{"title":"边缘型人格障碍部分住院和住院服务中辩证行为治疗的可得性:2014 - 2021年全国精神卫生服务调查的探索性纵向研究","authors":"Daniel S Spina, Kenneth N Levy","doi":"10.1037/ccp0000870","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Treatment guidelines on borderline personality disorder (BPD) recommend day-hospital or residential treatments for patients with BPD who cannot tolerate outpatient treatment (American Psychiatric Association, 2010; National Health & Medical Research Council, 2013). However, the current literature suggests that evidence-based treatment for BPD may be difficult to access (Lohman et al., 2017). The present study aims to characterize the accessibility of dialectical behavioral therapy (DBT) in day-treatment and residential programs in the United States in the last 7 years and examines whether day-treatment and residential programs that accept state benefits (i.e., Medicaid) are significantly less likely to offer DBT.</p><p><strong>Method: </strong>Using mixed logistic regression, we examined trends in the National Mental Health Services Survey data from 2014 to 2021, a survey of U.S. mental health facilities which tracks whether facilities provide DBT.</p><p><strong>Results: </strong>We found that the likelihood that a residential or day-hospital facility offers DBT has been growing over time at the national level (<i>OR</i><sub>day-treatment</sub> = 1.07, <i>SE</i> = .03, <i>z</i> = 1.90, <i>p</i> = .05; <i>OR</i><sub>residential</sub> = 1.08, <i>SE</i> = .05, <i>z</i> = 1.77, <i>p</i> = .08). We also found significant variability in these trends at the state level. In addition, we found that facilities accepting state benefits were less likely to offer DBT (<i>OR</i><sub>day-treatment</sub> = .66, <i>SE</i> = .021, <i>z</i> = -1.93, <i>p</i> = .05; <i>OR</i><sub>residential</sub> = .67, <i>SE</i> = .21, <i>z</i> = -1.91, <i>p</i> = .06).</p><p><strong>Conclusion: </strong>Consistent with previous literature, our study suggests that these programs are very scarce across the United States and difficult to access for those with Medicaid.guidelines on borderline personality disorder (BPD) recommend day-hospital or residential treatments for patients with BPD who cannot tolerate outpatient treatment (American Psychiatric Association, 2010; National Health & Medical Research Council, 2013). However, the current literature suggests that evidence-based treatment for BPD may be difficult to access (Lohman et al., 2017). The present study aims to characterize the accessibility of dialectical behavioral therapy (DBT) in day-treatment and residential programs in the United States in the last 7 years and examines whether day-treatment and residential programs that accept state benefits (i.e., Medicaid) are significantly less likely to offer DBT.</p><p><strong>Method: </strong>Using mixed logistic regression, we examined trends in the National Mental Health Services Survey data from 2014 to 2021, a survey of U.S. mental health facilities which tracks whether facilities provide DBT.</p><p><strong>Results: </strong>We found that the likelihood that a residential or day-hospital facility offers DBT has been growing over time at the national level (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":null,"pages":null},"PeriodicalIF":4.5000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The availability of dialectical behavior therapy in partial hospitalization and residential services for borderline personality disorder: An exploratory longitudinal study of the National Mental Health Services Survey from 2014 to 2021.\",\"authors\":\"Daniel S Spina, Kenneth N Levy\",\"doi\":\"10.1037/ccp0000870\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Treatment guidelines on borderline personality disorder (BPD) recommend day-hospital or residential treatments for patients with BPD who cannot tolerate outpatient treatment (American Psychiatric Association, 2010; National Health & Medical Research Council, 2013). However, the current literature suggests that evidence-based treatment for BPD may be difficult to access (Lohman et al., 2017). The present study aims to characterize the accessibility of dialectical behavioral therapy (DBT) in day-treatment and residential programs in the United States in the last 7 years and examines whether day-treatment and residential programs that accept state benefits (i.e., Medicaid) are significantly less likely to offer DBT.</p><p><strong>Method: </strong>Using mixed logistic regression, we examined trends in the National Mental Health Services Survey data from 2014 to 2021, a survey of U.S. mental health facilities which tracks whether facilities provide DBT.</p><p><strong>Results: </strong>We found that the likelihood that a residential or day-hospital facility offers DBT has been growing over time at the national level (<i>OR</i><sub>day-treatment</sub> = 1.07, <i>SE</i> = .03, <i>z</i> = 1.90, <i>p</i> = .05; <i>OR</i><sub>residential</sub> = 1.08, <i>SE</i> = .05, <i>z</i> = 1.77, <i>p</i> = .08). We also found significant variability in these trends at the state level. In addition, we found that facilities accepting state benefits were less likely to offer DBT (<i>OR</i><sub>day-treatment</sub> = .66, <i>SE</i> = .021, <i>z</i> = -1.93, <i>p</i> = .05; <i>OR</i><sub>residential</sub> = .67, <i>SE</i> = .21, <i>z</i> = -1.91, <i>p</i> = .06).