pcit

PCIT
  • 文章类型: Case Reports
    据作者所知,本文是阿尔巴尼亚和邻国首次通过认知行为疗法研究变革性协同干预方法,亲子互动疗法(PCIT),对患有注意力缺陷/多动障碍(ADHD)和并存的对立反抗障碍(ODD)和阅读障碍的儿童进行重金属排毒。阿尔巴尼亚的心理健康意识有限,特别是关于PCIT和类似的治疗,强调了此类干预措施的适用性和适应性的重要性。这项研究表明,多动症合并症的快速管理,比如ODD和阅读障碍,通过联合干预方法和调查生物学方面更好地实现。需要进行大样本量的进一步研究,以评估这种方法的长期可持续性和可扩展性。
    To the best of the authors\' knowledge, this article is the first of its kind in Albania and neighboring countries to investigate the transformative synergistic intervention approach through cognitive behavioral therapy, parent-child interaction therapy (PCIT), and heavy metal detoxification on a child with attention-deficit/hyperactivity disorder (ADHD) and comorbid oppositional defiant disorder (ODD) and dyslexia. The limited mental health awareness in Albania, particularly regarding PCIT and similar treatments, highlights the importance of the applicability and adaptability of such interventions. This study suggests that the rapid management of comorbidities in ADHD, such as ODD and dyslexia, is better achieved by a combined intervention approach and by investigating the biological aspects. Further research with a large sample size is needed to assess the long-term sustainability and scalability of such an approach.
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  • 文章类型: Journal Article
    注意缺陷/多动障碍(ADHD)在儿童早期非常普遍,并且在不治疗时会产生长期的负面影响。亲子互动疗法(PCIT)是针对2至7岁儿童的早期干预措施,通过教导父母管理儿童行为的有效策略来治疗儿童外化问题的广泛证据。然而,PCIT对患有ADHD的儿童家庭的影响尚不完全清楚.本荟萃分析旨在综合研究PCIT在ADHD儿童中的应用。对711项确定的研究中的9项进行了分析。使用儿童ADHD症状的标准化平均增益计算汇总效应大小,儿童行为,父母的压力,和育儿行为,并计算失效安全N以确定结果的稳健性。总的来说,PCIT对儿童ADHD症状有显著的有益作用(g=0.90),儿童行为(g=0.44),亲本应力(g=0.82),和育儿行为(g=2.15)。这项荟萃分析的结果表明,PCIT是减轻ADHD核心症状的有效治疗方法。
    Attention-deficit/hyperactivity disorder (ADHD) is highly prevalent in early childhood and has long-term negative effects when left untreated. Parent-Child Interaction Therapy (PCIT) is an early intervention for children aged 2- to-7-years that has extensive evidence for treating child externalizing problems by teaching parents effective strategies to manage child behavior. However, the effect of PCIT for families with children diagnosed with ADHD is not completely understood. This meta-analysis aims to synthesize research on the use of PCIT for children with ADHD. Nine out of 711 identified studies were analyzed. Summary effect sizes were calculated using the standardized mean gain for child ADHD symptoms, child behaviors, parent stress, and parenting behaviors, and the Fail-Safe N was calculated to determine the robustness of the results. Overall, PCIT had a significant beneficial effect on child ADHD symptoms (g = 0.90), child behavior (g = 0.44), parent stress (g = 0.82), and parenting behaviors (g = 2.15). Results of this meta-analysis suggest that PCIT is an effective treatment for reducing core symptoms of ADHD.
