Roosa Ordway Monica, McMahon Thomas J, De Las Heras Kuhn Lourdes, Suchman Nancy E
Yale University.
Infant Ment Health J. 2018 Jan;39(1):92-105. doi: 10.1002/imhj.21691. Epub 2017 Dec 28.
The process of mental health intervention implementation with vulnerable populations is not well-described in the literature. The authors worked as a community-partnered team to adapt and pilot an empirically supported intervention program for mothers of infants and toddlers in an outpatient mental health clinic that primarily serves a low-income community. We used qualitative ethnographic methods to document the adaption of an evidence-based intervention, Mothering from the Inside Out, and the pilot implementation in a community mental health clinic. Seventeen mothers and their identified 0- to 84-month-old children were enrolled in the study. Key lessons from this implementation include (a) the importance of formative work to build community relationships and effectively adapt the intervention to meet the needs of the therapists and their clients, (b) the importance of designing plans for training and reflective supervision that fit within the flow of the clinic and can tolerate disruptions, and (c) that use of an interdisciplinary approach is feasible with the development of a plan for communication and the support of a trained reflective clinical supervisor. These key lessons advance the scientific knowledge available to healthcare managers and researchers who are looking to adapt mental health clinical interventions previously tested in clinical trials to implementation in community settings.
关于对弱势群体实施心理健康干预的过程，文献中描述得并不充分。作者作为一个社区合作团队，对一项基于实证的干预项目进行了调整，并在一家主要服务低收入社区的门诊心理健康诊所，针对婴幼儿母亲开展了该项目的试点。我们运用定性人种学方法，记录了基于证据的干预措施“由内而外做母亲”的调整过程，以及在社区心理健康诊所的试点实施情况。该研究招募了17位母亲及其0至84个月大的子女。此次实施过程的关键经验包括：（a）开展形成性工作以建立社区关系并有效调整干预措施以满足治疗师及其客户需求的重要性；（b）设计适合诊所工作流程且能应对干扰的培训和反思性督导计划的重要性；（c）通过制定沟通计划并在受过培训的反思性临床督导的支持下，采用跨学科方法是可行的。这些关键经验丰富了可供医疗保健管理人员和研究人员参考的科学知识，他们希望将先前在临床试验中测试过的心理健康临床干预措施调整后应用于社区环境。
