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为晚期癌症患者提供认知行为疗法:对英国一项心理服务中治疗师经历的定性探索。

Delivering cognitive behavioural therapy to advanced cancer patients: A qualitative exploration into therapists' experiences within a UK psychological service.

作者信息

Hassan Suzan, Bennett Kirsty, Serfaty Marc

机构信息

Division of Psychiatry, University College London, London, UK.

Priory Hospital North London, The Bourne, Southgate, London, UK.

出版信息

Clin Psychol Psychother. 2018 Mar 25. doi: 10.1002/cpp.2190.

Abstract

BACKGROUND

Cognitive behavioural therapy (CBT) is commonly used to treat cancer patients with psychological disorders such as depression. There has been little qualitative research exploring the experience of therapists delivering CBT to patients with advanced cancer and long-term health conditions generally. Therapists' views may help identify difficulties in delivering therapy and how these may be overcome. The aim of this study was to inform practice by qualitatively exploring the experiences of therapists delivering CBT to patients with advanced cancer.

DESIGN

Sixteen semi-structured interviews were conducted with therapists from Increasing Access to Psychological Therapy (IAPT) services in London, UK, who had delivered CBT to patients enrolled on the CanTalk trial. Interviews were recorded, transcribed, and analysed using framework analysis.

RESULTS

Therapists reported positive experiences when working with the target population. Flexibility, adaptability, and a consideration of individual needs were identified as important when delivering CBT, but the rigidity of IAPT policies and demand for services were perceived as problematic. Although therapists reported adequate training, specialist supervision was desired when delivering therapy to this complex population.

CONCLUSION

IAPT therapists can deliver CBT to advanced cancer patients, given therapists positive experiences evident in the present study. However, it was concluded that additional service and modifications of therapy may be needed before positive outcomes for both therapists and patients can be achieved.

摘要

背景

认知行为疗法(CBT)常用于治疗患有抑郁症等心理障碍的癌症患者。目前很少有定性研究探讨治疗师为晚期癌症患者及一般长期健康状况患者提供CBT的经历。治疗师的观点可能有助于识别治疗过程中的困难以及如何克服这些困难。本研究的目的是通过定性探索治疗师为晚期癌症患者提供CBT的经历来为实践提供参考。

设计

对英国伦敦“增加心理治疗可及性”(IAPT)服务机构中为参与“CanTalk试验”的患者提供CBT的治疗师进行了16次半结构式访谈。访谈进行了录音、转录,并采用框架分析法进行分析。

结果

治疗师报告称在与目标人群合作时有着积极的体验。在提供CBT时,灵活性、适应性以及对个体需求的考虑被认为很重要,但IAPT政策的僵化和对服务的需求被视为存在问题。尽管治疗师报告接受了充分的培训,但在为这一复杂人群提供治疗时仍希望获得专业督导。

结论

鉴于本研究中治疗师的积极体验,IAPT治疗师可以为晚期癌症患者提供CBT。然而,得出的结论是,在治疗师和患者都能取得积极结果之前,可能需要额外的服务和治疗调整。

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