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  • 文章类型: Journal Article
    生活在贫困中并面临相关形式的逆境的儿童面临并发和后来的精神病理学的风险更高。虽然消极的心理结果可以通过在发育早期加强敏感和反应迅速的护理来改善,针对照顾者-儿童二元的干预措施不容易获得。本研究调查了针对3-6岁儿童(N=62)在低收入社区长大的精神病理学风险较高的早期干预措施,亲自或远程提供缩短的八节亲子互动治疗-情感发展(PCIT-ED)形式的可行性和有效性。照顾者-儿童二元被随机分配到八次PCIT-ED或在线育儿教育中。相对于育儿教育,接受PCIT-ED的儿童在干预后表现出较低的外化症状和功能损害,以及较积极的同伴关系.研究结果支持这种缩短形式的PCIT-ED的有效性,亲自或远程交付,作为改善生活在贫困中的高风险儿童的精神病理学症状和功能的早期干预措施。试验注册Clinicaltrials.gov;NCT04399629。
    Children living in poverty and facing related forms of adversity are at higher risk for experiencing concurrent and later psychopathology. Although negative psychological outcomes can be improved by enhancing sensitive and responsive caregiving early in development, interventions targeting the caregiver-child dyad are not readily accessible. The present study investigated the feasibility and effectiveness of delivering a shortened eight-session form of Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) in-person or remotely as an early intervention for 3-6-year-old children (N = 62) at elevated risk for psychopathology who were growing up in low-income communities. Caregiver-child dyads were randomized to eight-sessions of PCIT-ED or online parenting education. Relative to parenting education, children receiving PCIT-ED exhibited lower externalizing symptoms and functional impairment and more positive peer relationships following the intervention. Findings support the effectiveness of this shortened form of PCIT-ED, delivered in-person or remotely, as an early intervention to improve symptoms of psychopathology and functioning in high-risk children living in poverty.Trial registration Clinicaltrials.gov; NCT04399629.
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  • 文章类型: Journal Article
    亲子互动疗法(PCIT)是对儿童行为问题的经验支持的治疗方法,随着越来越多的临床医生在Aotearoa/新西兰接受培训。然而,确保在常规护理环境中由训练有素的临床医生持续提供有效的治疗是众所周知的挑战.本定性研究的目的是(1)系统地检查并优先考虑PCIT实施障碍和促进者,(2)制定一个明确的和理论驱动的“重新实施”干预措施,以支持已经受过培训的临床医生恢复或增加PCIT的实施。为了从早期的横断面调查中三角剖分和完善对PCIT实施决定因素的现有理解,我们将之前未分析的定性调查数据(54名受访者;应答率60%)与来自6个新焦点小组的定性数据进行了整合,其中15名在Aotearoa/新西兰接受过PCIT培训的临床医生和管理人员.我们对数据进行演绎编码,使用定向内容分析过程和理论域框架,从而确定了其中的重要理论领域和信念陈述。然后,我们使用理论和技术工具来识别行为改变技术,可能的干预组件,以及他们假设的作用机制。14个理论领域中有8个被确定为对PCIT培训的临床医生实施行为有影响(知识;社会/专业角色和身份;关于能力的信念;关于后果的信念;记忆,注意力和决策过程;环境背景和资源;社会影响;情绪)。其中两个似乎特别突出:(1)“环境背景和资源”,特别是缺乏合适的PCIT设备,(缺乏)进入设备齐全的诊所似乎以多种方式影响实施行为。(2)“社会/职业角色和身份”,与同事认为超时对儿童有害的看法有关的信念,担心国际开发的PCIT不适合非毛利人临床医生向土著毛利人家庭提供服务,和临床医生在倡导PCIT交付时感到有义务但孤立。总之,在最初的实施停滞不前或停滞不前的地方,重新实施是可能的,并且很有意义,财政上和实际上。这项研究表明,在Aotearoa/NewZealand重新实施PCIT可能会通过干预组件来促进,例如确保访问支持PCIT交付的同事或同事。使用合适的设备(特别是超时室),并有针对性地为临床医生提供有关儿童超时安全的额外培训。这些干预措施的可行性和可接受性将在未来的临床试验中进行测试。
    Parent-Child Interaction Therapy (PCIT) is an empirically supported treatment for childhood conduct problems, with increasing numbers of clinicians being trained in Aotearoa/New Zealand. However, ensuring sustained delivery of effective treatments by trained clinicians in routine care environments is notoriously challenging. The aims of this qualitative study were to (1) systematically examine and prioritise PCIT implementation barriers and facilitators, and (2) develop a well specified and theory-driven \'re-implementation\' intervention to support already-trained clinicians to resume or increase their implementation of PCIT. To triangulate and refine existing understanding of PCIT implementation determinants from an earlier cross-sectional survey, we integrated previously unanalysed qualitative survey data (54 respondents; response rate 60%) with qualitative data from six new focus groups with 15 PCIT-trained clinicians and managers in Aotearoa/New Zealand. We deductively coded data, using a directed content analysis process and the Theoretical Domains Framework, resulting in the identification of salient theoretical domains and belief statements within these. We then used the Theory and Techniques Tool to identify behaviour change techniques, possible intervention components, and their hypothesised mechanisms of action. Eight