Examining the nature and determinants of evidence-based treatment (EBT) modification is an important step toward understanding the impact of modifications and informing modification guidelines. We examined the prevalence, types, reasons for, and predictors of clinician-reported modification to cognitive behavioral therapy (CBT) for children and adolescents. Ninety-eight clinicians trained in CBT completed surveys on their intent to modify CBT, perceptions of CBT characteristics, confidence in their ability to appropriately deliver CBT in complex clinical situations, and organizational EBT implementation climate post-training. Post-consultation, clinicians self-reported the types and reasons for modifications they performed. Ninety-three percent of clinicians reported they modified CBT, primarily with fewer than half of their clients. Client needs and clinician preference or style accounted for the highest proportion of modification reasons. The number of reported modifications performed was predicted by clinician confidence in their ability to deliver CBT appropriately (b = .90, p = .01) and their intent to modify (b = .55, p = .01).

中文翻译：

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临床医生报告的对儿童心理健康 CBT 方法的修改

检查循证治疗 (EBT) 修改的性质和决定因素是了解修改影响和告知修改指南的重要一步。我们检查了临床医生报告的儿童和青少年认知行为疗法 (CBT) 修改的流行率、类型、原因和预测因素。98 名接受 CBT 培训的临床医生完成了关于他们修改 CBT 的意图、对 CBT 特征的看法、对他们在复杂临床情况下适当实施 CBT 的能力的信心以及培训后组织 EBT 实施氛围的调查。会诊后，临床医生自我报告了他们进行修改的类型和原因。93% 的临床医生报告说他们修改了 CBT，主要是针对不到一半的客户。客户需求和临床医生偏好或风格在修改原因中所占的比例最高。报告的修改次数由临床医生对其适当提供 CBT 的能力的信心 (b = .90, p = .01) 和他们的修改意图 (b = .55, p = .01) 预测。