Timimi Sami, Tetley Dianne, Burgoine Wayne, Walker Gill
Faculty of Life, Health, and Social Sciences, University of Lincoln, UK.
Clin Child Psychol Psychiatry. 2013 Apr;18(2):169-84. doi: 10.1177/1359104512444118. Epub 2012 May 1.
The international evidence base on factors that most influence outcomes in mental health care finds that matching therapeutic intervention to diagnosis has a clinically insignificant impact on outcomes. Decades of outcome research into treatment of psychiatric disorders shows that, despite the development of many new techniques, the outcomes being achieved in studies 30 years ago are similar to those being achieved now. In the last few years, new service models that incorporate systems of feedback on progress and alliance have emerged and show promise with regards improving overall outcomes for mental health service users. Growing familiarity with this outcome literature, together with a desire to be part of a service that can continue to improve patient outcomes, led a small community Child and Adolescent Mental Health Services team to develop a new whole service model - Outcome Orientated Child and Adolescent Mental Health Services (OO-CAMHS). OO-CAMHS incorporates key aspects of the evidence base on what could make a differential positive impact on outcomes and relinquishes those aspects that do not. In this paper, we outline the evidence base on which OO-CAMHS is built, describe the key features of the approach and present some of the early findings on its impact.
关于对精神卫生保健结果影响最大的因素的国际证据表明,使治疗干预与诊断相匹配对结果的临床影响微不足道。几十年来对精神疾病治疗的结果研究表明,尽管开发了许多新技术,但30年前研究中所取得的结果与现在所取得的结果相似。在过去几年中,出现了一些新的服务模式,这些模式纳入了关于进展和联盟的反馈系统,并且在改善精神卫生服务使用者的总体结果方面显示出前景。对这一结果文献的日益熟悉,以及希望成为能够持续改善患者结果的服务的一部分的愿望,促使一个小型社区儿童和青少年精神卫生服务团队开发了一种新的整体服务模式——以结果为导向的儿童和青少年精神卫生服务(OO-CAMHS)。OO-CAMHS纳入了证据基础中对结果可能产生积极差异影响的关键方面,并摒弃了那些没有影响的方面。在本文中,我们概述了构建OO-CAMHS的证据基础,描述了该方法的关键特征,并展示了一些关于其影响的早期发现。