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培训一线心理健康工作人员为精神病患者提供“低强度”心理治疗:对治疗师和服务使用者关于该治疗及其未来实施的观点进行定性分析。

Training frontline mental health staff to deliver "low intensity" psychological therapy for psychosis: a qualitative analysis of therapist and service user views on the therapy and its future implementation.

作者信息

Waller Helen, Garety Philippa, Jolley Suzanne, Fornells-Ambrojo Miriam, Kuipers Elizabeth, Onwumere Juliana, Woodall Anna, Craig Tom

机构信息

Institute of Psychiatry,King's College London,UK.

University College London,and South London and Maudsley NHS Foundation Trust,UK.

出版信息

Behav Cogn Psychother. 2015 May;43(3):298-313. doi: 10.1017/S1352465813000908. Epub 2013 Oct 23.

Abstract

BACKGROUND

Increasing access to evidence-based talking therapies for people with psychosis is a national health priority. We have piloted a new, "low intensity" (LI) CBT intervention specifically designed to be delivered by frontline mental health staff, following brief training, and with ongoing supervision and support. A pilot feasibility study has demonstrated significant improvement in service user outcomes. This study is a qualitative analysis of the experiences of the staff and service users taking part in the evaluation.

AIMS

To evaluate the acceptability of the training protocol and the therapy, and to examine the factors promoting and restraining implementation.

METHOD

All trained staff and service users completed a semi-structured interview that was transcribed and subjected to thematic analysis.

RESULTS

Service users spoke about learning new skills and achieving their goals. Staff spoke about being able to use a brief, structured intervention to achieve positive outcomes for their clients. Both groups felt that longer, more sophisticated interventions were required to address more complex problems. The positive clinical outcomes motivated therapists to continue using the approach, despite organizational barriers.

CONCLUSIONS

For both trained staff and service users, taking part in the study was a positive experience. Staff members' perceived skill development and positive reaction to seeing their clients improve should help to promote implementation. Work is needed to clarify whether and how more complex difficulties should be addressed by frontline staff.

摘要

背景

增加为精神病患者提供循证心理治疗的机会是一项国家卫生优先事项。我们已经试点了一种新的“低强度”(LI)认知行为疗法干预措施,该措施专门设计为由一线心理健康工作人员在接受简短培训后,并在持续监督和支持下实施。一项试点可行性研究表明,服务使用者的治疗效果有显著改善。本研究是对参与评估的工作人员和服务使用者的经历进行的定性分析。

目的

评估培训方案和治疗方法的可接受性,并研究促进和限制实施的因素。

方法

所有接受培训的工作人员和服务使用者都完成了一次半结构化访谈,访谈内容被转录并进行了主题分析。

结果

服务使用者谈到学习了新技能并实现了目标。工作人员谈到能够使用简短、结构化的干预措施为他们的客户取得积极成果。两组都认为需要更长、更复杂的干预措施来解决更复杂的问题。尽管存在组织障碍,但积极的临床结果促使治疗师继续使用该方法。

结论

对于接受培训的工作人员和服务使用者来说,参与这项研究都是一次积极的经历。工作人员察觉到的技能发展以及对看到客户改善的积极反应应有助于推动该方法的实施。需要开展工作来明确一线工作人员是否以及如何应对更复杂的困难。

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