of the 14 theoretical domains were identified as influential on PCIT-trained clinician implementation behaviour (Knowledge; Social/Professional Role and Identity; Beliefs about Capabilities; Beliefs about Consequences; Memory, Attention and Decision Processes; Environmental Context and Resources; Social Influences; Emotion). Two of these appeared to be particularly salient: (1) \'Environmental Context and Resources\', specifically lacking suitable PCIT equipment, with (lack of) access to a well-equipped clinic room appearing to influence implementation behaviour in several ways. (2) \'Social/Professional Role and Identity\', with beliefs relating to a perception that colleagues view time-out as harmful to children, concerns that internationally-developed PCIT is not suitable for non-Māori clinicians to deliver to Indigenous Māori families, and clinicians feeling obligated yet isolated in their advocacy for PCIT delivery. In conclusion, where initial implementation has stalled or languished, re-implementation may be possible, and makes good sense, both fiscally and practically. This study suggests that re-implementation of PCIT in Aotearoa/New Zealand may be facilitated by intervention components such as ensuring access to a colleague or co-worker who is supportive of PCIT delivery, access to suitable equipment (particularly a time-out room), and targeted additional training for clinicians relating to the safety of time-out for children. The feasibility and acceptability of these intervention components will be tested in a future clinical trial.
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  • 文章类型: Journal Article
    亲子互动疗法(PCIT)被认为是2-7岁有行为问题的儿童的有效干预措施。PCIT研究已经进行了大约50年;然而,一般研究模式分析尚未发表。在这种情况下,本研究概述了科学合作的文献计量分析,基于国家和组织的不同地点的患病率,领先的研究人员,以及PCIT研究中的趋势。研究结果表明,PCIT是一个国际科学合作紧张和最新的领域,合作继续在世界各地形成。此外,结果表明,跨文化PCIT适应的传播是连续的。
    Parent-child interaction therapy (PCIT) is considered to be an effective intervention for children aged 2-7 years with conduct problems. PCIT research has been conducted for approximately 50 years; however, an analysis of general research patterns has not been published. In this context, the present study outlines a bibliometric analysis of scientific collaborations, prevalence across locations on the basis of countries and organizations, leading researchers, and trends within PCIT research. Findings demonstrate that PCIT is an area in which international scientific collaborations are intense and current, and collaborations continue to be formed around the world. Additionally, results indicate that dissemination of intercultural PCIT adaptations are continuous.
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  • 文章类型: Journal Article
    背景:尽管许多临床医生在新西兰奥特亚罗阿接受了亲子互动疗法(PCIT)的培训,很少有人定期提供治疗,使用障碍,包括缺乏合适的设备和缺乏专业支持。这种务实,平行臂,随机化,受控试点试验包括未经PCIT培训的临床医生,或者很少使用,这种有效的治疗方法。这项研究旨在评估可行性,研究方法和干预成分的可接受性和文化响应性,并收集有关建议的未来主要结果变量的方差数据,为未来做准备,更大的审判。
    方法:该试验将比较新颖的“重新实施”干预措施与进修培训和解决问题的控制。已经系统地开发了干预组件,以使用实施理论来解决临床医生使用PCIT的障碍和促进者,以及具有假设作用机制的逻辑模型草案,从一系列的初步研究中得出。干预包括免费使用PCIT实施所需的设备(视听设备,a\'pop-up\'超时空间,玩具),移动高级PCIT同事和可选的每周PCIT咨询小组,为期6个月。结果将包括招募和试验程序的可行性;临床医生对干预方案和数据收集方法的可接受性;以及临床医生采用PCIT。
    结论:相对较少研究关注干预措施,以恢复停滞不前的实施工作。这个务实的试点RCT的结果将完善和塑造与在社区环境中嵌入PCIT的持续交付可能需要的知识,为更多的儿童和家庭提供这种有效的治疗。
    背景:ANZCTR,ACTRN12622001022752,2022年7月21日注册。
    BACKGROUND: Despite a number of clinicians having been trained in Parent-Child Interaction Therapy (PCIT) in Aotearoa/New Zealand, few are regularly delivering the treatment, with barriers to use including a lack of suitable equipment and lack of professional support. This pragmatic, parallel-arm, randomised, controlled pilot trial includes PCIT-trained clinicians who are not delivering, or only rarely utilising, this effective treatment. The study aims to assess the feasibility, acceptability and cultural responsivity of study methods and intervention components and to collect variance data on the proposed future primary outcome variable, in preparation for a future, larger trial.
