Higa-McMillan Charmaine, Kotte Amelia, Jackson David, Daleiden Eric L
University of Hawai'i at Hilo, Hilo, HI, USA.
University of Hawai'i at Mānoa, Honolulu, HI, USA.
J Behav Health Serv Res. 2017 Oct;44(4):684-694. doi: 10.1007/s11414-016-9502-2.
This study compared consistencies and discrepancies in usual care with practices derived from the evidence-base (PDEB) for youth anxiety in a public mental health system. Youth-level factors (diagnosis, functional impairment) as predictors of the discrepancies were also examined. Psychosocial and service data from 2485 youth with an anxiety disorder and/or receiving services for an anxiety treatment target were extracted. Therapists (N = 616) identified the treatment targets and practices youth received. Although many PDEB for youth anxiety were used by therapists in this sample, Exposure was only used in 15% of cases. Practices not consistent with youth anxiety treatment were also reported and included: PDEB for other conditions, practices common to all therapies, and practices that are not consistent with evidence-based care. Age and diagnosis predicted the delivery of PDEB for youth anxiety. Usual care incorporated many components of evidence-based care but was more diffuse and less focused on well-supported practices.
本研究比较了公共心理健康系统中青少年焦虑症常规护理与基于循证实践（PDEB）的做法之间的一致性和差异。还研究了作为差异预测因素的青少年层面因素（诊断、功能损害）。提取了2485名患有焦虑症和/或接受焦虑症治疗目标服务的青少年的心理社会和服务数据。治疗师（N = 616）确定了青少年接受的治疗目标和做法。尽管该样本中的治疗师使用了许多针对青少年焦虑症的PDEB，但暴露疗法仅在15%的病例中使用。还报告了与青少年焦虑症治疗不一致的做法，包括：针对其他病症的PDEB、所有疗法共有的做法以及与循证护理不一致的做法。年龄和诊断预测了针对青少年焦虑症的PDEB的实施情况。常规护理纳入了循证护理的许多组成部分，但更为分散，对有充分支持的做法关注较少。
