Dr. Jolley is with the Institute of Psychiatry, Psychology, and Neuroscience, Department of Psychology, King's College London, London.
Psychiatr Serv. 2018 Sep 1;69(9):952-955. doi: 10.1176/appi.ps.201800131. Epub 2018 Jul 25.
International treatment guidelines recommend cognitive-behavioral therapies for people with psychosis, but implementation remains problematic. This column reports on local work to improve implementation and two recent initiatives by the National Health Service in England. The aim is to operationalize key facilitators of implementation, including adequate training, time for delivery, and supervision; systems to identify the target caseload and monitor access, provision, and outcomes; effective pathways for offering and delivering therapy; and organizational support. With these facilitators in place, new investment translates readily into effective delivery. Still, achieving universal access to cognitive-behavioral therapies may require an alternative model.
国际治疗指南建议为精神病患者提供认知行为疗法，但实施仍然存在问题。本专栏报道了改善实施情况的本地工作以及英格兰国民保健制度最近的两项举措。目的是将实施的关键促进因素（包括充分的培训、交付时间和监督；用于确定目标患者人群并监测获取、提供和结果的系统；提供和实施治疗的有效途径；以及组织支持）付诸实践。有了这些促进因素，新的投资就可以很容易地转化为有效的实施。尽管如此，要实现普遍获得认知行为疗法的机会，可能还需要一个替代模式。
