Kraus-Schuman Cynthia, Wilson Nancy L, Amspoker Amber B, Wagener Paula D, Calleo Jessica S, Diefenbach Gretchen, Hopko Derek, Cully Jeffrey A, Teng Ellen, Rhoades Howard M, Kunik Mark E, Stanley Melinda A
Mental Health Care Line (MHCL 116), Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd., Houston, TX 77030 USA ; Baylor College of Medicine, Houston, TX USA.
Houston VA HSR&D Center for Innovation in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX USA ; Baylor College of Medicine, Houston, TX USA.
Transl Behav Med. 2015 Sep;5(3):247-53. doi: 10.1007/s13142-015-0306-3.
The Institute of Medicine advocates the examination of innovative models of care to expand mental health services available for older adults. This article describes training and supervision procedures in a recent clinical trial of cognitive behavioral therapy (CBT) for older adults with generalized anxiety disorder (GAD) delivered by bachelor-level lay providers (BLPs) and to Ph.D.-level expert providers (PLPs). Supervision and training differences, ratings by treatment integrity raters (TIRs), treatment characteristics, and patient perceptions between BLPs and PLPs are examined. The training and supervision procedures for BLPs led to comparable integrity ratings, patient perceptions, and treatment characteristics compared with PLPs. These results support this training protocol as a model for future implementation and effectiveness trials of CBT for late-life GAD, with treatment delivered by lay providers supervised by a licensed provider in other practice settings.
美国国家医学院提倡对创新护理模式进行研究，以扩大为老年人提供的心理健康服务。本文描述了一项近期临床试验中的培训和监督程序，该试验针对患有广泛性焦虑症（GAD）的老年人开展认知行为疗法（CBT），由本科水平的非专业提供者（BLP）和博士水平的专家提供者（PLP）实施。研究考察了BLP和PLP之间的监督和培训差异、治疗完整性评估者（TIR）的评分、治疗特征以及患者的看法。与PLP相比，BLP的培训和监督程序在完整性评分、患者看法和治疗特征方面具有可比性。这些结果支持了该培训方案，可作为未来在其他实践环境中由持牌提供者监督非专业提供者为老年广泛性焦虑症患者实施CBT的实施和有效性试验的模型。
