Sempértegui Gabriela A, Knipscheer Jeroen W, Bekker Marrie H J
Tilburg University.
Utrecht University.
Transcult Psychiatry. 2018 Feb;55(1):31-54. doi: 10.1177/1363461517725224. Epub 2017 Sep 26.
Studies in Europe indicate that some ethnic minorities have higher rates of mental disorders and less favorable treatment outcomes than their counterparts from majority groups. To date, efforts regarding training to reduce disparities have mainly focused on ethnocultural competences of therapists, with less attention paid to other aspects of diversity, such as sex/gender and socioeconomic status. In this study, we aim to determine the effectiveness of a population-specific, diversity-oriented competence training designed to increase therapists' competencies to integrate aspects of diversity features in clinical assessment, diagnosis, and treatment of depressive disorders in Turkish- and Moroccan-Dutch patients. A group of 40 therapists were location-based assigned to either training or a control condition (no training). Self-reported diversity competence, a knowledge test, and therapists' satisfaction with training were used to monitor the training and to measure competence levels at baseline, post-training, and three-month follow-up. Attitude-awareness and knowledge components of the self-reported diversity competence and test-measured knowledge increased in the training condition. Most gains remained stable at follow-up except test-measured knowledge after controlling for percentage of ethnic minority patients in caseload. There were no changes regarding therapists' self-reported skills. Therapists expressed medium-high satisfaction with the training, acknowledging the relevance of diversity competence for their daily practice. Future training must ensure better adjustment to therapists' pre-existing knowledge and be followed by long-term efforts to maintain competence levels and enhance competence transfer within teams.
欧洲的研究表明，一些少数族裔群体的精神障碍发病率高于多数群体，且治疗效果不如多数群体。迄今为止，减少差距的培训主要集中在治疗师的种族文化能力上，而对多样性的其他方面，如性别和社会经济地位的关注较少。在本研究中，我们旨在确定一种针对特定人群、以多样性为导向的能力培训的有效性，该培训旨在提高治疗师在临床评估、诊断和治疗土耳其裔和摩洛哥裔荷兰患者抑郁症时整合多样性特征的能力。一组40名治疗师根据地点被分配到培训组或对照组（不培训）。使用自我报告的多样性能力、知识测试以及治疗师对培训的满意度来监测培训情况，并在基线、培训后和三个月随访时测量能力水平。在培训组中，自我报告的多样性能力的态度意识和知识成分以及测试测量的知识有所增加。在控制病例负荷中少数族裔患者的百分比后，除测试测量的知识外，大多数收获在随访时保持稳定。治疗师自我报告的技能没有变化。治疗师对培训表示中等偏高的满意度，承认多样性能力与其日常实践的相关性。未来的培训必须确保更好地适应治疗师已有的知识，并随后进行长期努力以维持能力水平并加强团队内部的能力转移。