    METHODS: The trial will compare a novel \'re-implementation\' intervention with a refresher training and problem-solving control. Intervention components have been systematically developed to address barriers and facilitators to clinician use of PCIT using implementation theory, and a draft logic model with hypothesised mechanisms of action, derived from a series of preliminary studies. The intervention includes complimentary access to necessary equipment for PCIT implementation (audio-visual equipment, a \'pop-up\' time-out space, toys), a mobile senior PCIT co-worker and an optional weekly PCIT consultation group, for a 6-month period. Outcomes will include the feasibility of recruitment and trial procedures; acceptability of the intervention package and data collection methods to clinicians; and clinician adoption of PCIT.
    CONCLUSIONS: Relatively little research attention has been directed at interventions to resurrect stalled implementation efforts. Results from this pragmatic pilot RCT will refine and shape knowledge relating to what it might take to embed the ongoing delivery of PCIT in community settings, providing more children and families with access to this effective treatment.
    BACKGROUND: ANZCTR, ACTRN12622001022752, registered on July 21, 2022.
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  • 文章类型: Journal Article
    尽管行为家长培训(BPT)计划的在线管理的有效性是公认的,这些计划解决了学校准备困难的单一风险因素(行为功能)(由学者组成,认知技能,社会,情感,和行为功能)。本研究旨在研究可行性,可接受性,以及学校准备育儿计划(SRPP)的远程医疗服务的有效性,PCIT的综合适应,旨在解决学校准备的行为和学术领域。本研究朝着验证SRPP的在线管理作为儿童早期破坏性行为的治疗迈出了第一步。收集了64名2-6岁儿童(Mage=4.63,SD=0.86;78.1%的西班牙裔/拉丁裔)及其家人的数据,谁接受了有时限的PCIT(PCIT-TL;n=30)的亲自管理或SRPP的在线管理(n=34)。进行了一系列重复的ANOVAS措施,以检查组内和组间的影响。结果表明,SRPP和PCIT-TL均显着减少了注意力不集中(d\s=-0.54至-0.88),侵略(d\'s=-0.55至-1.06),和行为症状学(d\s=-0.55至-0.85),并在父母技能方面产生了显着提高(d\s=-1.47至2.99)。值得注意的是,在线SRPP在积极的父母言语表达方面表现出更大的改善,而PCIT-TL在父母压力方面表现出更大的降低。总的来说,研究结果支持在线SRPP解决行为学校准备问题的实用性。
    Although the efficacy of online administration of behavioral parent training (BPT) programs is well-established, such programs address a single risk factor (behavioral functioning) for school readiness difficulties (comprised of academics, cognitive skills, and social, emotional, and behavioral functioning). The current study aims to examine the feasibility, acceptability, and efficacy of a telemedicine delivery of the School Readiness Parenting Program (SRPP), an integrative adaptation of PCIT designed to address the behavioral and academic domains of school readiness. The present study takes the first step towards validating an online administration of the SRPP as a treatment for early childhood disruptive behavior. Data were collected for 64 children ages 2-6 years (Mage = 4.63, SD = 0.86; 78.1% Hispanic/Latinx) and their families, who received either in-person administration of time-limited PCIT (PCIT-TL; n=30) or online administration of SRPP (n=34). A series of repeated measures ANOVAS were conducted to examine within and between group effects. Results revealed that both SRPP and PCIT-TL significantly reduced inattention (d\'s = -0.54 to -0.88), aggression (d\'s = -0.55 to -1.06), and behavioral symptomology (d\'s = -0.55 to -0.85) and produced significant gains in parental skills (d\'s = -1.47 to 2.99). Notably, online SRPP demonstrated greater improvement in positive parental verbalization, whereas PCIT-TL demonstrated greater reductions in parental stress. Overall, findings support the utility of online SRPP for addressing behavioral school readiness concerns.
