60637, USA.
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