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将药物干预整合到青少年注意力缺陷多动障碍行为治疗中的临床策略:药物整合方案。

Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol.

作者信息

Hogue Aaron, Bobek Molly, Tau Gregory Z, Levin Frances R

机构信息

The National Center on Addiction and Substance Abuse at Columbia University, New York, New York, USA.

Division of Child and Adolescent Psychiatry at Columbia University, New York, New York, USA and New York State Psychiatric Institute.

出版信息

Child Fam Behav Ther. 2014 Oct 1;36(4):280-304. doi: 10.1080/07317107.2014.967631.

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent among adolescents enrolled in behavioral health services but remains undertreated in this age group. Also the first-line treatment for adolescent ADHD, stimulant medication, is underutilized in routine practice. This article briefly describes three behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. It then introduces the Medication Integration Protocol (MIP), which incorporates all three interventions into a five-task protocol: ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about best practices for medication integration across diverse settings and populations: integrating medication interventions into primary care, managing medication priorities and polypharmacy issues for adolescents with multiple diagnoses, providing ADHD medications to adolescent substance users, and the compatibility of MIP intervention strategies with everyday practice conditions.

摘要

注意力缺陷多动障碍(ADHD)在接受行为健康服务的青少年中极为普遍,但在这个年龄段仍未得到充分治疗。同样,作为青少年ADHD的一线治疗方法,兴奋剂药物在常规治疗中未得到充分利用。本文简要介绍了三种行为干预措施,旨在促进药物干预更有力地融入青少年ADHD的治疗计划中:家庭ADHD心理教育、基于家庭的药物决策,以及行为治疗师在协调药物整合方面的主导作用。然后介绍了药物整合方案(MIP),该方案将所有三种干预措施纳入一个五项任务方案中:ADHD评估与药物咨询;ADHD心理教育与患者接受度;ADHD症状与家庭关系;ADHD药物治疗与家庭决策;以及药物管理与整合计划。文章最后强调了行为治疗师应了解的关于在不同环境和人群中进行药物整合的最佳实践:将药物干预融入初级保健、管理患有多种诊断的青少年的药物治疗优先级和多药治疗问题、为青少年药物使用者提供ADHD药物,以及MIP干预策略与日常实践条件的兼容性。

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