</p><p><strong>Conclusion: </strong>Consistent with previous literature, our study suggests that these programs are very scarce across the United States and difficult to access for those with Medicaid.guidelines on borderline personality disorder (BPD) recommend day-hospital or residential treatments for patients with BPD who cannot tolerate outpatient treatment (American Psychiatric Association, 2010; National Health & Medical Research Council, 2013). However, the current literature suggests that evidence-based treatment for BPD may be difficult to access (Lohman et al., 2017). The present study aims to characterize the accessibility of dialectical behavioral therapy (DBT) in day-treatment and residential programs in the United States in the last 7 years and examines whether day-treatment and residential programs that accept state benefits (i.e., Medicaid) are significantly less likely to offer DBT.</p><p><strong>Method: </strong>Using mixed logistic regression, we examined trends in the National Mental Health Services Survey data from 2014 to 2021, a survey of U.S. mental health facilities which tracks whether facilities provide DBT.</p><p><strong>Results: </strong>We found that the likelihood that a residential or day-hospital facility offers DBT has been growing over time at the national level (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>\",\"PeriodicalId\":15447,\"journal\":{\"name\":\"Journal of consulting and clinical psychology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of consulting and clinical psychology\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1037/ccp0000870\",\"RegionNum\":1,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/12/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHOLOGY, CLINICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of consulting and clinical psychology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1037/ccp0000870","RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/7 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
引用次数: 0
摘要
目的:边缘型人格障碍(BPD)治疗指南推荐对不能忍受门诊治疗的BPD患者进行日间住院或住院治疗(美国精神病学协会，2010;国家卫生和医学研究委员会，2013年)。然而，目前的文献表明，BPD的循证治疗可能难以获得(Lohman等人，2017)。本研究旨在描述辩证行为疗法(DBT)在过去7年中在美国日间治疗和住院治疗项目中的可及性，并检查接受国家福利(即医疗补助)的日间治疗和住院治疗项目是否明显不太可能提供DBT。方法:使用混合逻辑回归，我们检查了2014年至2021年国家精神卫生服务调查数据的趋势，这是一项对美国精神卫生机构的调查，追踪设施是否提供DBT。结果:我们发现，在全国范围内，住宅或日间医院设施提供DBT的可能性随着时间的推移而增加(日间治疗= 1.07,SE = 0.03, z = 1.90, p = 0.05;ORresidential = 1.08, SE = 0.05, z = 1.77, p = 0.08)。我们还发现，这些趋势在各州层面上存在显著差异。此外，我们发现接受国家福利的机构不太可能提供DBT(日常治疗= 0.66,SE = 0.021, z = -1.93, p = 0.05;ORresidential = .67, SE = .21, z = -1.91, p = .06)。结论:与之前的文献一致，我们的研究表明，这些项目在美国非常稀缺，而且对于那些有医疗补助的人来说很难获得。边缘型人格障碍(BPD)指南建议对不能忍受门诊治疗的BPD患者进行日间医院或住院治疗(美国精神病学协会，2010;国家卫生和医学研究委员会，2013年)。然而，目前的文献表明，BPD的循证治疗可能难以获得(Lohman等人，2017)。本研究旨在描述辩证行为疗法(DBT)在过去7年中在美国日间治疗和住院治疗项目中的可及性，并检查接受国家福利(即医疗补助)的日间治疗和住院治疗项目是否明显不太可能提供DBT。方法:使用混合逻辑回归，我们检查了2014年至2021年国家精神卫生服务调查数据的趋势，这是一项对美国精神卫生机构的调查，追踪设施是否提供DBT。结果:我们发现，在国家层面上，住宅或日间医院设施提供DBT的可能性随着时间的推移而增加(PsycInfo数据库记录(c) 2023 APA，所有权利保留)。
The availability of dialectical behavior therapy in partial hospitalization and residential services for borderline personality disorder: An exploratory longitudinal study of the National Mental Health Services Survey from 2014 to 2021.
Objective: Treatment guidelines on borderline personality disorder (BPD) recommend day-hospital or residential treatments for patients with BPD who cannot tolerate outpatient treatment (American Psychiatric Association, 2010; National Health & Medical Research Council, 2013). However, the current literature suggests that evidence-based treatment for BPD may be difficult to access (Lohman et al., 2017). The present study aims to characterize the accessibility of dialectical behavioral therapy (DBT) in day-treatment and residential programs in the United States in the last 7 years and examines whether day-treatment and residential programs that accept state benefits (i.e., Medicaid) are significantly less likely to offer DBT.
Method: Using mixed logistic regression, we examined trends in the National Mental Health Services Survey data from 2014 to 2021, a survey of U.S. mental health facilities which tracks whether facilities provide DBT.
Results: We found that the likelihood that a residential or day-hospital facility offers DBT has been growing over time at the national level (ORday-treatment = 1.07, SE = .03, z = 1.90, p = .05; ORresidential = 1.08, SE = .05, z = 1.77, p = .08). We also found significant variability in these trends at the state level. In addition, we found that facilities accepting state benefits were less likely to offer DBT (ORday-treatment = .66, SE = .021, z = -1.93, p = .05; ORresidential = .67, SE = .21, z = -1.91, p = .06).
Conclusion: Consistent with previous literature, our study suggests that these programs are very scarce across the United States and difficult to access for those with Medicaid.guidelines on borderline personality disorder (BPD) recommend day-hospital or residential treatments for patients with BPD who cannot tolerate outpatient treatment (American Psychiatric Association, 2010; National Health & Medical Research Council, 2013). However, the current literature suggests that evidence-based treatment for BPD may be difficult to access (Lohman et al., 2017). The present study aims to characterize the accessibility of dialectical behavioral therapy (DBT) in day-treatment and residential programs in the United States in the last 7 years and examines whether day-treatment and residential programs that accept state benefits (i.e., Medicaid) are significantly less likely to offer DBT.
Method: Using mixed logistic regression, we examined trends in the National Mental Health Services Survey data from 2014 to 2021, a survey of U.S. mental health facilities which tracks whether facilities provide DBT.
Results: We found that the likelihood that a residential or day-hospital facility offers DBT has been growing over time at the national level (PsycInfo Database Record (c) 2024 APA, all rights reserved).
期刊介绍：
The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
