Cartreine James A, Chang Trina E, Seville Janette L, Sandoval Luis, Moore John B, Xu Shuai, Hegel Mark T
Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, 1249 Boylston Avenue 3rd floor, Boston, MA 02215, USA ; Harvard Medical School, Boston, MA 02215, USA.
Depress Res Treat. 2012;2012:309094. doi: 10.1155/2012/309094. Epub 2012 Nov 14.
Problem-solving treatment (PST) offers a promising approach to the depression care; however, few PST training opportunities exist. A computer-guided, interactive media program has been developed to deliver PST electronically (ePST), directly to patients. The program is a six-session, weekly intervention modeled on an evidence-based PST protocol. Users are guided through each session by a clinician who is presented via hundreds of branching audio and video clips. Because expert clinician behaviors are modeled in the program, not only does the ePST program have the potential to deliver PST to patients but it may also serve as a training tool to teach clinicians how to deliver PST. Thirteen social workers and trainees used ePST self-instructionally and subsequently attended a day-long workshop on PST. Participants' PST knowledge level increased significantly from baseline to post-ePST (P = .001) and did not increase significantly further after attending the subsequent workshop. Additionally, attending the workshop did not significantly increase the participants' skill at performing PST beyond the use of the ePST program. Using the ePST program appears to train novices to a sufficient level of competence to begin practicing PST under supervision. This self-instructional training method could enable PST for depression to be widely disseminated, although follow-up supervision is still required.
解决问题疗法（PST）为抑郁症护理提供了一种很有前景的方法；然而，PST培训机会却很少。一种计算机引导的交互式媒体程序已被开发出来，以电子方式（ePST）直接向患者提供PST。该程序是一个为期六周、每周一次的干预措施，以基于证据的PST协议为蓝本。在每次疗程中，用户会由一位临床医生引导，这位医生通过数百个分支音频和视频片段呈现。由于该程序模拟了专家临床医生的行为，ePST程序不仅有潜力向患者提供PST，还可以作为一种培训工具，教导临床医生如何提供PST。13名社会工作者和学员自行使用ePST，随后参加了为期一天的PST研讨会。参与者的PST知识水平从基线到ePST后显著提高（P = .001），在参加后续研讨会后没有进一步显著提高。此外，参加研讨会并没有显著提高参与者在使用ePST程序之外进行PST的技能。使用ePST程序似乎能将新手培训到足够的能力水平，以便在监督下开始实施PST。这种自我指导培训方法可以使抑郁症的PST得到广泛传播，尽管仍然需要后续监督。