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  • 文章类型: Journal Article
    UNASSIGNED:亲子互动疗法(PCIT)是一项为学龄前儿童设计的基于证据的行为父母培训计划,强调支持亲子互动模式,以改善儿童行为并提高亲子关系的质量。PCIT被认为可有效治疗患有破坏性行为障碍的儿童,最近的研究表明,利用PCIT与自闭症谱系障碍(ASD)儿童的各个方面取得了有希望的结果,但这些研究均未按照手动方案应用整个PCIT干预.本研究是第一个测试PCIT的功效,没有修改,与患有ASD的学龄前儿童的家庭没有合并症行为困难。
    UNASSIGNED:本研究采用单受试者多探针设计,在4个月的时间内,对4个有2至4岁(M=40个月)ASD儿童的家庭进行PCIT的疗效评估。
    未经证实:PCIT在增加积极的育儿行为方面是有效的,减少消极的育儿行为,并提高孩子对父母命令的依从性。父母报告说,对治疗后的育儿能力有了更大的信心,自闭症症状学的核心领域也有了显着改善。父母认可亲子关系方面的显着改善,如依恋和参与。
    UNASSIGNED:ASD儿童的父母表现出更积极有效的育儿行为,并报告了参加PCIT后亲子关系的增强。儿童更遵守父母的命令,并表现出社会和行为功能的改善。在治疗后1个月以及在推广过程中,在诊所之外,积极的育儿行为和孩子对父母要求的依从性都保持了增加。ASD儿童的父母报告对PCIT的满意度很高。
    UNASSIGNED:本研究提供了对患有ASD的学龄前儿童家庭使用PCIT的有效性的初步证据,并支持对该人群PCIT的有效性进行持续调查。
    UNASSIGNED: Parent-child interaction therapy (PCIT) is an evidence-based behavioral parent training program designed for preschool-age children that emphasizes supporting parent-child interaction patterns to improve child behavior and enhance the quality of parent-child relationships. PCIT has been deemed efficacious in treating children with disruptive behavior disorders, and recent studies have shown promising results utilizing aspects of PCIT with children with autism spectrum disorder (ASD), but none of these studies applied the entire PCIT intervention per manual protocol. The present study is the first to test the efficacy of PCIT, without modification, with families of preschool-age children with ASD without comorbid behavioral difficulties.
    UNASSIGNED: This study employed a single-subject multiple-probe design to evaluate the efficacy of PCIT with four families with children with ASD between the ages of 2 and 4 years old (M = 40 months) over a 4-month period.
    UNASSIGNED: PCIT was effective in increasing positive parenting behavior, decreasing negative parenting behavior, and increasing child compliance to parental commands. Parents reported greater confidence in parenting abilities post-treatment and significant improvement in the core areas of autism symptomatology. Parents endorsed significant improvement in aspects of the parent-child relationship, such as attachment and involvement.
    UNASSIGNED: Parents of children with ASD demonstrated more positive and effective parenting behavior and reported enhancements in the parent-child relationship after participating in PCIT. Children were more compliant to parental commands and exhibited improvements in social and behavioral functioning. Increases in positive parenting behaviors and child compliance to parental requests were maintained 1 month after treatment and outside the clinic setting during generalization sessions. Parents of children with ASD reported a high degree of satisfaction with PCIT.
    UNASSIGNED: The present study provides initial evidence of the efficacy of utilizing PCIT with families of preschool-age children with ASD and supports the continued investigation of the efficacy of PCIT with this population.
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  • 文章类型: Journal Article
    UNASSIGNED:比较正常和骨关节炎膝关节软骨的共表达网络,以揭示与转录失调相关的分子,这些分子对软骨稳态至关重要。
    UNASSIGNED:正常和骨关节炎人膝软骨RNA-seqGSE114007数据集从基因表达综合数据库获得。使用部分相关和信息论(PCIT)算法来构建共表达网络,其中包含连接到正常和骨关节炎网络中至少一个差异表达基因(DEG)的所有节点。集线器和集线器中心基因用于进行功能富集分析。深入比较了已知与健康和患病软骨相关的富集BP。
    UNASSIGNED:差异共表达网络分析允许将DDX43和USP42鉴定为与正常和骨关节炎网络中的DEG专一共表达,分别。这些网络的最高枢纽和枢纽中心基因是HIST1H3A和SNHG12(正常)以及TAF9B和OTUD1(骨关节炎)。富集分析显示,对比组之间有几个共享的BP,这在骨关节炎的发病机制中是众所周知的。这些BP的蛋白质-蛋白质相互作用网络分析显示骨关节炎中转录因子的整体下调。特异性转录因子被鉴定为关节软骨维持中的多效性介质,因为它们参与多个BP。此外,发现染色质组织和修饰蛋白与骨关节炎的发展有关。
    UASSIGNED:差异基因共表达分析允许鉴定新的和高度优先的治疗候选基因,这些基因可能驱动骨关节炎软骨转录“状态”的修饰。
    UNASSIGNED: To compare co-expression networks of normal and osteoarthritis knee cartilage to uncover molecules associated with the transcriptional misregulation compromising biological processes (BPs) critical for cartilage homeostasis.
