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基于正念的认知疗法的实施:借鉴英国国民医疗服务体系的经验。

The Implementation of Mindfulness-Based Cognitive Therapy: Learning From the UK Health Service Experience.

作者信息

Crane Rebecca S, Kuyken Willem

机构信息

Centre for Mindfulness Research and Practice, School of Psychology, Bangor University, Gwynedd, LL57 1UT UK.

出版信息

Mindfulness (N Y). 2013;4(3):246-254. doi: 10.1007/s12671-012-0121-6.

Abstract

Mindfulness-based cognitive therapy (MBCT) is an effective depression prevention programme for people with a history of recurrent depression. In the UK, the National Institute for Clinical Excellence (NICE) has suggested that MBCT is a priority for implementation. This paper explores the exchange, synthesis and application of evidence and guidance on MBCT between the academic settings generating the evidence and delivering practitioner training and the practice settings where implementation takes place. Fifty-seven participants in a workshop on MBCT implementation in the NHS were asked for their experience of facilitators and obstacles to implementation, and a UK-wide online survey of 103 MBCT teachers and stakeholders was conducted. While MBCT is starting to become available in the NHS, this is rarely part of a strategic, coherent or appropriately resourced approach. A series of structural, political cultural, educational, emotional and physical/technological obstacles and facilitators to implementation were identified. Nearly a decade since NICE first recommended MBCT, only a small number of mental health services in the UK have systematically implemented the guidance. Guiding principles for implementation are set out. We offer an implementation resource to facilitate the transfer of MBCT knowledge into action.

摘要

基于正念的认知疗法(MBCT)是一项针对有复发性抑郁症病史人群的有效抑郁症预防方案。在英国,国家临床优化研究所(NICE)建议将MBCT作为实施重点。本文探讨了在产生证据并提供从业者培训的学术环境与进行实施的实践环境之间,关于MBCT的证据与指南的交流、整合及应用情况。在一次关于国民保健制度(NHS)中MBCT实施的研讨会上,57名参与者被问及他们在实施过程中遇到的促进因素和障碍,同时还对全英国103名MBCT教师及利益相关者进行了在线调查。虽然MBCT开始在NHS中可用,但这很少成为战略、连贯或资源充足方法的一部分。确定了一系列实施过程中的结构性、政治文化性、教育性、情感性以及身体/技术性障碍和促进因素。自NICE首次推荐MBCT近十年以来,英国只有少数心理健康服务机构系统地实施了该指南。文中阐述了实施的指导原则。我们提供一种实施资源,以促进将MBCT知识转化为行动。

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