Dorflinger Lindsey M, Fortin Auguste H, Foran-Tuller Kelly A
VA Connecticut Healthcare System, West Haven, USA; Yale University School of Medicine, New Haven, USA.
Yale University School of Medicine, New Haven, USA.
Patient Educ Couns. 2016 Aug;99(8):1285-92. doi: 10.1016/j.pec.2016.02.014. Epub 2016 Mar 2.
Patients often seek mental health treatment through primary care. Training primary care physicians (PCPs) in approaches to address common mental health concerns may be a useful method for narrowing gaps in care. Cognitive Behavioral Therapy (CBT) is especially applicable in medical settings given its brief, skill-based approach and strong evidence for a number of presenting problems. This paper reviews the current literature on training PCPs in CBT with a focus on PCP-level outcomes.
We reviewed studies that described and evaluated CBT training programs for PCPs. Of 652 records identified and screened, 33 full-text articles were assessed for eligibility, resulting in 9 articles identified for inclusion.
We extracted and report information about study design, participants, intervention and dose, training content, and outcomes (PCP reaction, learning, and performance; patient outcomes).
There was substantial variability in sample size, methodology, training content and design, and assessment of outcomes, which translated into mixed findings across studies. In order to best assess effectiveness and allow replicability, future studies should provide adequate information about training curricula and assess multiple levels of learning outcomes.
Additional studies are needed to determine whether PCPs effectively implement skills within routine practice after CBT training.
患者常常通过初级保健寻求心理健康治疗。对初级保健医生（PCP）进行应对常见心理健康问题方法的培训，可能是缩小护理差距的有效方法。认知行为疗法（CBT）因其简短、基于技能的方法以及对多种呈现问题的有力证据，在医疗环境中尤其适用。本文回顾了当前关于培训初级保健医生进行认知行为疗法的文献，重点关注初级保健医生层面的结果。
我们回顾了描述和评估针对初级保健医生的认知行为疗法培训项目的研究。在识别和筛选的652条记录中，对33篇全文文章进行了资格评估，最终确定9篇文章纳入研究。
我们提取并报告了有关研究设计、参与者、干预措施和剂量、培训内容以及结果（初级保健医生的反应、学习和表现；患者结果）的信息。
在样本量、方法、培训内容和设计以及结果评估方面存在很大差异，这导致各项研究结果不一。为了最好地评估有效性并实现可重复性，未来的研究应提供有关培训课程的充分信息，并评估多个层面的学习成果。
需要进一步的研究来确定初级保健医生在接受认知行为疗法培训后，是否能在日常实践中有效运用相关技能。
