治疗师对暴露疗法体验式培训的看法。

IF 2 4区 心理学 Q3 PSYCHOLOGY, CLINICAL
Behavioural and Cognitive Psychotherapy Pub Date : 2023-05-01 Epub Date: 2023-02-21 DOI:10.1017/S1352465822000728
Hannah E Frank, Lara S Rifkin, Kate Sheehan, Emily M Becker-Haimes, Margaret E Crane, Katherine E Phillips, Sophie A Palitz Buinewicz, Joshua Kemp, Kristen Benito, Philip C Kendall
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引用次数: 0

摘要

背景:尽管有证据表明暴露疗法对焦虑症有疗效,但在常规护理环境中却很少使用。治疗师对暴露疗法的负面看法是阻碍其使用的一个主要因素,为解决这一问题,我们采取了治疗师层面的实施策略,如培训和咨询。体验式培训,即治疗师自己进行暴露,最近已证明了增加暴露使用的可行性、可接受性和初步有效性。目的:本研究旨在评估:(1)治疗师对体验式培训的看法;(2)培训后实施暴露的障碍和促进因素:接受体验式培训的治疗师(12 人)完成了定性访谈和定量问卷调查。采用归纳法和演绎法相结合的综合方法对访谈进行编码。混合方法分析研究了不同实践环境(社区心理健康与私人实践)和接触使用情况下的主题差异:结果:结果凸显了治疗师层面的因素(如临床医师的自我效能感)是如何与内在和外在环境因素相互作用的。参加者在培训后报告了对暴露的积极看法;他们指出,直接解决关于暴露的迷思和亲自体验暴露改善了他们对暴露的态度。与之前的文献一致,督导支持不足、组织限制和客户特征等问题使得暴露的实施具有挑战性:讨论:结果凸显了体验式培训的益处,同时也强调了考虑环境决定因素的必要性。不同实践环境下的反应差异凸显了干预的领域以及量身定制实施策略的重要性。未使用暴露疗法的治疗师所面临的障碍(如对暴露疗法是否适合大多数客户犹豫不决)为今后的实施工作指明了方向。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Therapist perceptions of experiential training for exposure therapy.

Background: Despite evidence for its efficacy, exposure therapy for anxiety is rarely used in routine care settings. Efforts to address one major barrier to its use - therapists' negative beliefs about exposure - have included therapist-level implementation strategies, such as training and consultation. Experiential training, in which therapists themselves undergo exposures, has recently demonstrated feasibility, acceptability and preliminary effectiveness for increasing exposure use.

Aims: This study aimed to assess: (1) therapists' perceptions of experiential training and (2) barriers and facilitators to implementing exposure following training.

Method: Therapists who underwent experiential training (n=12) completed qualitative interviews and quantitative questionnaires. Interviews were coded using an integrated approach, combining both inductive and deductive approaches. Mixed methods analyses examined how themes varied by practice setting (community mental health versus private practice) and exposure use.

Results: Results highlight how therapist-level factors, such as clinician self-efficacy, interact with inner- and outer-setting factors. Participants reported positive perceptions of exposure after training; they noted that directly addressing myths about exposure and experiencing exposures themselves improved their attitudes toward exposure. Consistent with prior literature, issues such as insufficient supervisory support, organizational constraints, and client characteristics made it challenging to implement exposures.

Discussion: Results highlight the benefits of experiential training, while also highlighting the need to consider contextual determinants. Differences in responses across practice settings highlight areas for intervention and the importance of tailoring implementation strategies. Barriers that were specific to therapists who did not use exposure (e.g. hesitancy about its appropriateness for most clients) point to directions for future implementation efforts.

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来源期刊
CiteScore
3.50
自引率
5.60%
发文量
82
期刊介绍: An international multidisciplinary journal aimed primarily at members of the helping and teaching professions. Behavioural and Cognitive Psychotherapy features original research papers, covering both experimental and clinical work, that contribute to the theory, practice and evolution of cognitive and behaviour therapy. The journal aims to reflect and influence the continuing changes in the concepts, methodology, and techniques of behavioural and cognitive psychotherapy. A particular feature of the journal is its broad ranging scope - both in terms of topics and types of study covered. Behavioural and Cognitive Psychotherapy encompasses most areas of human behaviour and experience, and represents many different research methods, from randomized controlled trials to detailed case studies.
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