The National Institute of Health has made it a priority to identify, develop, and refine strategies to disseminate and implement effective interventions (National Institute of Health, 2015). This study examined qualitative reports of the strategies therapists used to manage common implementation problems they encountered during midtreatment in Multisystemic Therapy^® (MST) and Functional Family Therapy (FFT), two widely disseminated evidence- and family-based treatments for substance abusing and delinquent adolescents. Experienced therapists from dissemination sites across the U.S. described cases in which they encountered midtreatment problems they perceived as serious threats to treatment success. They indicated why each case terminated and rated the outcome of the case. Qualitative analyses examined 16 treatment failures and then 16 treatment successes to identify contextual obstacles that accompanied the problems therapists identified, along with strategies they reported using with families that ultimately succeeded or failed. Therapists reported that midtreatment problems were often embedded in additional related difficulties and that they employed multiple relationship techniques and process-focused strategies to try to resolve these problems. For the most part, therapists described obstacles and strategies for successful and unsuccessful families in similar ways. Patterns of themes and subthemes suggested, however, that therapists in successful cases may be more likely to report “on-script” strategies and therapists in unsuccessful cases may describe more “off-script” strategies as well as more generic relationship building and advice-giving strategies.

中文翻译：

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社区环境中循证干预中治疗中期问题的治疗师策略

美国国立卫生研究院已将确定、制定和完善战略以传播和实施有效干预措施作为优先事项（美国国立卫生研究院，2015 年）。^{本研究检查了治疗师用于管理他们在多系统治疗®}中期治疗期间遇到的常见实施问题的策略的定性报告（MST）和功能性家庭治疗（FFT），两种广泛传播的基于证据和家庭的治疗药物滥用和犯罪青少年。来自美国各地传播站点的经验丰富的治疗师描述了他们遇到的治疗过程中遇到的问题，他们认为这些问题严重威胁治疗成功。他们说明了为什么每个案件都终止了，并对案件的结果进行了评级。定性分析检查了 16 次治疗失败和 16 次治疗成功，以确定伴随治疗师发现的问题的背景障碍，以及他们报告的与最终成功或失败的家庭一起使用的策略。治疗师报告说，中间治疗问题通常嵌入额外的相关困难中，他们采用多种关系技术和以过程为中心的策略来尝试解决这些问题。在大多数情况下，治疗师以类似的方式描述了成功和不成功家庭的障碍和策略。然而，主题和子主题的模式表明，成功案例中的治疗师可能更有可能报告“脚本”策略，而不成功案例中的治疗师可能会描述更多“脚本之外”策略以及更通用的关系建立和建议-给予策略。