在初级保健精神卫生服务提供中使用基于认知行为治疗的简短、便利的自助干预措施:对一个为期10天的培训方案的评价

David M. Ekers MSc, Dip Behavioural & Cognitive Psychotherapy, RN (Consultant Nurse Primary Care Mental Health) , Karina Lovell PhD, MSc, Dip Behavioural & Cognitive Psychotherapy, RN (Professor of Mental Health Nursing) , John F. Playle MSc, BSc (Hons), Dip Couns, CPN Cert, RN, RNT (Senior Lecturer, Head of Mental Health Division)
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引用次数: 9

摘要

背景:有明确的证据表明,针对初级保健中常见的精神卫生问题,具体干预措施是有效的。一项重大挑战是传统方法在应对大量需求方面缺乏灵活性。基于指导自助干预的简短认知行为疗法(CBT)的证据正在涌现,可能为应对数量和可及性问题提供一条前进的道路。我们提出了一项培训课程的评估,该课程旨在使未经CBT培训的工作人员能够提供此类干预措施。17名初级保健精神卫生工作者参加了为期10天的培训课程,重点是基于认知行为疗法的便利自助方法。以认知行为治疗知识为主的评价;培训的可接受性/有效性;自我感知融入参与者的临床实践和感知障碍使用获得的知识和技能。分别在培训前后和6个月后采取措施。结果两组患者在认知、认知行为疗法使用自评、培训有效性等方面均有积极变化,且在课程结束后6个月基本保持。人们注意到,特别是在机构领域,实施干预措施的障碍在课程结束后长达6个月仍然存在。讨论在这组工作人员中,概述的培训能够产生所需的更改,并得到维护。这些变化在多大程度上改善了获取或有效性超出了本文的范围。建议进一步研究提供有效的短期干预所需的最佳培训水平,作为阶梯式精神卫生保健系统的一部分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The use of CBT based, brief, facilitated self-help interventions in primary care mental health service provision: Evaluation of a 10-day training programme

Background

There is clear evidence for the effectiveness of specific interventions for common mental health problems in primary care. A major challenge is the inflexibility of traditional approaches to respond to the sheer volume of need. Evidence for brief cognitive behavioural therapy (CBT) based guided self-help interventions is emergent and may offer a way forward in responding to the issues of volume and accessibility. We present, an evaluation of a training course designed to equip non CBT trained workers to deliver such interventions.

Process

Seventeen primary care mental health workers participated in a 10-day training course focussed on CBT based facilitated self-help approaches. Evaluation focussed on knowledge of CBT; acceptability/usefulness of the training; self perceived incorporation into participants’ clinical practice and perceived barriers to the use of the knowledge and skills acquired. Measures were administered pre and post training and 6 months later.

Results

Positive changes were recorded in knowledge, self rating of use of CBT techniques, usefulness of training which largly maintained 6 months after the course concluded. Perceived barriers to implementation of the intervention were noted particularly in the institutional domain and remained up to 6 months post the course.

Discussion

In this group of staff the training outlined was able to produce desired changes that were maintained. The degree to which these changes were responsible for improved access or effectiveness is beyond the scope of this paper. Further research is recommended in relation to the optimum level of training required to deliver effective brief interventions as part of a stepped system of mental health care.

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