    UNASSIGNED: Normal and osteoarthritis human knee cartilage RNA-seq GSE114007 dataset was obtained from the Gene Expression Omnibus database. Partial Correlation and Information Theory (PCIT) algorithm was used to build co-expression networks containing all nodes connecting to at least one differentially expressed gene (DEG) in normal and osteoarthritis networks. Hub and hub centrality genes were used to perform functional enrichment analysis. Enriched BPs known to be associated with both healthy and diseased cartilage were compared in depth.
    UNASSIGNED: Differential co-expression network analyses allowed the identification of DDX43 and USP42 as exclusively co-expressed with DEGs in normal and osteoarthritis networks, respectively. The top hub and hub centrality genes of these networks were HIST1H3A and SNHG12 (normal) and TAF9B and OTUD1 (osteoarthritis). Enrichment analysis revealed several shared BPs between the contrasting groups, which are well-known in osteoarthritis pathogenesis. Protein-protein interaction network analysis for these BPs showed a global down-regulation of transcription factors in osteoarthritis. Specific transcription factors were identified as pleiotropic mediators in articular cartilage maintenance since they take part in several BPs. In addition, chromatin organisation and modification proteins were found relevant for osteoarthritis development.
    UNASSIGNED: Differential gene co-expression analysis allowed the identification of novel and high priority therapeutic candidate genes that may drive modifications in the transcriptional \"status\" of cartilage in osteoarthritis.
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  • 文章类型: Journal Article
    阿片类药物危机对西弗吉尼亚州儿童和家庭的破坏性影响因COVID-19大流行而加剧,并揭示了该州对更多精神卫生服务和提供者的迫切需要。亲子互动疗法(PCIT)是一种基于证据的儿童外化症状治疗方法,可教导父母积极和适当的策略来管理儿童行为。当前的定性研究详细介绍了在COVID-19大流行期间,西弗吉尼亚州与受阿片类药物影响的家庭一起传播和实施PCIT的障碍和促进因素。治疗师(n=34)谁参加了PCIT培训和咨询通过国家阿片类药物响应补助金被要求提供有关他们的经验PCIT培训的数据,协商,和执行。几乎所有治疗师(91%)都报告了远程医疗PCIT的障碍(例如,互联网连接不良,会议的不可预测性)。近一半的治疗师病例(45%)直接受到父母使用药物的影响。提出了有关远程医疗和阿片类药物使用对PCIT实施的影响的定性结果。在一个受远程医疗能力差和阿片类药物流行影响很大的州,PCIT的传播和实施与其他州的PCIT培训和治疗实施不同,强调探索农村环境实施因素的至关重要性。
    The devastating impact of the opioid crisis on children and families in West Virginia was compounded by the COVID-19 pandemic and brought to light the critical need for greater mental health services and providers in the state. Parent-Child Interaction Therapy (PCIT) is an evidence-based treatment for child externalizing symptoms that teaches parents positive and appropriate strategies to manage child behaviors. The current qualitative study details barriers and facilitators to disseminating and implementing PCIT with opioid-impacted families across West Virginia during the COVID-19 pandemic. Therapists (n = 34) who participated in PCIT training and consultation through a State Opioid Response grant were asked to provide data about their experiences with PCIT training, consultation, and implementation. Almost all therapists (91%) reported barriers to telehealth PCIT (e.g., poor internet connection, unpredictability of sessions). Nearly half of therapists\' cases (45%) were impacted directly by parental substance use. Qualitative findings about the impact of telehealth and opioid use on PCIT implementation are presented. The dissemination and implementation of PCIT in a state greatly impacted by poor telehealth capacity and the opioid epidemic differed from the implementation of PCIT training and treatment delivery in other states, highlighting the critical importance of exploring implementation factors in rural settings.
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