Ensuring that psychological interventions are delivered as intended on mental health inpatient wards.

IF 3.8 3区 心理学 Q1 PSYCHOLOGY, CLINICAL
Katherine Berry, Fritz Handerer, Sandra Bucci, Georgina Penn, Helen Morley, Jessica Raphael, Karina Lovell, Owen Price, Dawn Edge, Richard J Drake, Gillian Haddock
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Abstract

Objectives: Talk, Understand and Listen for InPatient Settings (TULIPS) was a multi-centred randomized control trial of an intervention that aimed to increase patient access to psychological therapies on acute mental health wards. This paper aims to: (i) describe a strategy for designing a psychological intervention that is implementable in inpatient mental health settings; (ii) describe methods for assessing the fidelity of interventions within these settings; (iii) report on the extent to which fidelity was achieved in the TULIPS trial.

Methods: The TULIPS intervention was designed using information from a systematic review, stakeholder interviews, pilot work and a consensus workshop. We assessed fidelity to the model in terms of the delivery and dose of essential elements of the intervention, quality of intervention delivery, engagement of participants with the intervention and differentiation between the intervention and usual care.

Results: Although the TULIPS intervention targeted known barriers to the delivery of psychological interventions on mental health wards, we found issues in implementing aspects of the intervention that were dependent upon the participation of members of the multidisciplinary team. Psychologists were able to overcome barriers to delivering individual therapy to patients as this provision was not reliant on the availability of other staff.

Conclusions: The intervention period in the study was 6 months. A greater period of time with a critical mass of psychological practitioners is needed to embed psychological interventions on inpatient wards. Our fidelity framework and assessment methods can be used by other researchers implementing and testing psychological therapies within inpatient environments.

确保在心理健康住院病人病房中按照预期进行心理干预。
目标:针对住院环境的谈话、理解和倾听(TULIPS)是一项多中心随机对照试验,旨在增加急诊精神科病房患者获得心理治疗的机会。本文旨在:(i) 描述一种设计可在住院精神健康环境中实施的心理干预的策略;(ii) 描述在这些环境中评估干预忠实性的方法;(iii) 报告 TULIPS 试验在多大程度上实现了忠实性:TULIPS 干预方案的设计参考了系统综述、利益相关者访谈、试点工作和共识研讨会的信息。我们从干预措施基本要素的实施和剂量、干预措施实施的质量、参与者对干预措施的参与度以及干预措施与常规护理之间的区别等方面评估了该模式的忠实性:结果:尽管TULIPS干预针对的是心理健康病房在实施心理干预时遇到的已知障碍,但我们发现在实施干预的某些方面存在问题,这些问题取决于多学科团队成员的参与。心理学家能够克服为患者提供个别治疗的障碍,因为这种治疗不依赖于其他工作人员的参与:本研究的干预期为 6 个月。要在住院病房开展心理干预,需要更长的时间和更多的心理从业人员。我们的忠实度框架和评估方法可供其他在住院环境中实施和测试心理疗法的研究人员使用。
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来源期刊
CiteScore
5.80
自引率
3.20%
发文量
57
期刊介绍: The British Journal of Clinical Psychology publishes original research, both empirical and theoretical, on all aspects of clinical psychology: - clinical and abnormal psychology featuring descriptive or experimental studies - aetiology, assessment and treatment of the whole range of psychological disorders irrespective of age group and setting - biological influences on individual behaviour - studies of psychological interventions and treatment on individuals, dyads, families and groups
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