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辩证行为疗法技能培训对儿童和青少年住院环境中精神卫生工作人员工作成果的影响。

Effects of dialectical behavior therapy skills training on outcomes for mental health staff in a child and adolescent residential setting.

作者信息

Haynos Ann F, Fruzzetti Alan E, Anderson Calli, Briggs David, Walenta Jason

机构信息

University of Minnesota Medical Center, United States.

University of Nevada, Reno, United States.

出版信息

J Hosp Adm. 2016 Apr;5(2):55-61. doi: 10.5430/jha.v5n2p55. Epub 2016 Jan 5.

Abstract

Training in Dialectical Behavior Therapy (DBT) skills coaching is desirable for staff in psychiatric settings, due to the efficacy of DBT in treating difficult patient populations. In such settings, training resources are typically limited, and staff turnover is high, necessitating brief training. This study evaluated the effects of a brief training in DBT skills coaching for nursing staff working in a child and adolescent psychiatric residential program. Nursing staff ( = 22) completed assessments of DBT skill knowledge, burnout, and stigma towards patients with borderline personality disorder (BPD) before and after a six-week DBT skills coaching training. Repeated measure ANOVAs were conducted to examine changes on all measures from pre- to post- treatment and hierarchical linear regressions to examine relationships between pre- training DBT knowledge, burnout, and BPD stigma and these same measures post-training. The brief DBT skill coaching training significantly increased DBT knowledge ( = .007) and decreased staff personal ( = .02) and work ( = .03) burnout and stigma towards BPD patients ( = .02). Burnout indices and BPD stigma were highly correlated at both time points ( < .001); however, while pre-training BPD stigma significantly predicted post-training client burnout ( = .04), pre-training burnout did not predict post-training BPD stigma. These findings suggest that brief training of psychiatric nursing staff in DBT skills and coaching techniques can result in significant benefits, including reduced staff burnout and stigma toward patients with BPD-related problems, and that reducing BPD stigma may particularly promote lower burnout.

摘要

由于辩证行为疗法(DBT)在治疗困难患者群体方面的有效性,精神病环境中的工作人员接受DBT技能指导培训是很有必要的。在这种环境中,培训资源通常有限,而且员工流动率高,因此需要进行简短的培训。本研究评估了在儿童和青少年精神病住院项目中工作的护理人员接受DBT技能指导简短培训的效果。22名护理人员在为期六周的DBT技能指导培训前后完成了对DBT技能知识、职业倦怠以及对边缘型人格障碍(BPD)患者的污名化的评估。进行重复测量方差分析以检验从治疗前到治疗后的所有测量指标的变化,并进行分层线性回归以检验培训前的DBT知识、职业倦怠和BPD污名与培训后这些相同测量指标之间的关系。简短的DBT技能指导培训显著增加了DBT知识(p = .007),并降低了员工的个人(p = .02)和工作(p = .03)倦怠以及对BPD患者的污名化(p = .02)。在两个时间点,倦怠指数和BPD污名都高度相关(p < .001);然而,虽然培训前的BPD污名显著预测了培训后的客户倦怠(p = .04),但培训前的倦怠并未预测培训后的BPD污名。这些发现表明,对精神科护理人员进行DBT技能和指导技术的简短培训可以带来显著的益处,包括减少员工倦怠和对患有BPD相关问题患者的污名化,而且减少BPD污名可能特别有助于降低倦怠。

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