Laurel D Sarfan, Zia Bajwa, Marlen Diaz, Sondra Tiab, Krista Fisher, Emma R Agnew, Shayna A Howlett, Sophia Oliver, Catherine A Callaway, Allison G Harvey
{"title":"通过跨诊断治疗睡眠和昼夜节律问题，\"许多其他事情都得到了改善\"：就治疗严重精神疾病患者对社区医疗服务提供者的访谈。","authors":"Laurel D Sarfan, Zia Bajwa, Marlen Diaz, Sondra Tiab, Krista Fisher, Emma R Agnew, Shayna A Howlett, Sophia Oliver, Catherine A Callaway, Allison G Harvey","doi":"10.1007/s10488-024-01410-1","DOIUrl":null,"url":null,"abstract":"<p><p>Community mental health centers (CMHCs) offer invaluable, publicly-funded treatment for serious mental illness (SMI). Unfortunately, evidence-based psychological treatments are often not delivered at CMHCs, in part due to implementation barriers, such as limited time, high caseloads, and complex clinical presentations. Transdiagnostic treatments may help address these barriers, because they allow providers to treat symptoms across multiple disorders concurrently. However, little research has investigated CMHC providers' experiences of delivering transdiagnostic treatments \"on the ground,\" particularly for adults with SMI. Thus, the aim of the present study was to assess CMHC providers' perspectives on delivering a transdiagnostic treatment - the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) - to adults diagnosed with SMI. In the context of a larger parent trial, providers were randomized to deliver a standard version of TranS-C (Standard TranS-C) or a version adapted to the CMHC context (Adapted TranS-C). Twenty-five providers from the parent trial participated in a semi-structured interview (n = 10 Standard TranS-C; n = 15 from Adapted TranS-C). Responses were deductively and inductively coded to identify themes related to Proctor's taxonomy of implementation outcomes. Four novel \"transdiagnostic take homes\" were identified: (1) transdiagnostic targets, such as sleep, can be perceived as motivating and appropriate when treating SMI, (2) strategies to bolster client motivation/adherence and address a wider range of symptom severity may improve transdiagnostic treatments, (3) balancing feasibility with offering in-depth resources is an important challenge for transdiagnostic treatment development, and (4) adapting transdiagnostic treatments to the CMHC context may improve provider perceptions of implementation outcomes.</p>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"\\\"So Many Other Things Improve\\\" with Transdiagnostic Treatment for Sleep and Circadian Problems: Interviews with Community Providers on Treating Clients with Serious Mental Illness.\",\"authors\":\"Laurel D Sarfan, Zia Bajwa, Marlen Diaz, Sondra Tiab, Krista Fisher, Emma R Agnew, Shayna A Howlett, Sophia Oliver, Catherine A Callaway, Allison G Harvey\",\"doi\":\"10.1007/s10488-024-01410-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Community mental health centers (CMHCs) offer invaluable, publicly-funded treatment for serious mental illness (SMI). 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"So Many Other Things Improve" with Transdiagnostic Treatment for Sleep and Circadian Problems: Interviews with Community Providers on Treating Clients with Serious Mental Illness.
Community mental health centers (CMHCs) offer invaluable, publicly-funded treatment for serious mental illness (SMI). Unfortunately, evidence-based psychological treatments are often not delivered at CMHCs, in part due to implementation barriers, such as limited time, high caseloads, and complex clinical presentations. Transdiagnostic treatments may help address these barriers, because they allow providers to treat symptoms across multiple disorders concurrently. However, little research has investigated CMHC providers' experiences of delivering transdiagnostic treatments "on the ground," particularly for adults with SMI. Thus, the aim of the present study was to assess CMHC providers' perspectives on delivering a transdiagnostic treatment - the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) - to adults diagnosed with SMI. In the context of a larger parent trial, providers were randomized to deliver a standard version of TranS-C (Standard TranS-C) or a version adapted to the CMHC context (Adapted TranS-C). Twenty-five providers from the parent trial participated in a semi-structured interview (n = 10 Standard TranS-C; n = 15 from Adapted TranS-C). Responses were deductively and inductively coded to identify themes related to Proctor's taxonomy of implementation outcomes. Four novel "transdiagnostic take homes" were identified: (1) transdiagnostic targets, such as sleep, can be perceived as motivating and appropriate when treating SMI, (2) strategies to bolster client motivation/adherence and address a wider range of symptom severity may improve transdiagnostic treatments, (3) balancing feasibility with offering in-depth resources is an important challenge for transdiagnostic treatment development, and (4) adapting transdiagnostic treatments to the CMHC context may improve provider perceptions of implementation outcomes.
期刊介绍：
The aim of Administration and Policy in Mental Health and Mental Health Services is to improve mental health services through research. This journal primarily publishes peer-reviewed, original empirical research articles. The journal also welcomes systematic reviews. Please contact the editor if you have suggestions for special issues or sections focusing on important contemporary issues. The journal usually does not publish articles on drug or alcohol addiction unless it focuses on persons who are dually diagnosed. Manuscripts on children and adults are equally welcome. Topics for articles may include, but need not be limited to, effectiveness of services, measure development, economics of mental health services, managed mental health care, implementation of services, staffing, leadership, organizational relations and policy, and the like. Please review previously published articles for fit with our journal before submitting your manuscript.
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