培训是否足够?考察退伍军人健康管理局抑郁症循证心理疗法的实施情况。

IF 1.9 3区 心理学 Q3 PSYCHOLOGY, CLINICAL
Princess E Ackland, Andrea Cutting, Michele R Spoont, Sean Nugent, Barbara A Clothier, Emily M Hudson, Hope Salameh, Hanna M Lefchak, Rose Degerstrom, Brent C Taylor
{"title":"培训是否足够?考察退伍军人健康管理局抑郁症循证心理疗法的实施情况。","authors":"Princess E Ackland, Andrea Cutting, Michele R Spoont, Sean Nugent, Barbara A Clothier, Emily M Hudson, Hope Salameh, Hanna M Lefchak, Rose Degerstrom, Brent C Taylor","doi":"10.1037/ser0000910","DOIUrl":null,"url":null,"abstract":"<p><p>Three evidence-based psychotherapies for depression (D-EBPs)-cognitive behavioral therapy for depression, acceptance and commitment therapy for depression, and interpersonal psychotherapy-are available in Veterans Health Administration (VHA) through its training initiative. However, training initiatives are not sufficient to move effective treatments into routine practice. Patient and clinic factors can impact evidence-based psychotherapies use. As part of a larger explanatory sequential mixed methods study, we assessed D-EBP use across VHA's outpatient general mental health (GMH) clinics and examined associations between patient- and clinic-level factors and D-EBP use. We identified all patients with a depression diagnosis seen in a VHA GMH clinic in fiscal year 2022. Patient-level variables included demographics, psychiatric medication for depression, and comorbid mental health diagnoses. Clinic-level variables included patient volume, D-EBP clinician capacity, and location. 635,653 patients with a diagnosis of depression were seen in a GMH clinic. 2.8% of those patients had a D-EBP session identified in their medical record, and 77.4% received a depression medication. Being male, older, having certain comorbidities, and using depression medication was associated with lower D-EBP use. Clinics with lower psychotherapy patient volume and in the Continental and Midwest districts had higher D-EBP use. D-EBP use was strikingly lower than depression medication use. Findings suggest clinicians may be challenged by patient comorbidities and high patient volume in practice. Further research on how these factors play out in clinical practice can shed light on whether there is a need for additional implementation strategies to increase D-EBP use. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Was training enough? Examining the implementation of evidence-based psychotherapies for depression in Veterans Health Administration.\",\"authors\":\"Princess E Ackland, Andrea Cutting, Michele R Spoont, Sean Nugent, Barbara A Clothier, Emily M Hudson, Hope Salameh, Hanna M Lefchak, Rose Degerstrom, Brent C Taylor\",\"doi\":\"10.1037/ser0000910\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Three evidence-based psychotherapies for depression (D-EBPs)-cognitive behavioral therapy for depression, acceptance and commitment therapy for depression, and interpersonal psychotherapy-are available in Veterans Health Administration (VHA) through its training initiative. However, training initiatives are not sufficient to move effective treatments into routine practice. Patient and clinic factors can impact evidence-based psychotherapies use. As part of a larger explanatory sequential mixed methods study, we assessed D-EBP use across VHA's outpatient general mental health (GMH) clinics and examined associations between patient- and clinic-level factors and D-EBP use. We identified all patients with a depression diagnosis seen in a VHA GMH clinic in fiscal year 2022. Patient-level variables included demographics, psychiatric medication for depression, and comorbid mental health diagnoses. Clinic-level variables included patient volume, D-EBP clinician capacity, and location. 635,653 patients with a diagnosis of depression were seen in a GMH clinic. 2.8% of those patients had a D-EBP session identified in their medical record, and 77.4% received a depression medication. Being male, older, having certain comorbidities, and using depression medication was associated with lower D-EBP use. Clinics with lower psychotherapy patient volume and in the Continental and Midwest districts had higher D-EBP use. D-EBP use was strikingly lower than depression medication use. Findings suggest clinicians may be challenged by patient comorbidities and high patient volume in practice. Further research on how these factors play out in clinical practice can shed light on whether there is a need for additional implementation strategies to increase D-EBP use. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>\",\"PeriodicalId\":20749,\"journal\":{\"name\":\"Psychological Services\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-11-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Psychological Services\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1037/ser0000910\",\"RegionNum\":3,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PSYCHOLOGY, CLINICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psychological Services","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1037/ser0000910","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
引用次数: 0

