There is a growing emphasis on utilizing evidence-based treatments in community settings; yet little is known about treatment practices in usual care. The first aim of this study sought to describe treatment-as-usual (TAU) for children at risk of physical abuse, and identify elements of one evidence-based treatment, Alternatives for Families: A Cognitive Behavior Therapy (AF-CBT), present in usual care. A second aim was to identify how contextual variables influenced treatment practices. Participants included 44 practitioners and 64 families that presented with concerns of risk of physical abuse. The Therapy Process Observational Coding System for Child Psychotherapy–Strategies Scale and AF-CBT Adherence Coding System were used to understand treatment practices in 278 therapy sessions. Similar to other studies on TAU, families received treatment for an extensive time (M = 19 sessions), and practitioners delivered a wide array of therapeutic techniques and some elements of AF-CBT; however, they did not utilize many techniques in great depth. An analysis of contextual factors indicated that there was variation based upon agency, practitioner, and family characteristics in the delivery of treatment practices. These findings are an important step in understanding treatment practices and contextual influences on usual care for children at risk of physical abuse.

中文翻译：

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社区心理健康中心对儿童身体虐待的照常治疗：治疗师特征、客户概况和治疗过程

越来越强调在社区环境中使用循证治疗；然而，人们对常规护理中的治疗实践知之甚少。本研究的第一个目的旨在描述对有身体虐待风险的儿童的照常治疗 (TAU)，并确定一种循证治疗的要素，家庭替代方案：认知行为疗法 (AF-CBT)，目前在平时的照顾。第二个目标是确定背景变量如何影响治疗实践。参与者包括 44 名从业者和 64 个家庭，他们担心遭受身体虐待的风险。儿童心理治疗策略量表的治疗过程观察编码系统和 AF-CBT 依从性编码系统用于了解 278 次治疗课程中的治疗实践。与其他关于 TAU 的研究类似，家庭接受了长时间的治疗（M = 19 次），从业者提供了广泛的治疗技术和 AF-CBT 的一些要素；然而，他们并没有深入使用许多技术。对背景因素的分析表明，在提供治疗实践的过程中，存在基于机构、从业者和家庭特征的差异。这些发现是了解治疗实践和背景对有身体虐待风险的儿童的日常护理的影响的重要一步。和家庭特征提供治疗实践。这些发现是了解治疗实践和背景对有身体虐待风险的儿童的日常护理的影响的重要一步。和家庭特征提供治疗实践。这些发现是了解治疗实践和背景对有身体虐待风险的儿童的日常护理的影响的重要一步。