Emergent Life Events: An In-Depth Investigation of Characteristics and Provider Responses during Youth Evidence-Based Treatment
Autor: | Jennifer L. Krull, Karen Guan, Jennifer M. Gamarra, Rachel Kim, Todd E. Brown, Bruce F. Chorpita, Naomi V. Rodas |
---|---|
Rok vydání: | 2018 |
Předmět: |
Male
050103 clinical psychology Psychotherapist Evidence-based practice Developmental & Child Psychology Article Life Change Events 03 medical and health sciences 0302 clinical medicine Clinical Research Behavioral and Social Science Developmental and Educational Psychology Psychology Humans 0501 psychology and cognitive sciences Preschool Child Pediatric 05 social sciences Stressor Life events Reproducibility of Results 030227 psychiatry Clinical Psychology Child Preschool Evidence-Based Practice Cognitive Sciences Female Psychosocial |
Zdroj: | Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, vol 48, iss 6 |
ISSN: | 1537-4424 |
Popis: | Emergent life events (ELEs), or acute client stressors disclosed within psychotherapy sessions, are not addressed by many evidence-based psychosocial treatments (EBTs). Preliminary provider-report studies suggest that ELEs may interfere with effective EBT implementation. The present study offers a detailed, observational examination of ELEs and their impact on EBT within therapy sessions. Data were observationally coded from 274 sessions with 55 primarily low-income, Latino youth clients (58% male, ages 5-15) in the modular EBT condition (Modular Approach to Therapy for Children [MATCH]) of the Child STEPs California trial. The ELE Coding System-Revised was used to measure ELEs, their characteristics, and provider responses to ELEs, including provider adherence to MATCH. Interrater reliability was generally high. At least one ELE was identified in 13% of randomly selected sessions. ELEs ranged widely in content, and their characteristics did not cluster together. Providers responded more frequently to ELEs with non-EBT content (e.g., information gathering, empathy) than EBT content; use of the ELE as a "teaching moment" for EBT content was the least common response (40% of ELEs). Multilevel regression analyses revealed that compared to sessions without an ELE, ELE sessions were significantly associated with reduced provider adherence to MATCH. Within ELE sessions, higher client distress when discussing the ELE was associated with reduced provider adherence to MATCH, but only when ELE severity was high. Beyond provider report, observational measures indicate that ELEs are prevalent and unpredictable in community settings and disrupt EBT delivery. Findings can inform the development of structured ELE management procedures to enhance existing EBTs. |
Databáze: | OpenAIRE |
Externí odkaz: |