摘要

退伍军人健康管理局(VHA)通过培训计划提供了三种基于证据的抑郁症心理疗法(D-EBPs)--抑郁症认知行为疗法、抑郁症接受与承诺疗法以及人际心理疗法。然而,培训计划并不足以将有效的治疗方法转化为常规实践。患者和诊所因素会影响循证心理疗法的使用。作为一项大型解释性顺序混合方法研究的一部分,我们评估了 VHA 普通心理健康(GMH)门诊中 D-EBP 的使用情况,并研究了患者和诊所层面的因素与 D-EBP 使用之间的关联。我们确定了 2022 财年在 VHA GMH 诊所就诊的所有抑郁症患者。患者层面的变量包括人口统计学特征、治疗抑郁症的精神科药物以及合并精神健康诊断。诊所层面的变量包括患者数量、D-EBP 临床医生能力和地点。有 635 653 名诊断为抑郁症的患者在 GMH 诊所就诊。其中 2.8% 的患者在病历中记录了 D-EBP 会话,77.4% 的患者接受了抑郁症药物治疗。男性、年龄较大、患有某些并发症以及使用抑郁症药物的患者使用 D-EBP 的比例较低。心理治疗病人数量较少的诊所以及大陆和中西部地区的诊所使用 D-EBP 的比例较高。D-EBP 的使用率明显低于抑郁药物的使用率。研究结果表明,临床医生在实践中可能会受到患者合并症和高患者量的挑战。进一步研究这些因素在临床实践中的作用,可以揭示是否需要采取额外的实施策略来提高 D-EBP 的使用率。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Was training enough? Examining the implementation of evidence-based psychotherapies for depression in Veterans Health Administration.

Three evidence-based psychotherapies for depression (D-EBPs)-cognitive behavioral therapy for depression, acceptance and commitment therapy for depression, and interpersonal psychotherapy-are available in Veterans Health Administration (VHA) through its training initiative. However, training initiatives are not sufficient to move effective treatments into routine practice. Patient and clinic factors can impact evidence-based psychotherapies use. As part of a larger explanatory sequential mixed methods study, we assessed D-EBP use across VHA's outpatient general mental health (GMH) clinics and examined associations between patient- and clinic-level factors and D-EBP use. We identified all patients with a depression diagnosis seen in a VHA GMH clinic in fiscal year 2022. Patient-level variables included demographics, psychiatric medication for depression, and comorbid mental health diagnoses. Clinic-level variables included patient volume, D-EBP clinician capacity, and location. 635,653 patients with a diagnosis of depression were seen in a GMH clinic. 2.8% of those patients had a D-EBP session identified in their medical record, and 77.4% received a depression medication. Being male, older, having certain comorbidities, and using depression medication was associated with lower D-EBP use. Clinics with lower psychotherapy patient volume and in the Continental and Midwest districts had higher D-EBP use. D-EBP use was strikingly lower than depression medication use. Findings suggest clinicians may be challenged by patient comorbidities and high patient volume in practice. Further research on how these factors play out in clinical practice can shed light on whether there is a need for additional implementation strategies to increase D-EBP use. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Psychological Services
Psychological Services PSYCHOLOGY, CLINICAL-
CiteScore
4.20
自引率
13.00%
发文量
216
期刊介绍: Psychological Services publishes high-quality data-based articles on the broad range of psychological services. While the Division"s focus is on psychologists in "public service," usually defined as being employed by a governmental agency, Psychological Services covers the full range of psychological services provided in any service delivery setting. Psychological Services encourages submission of papers that focus on broad issues related to psychotherapy outcomes, evaluations of psychological service programs and systems, and public policy analyses.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信