Department of Psychiatry.
Roca, Inc.
Psychotherapy (Chic). 2019 Mar;56(1):115-125. doi: 10.1037/pst0000188. Epub 2018 Nov 26.
The science-practice gap in the treatment of mental health is most pronounced in community settings, where clients with the highest needs often receive their care. Implementation science and community-based participatory research strategies aim to effectively address this gap by establishing partnerships that focus on scientifically rigorous, as well as clinically and socially relevant, research. Despite significant benefits, the community-based participatory research implementation framework has a unique set of challenges. The current article describes evidence-supported implementation strategies that were deployed to address various barriers to the implementation and long-term sustainability of an innovative cognitive-behavioral theory (CBT) life skills program identified during a feasibility trial. Through the committed work of an established partnership between a community-based nonprofit organization and researchers, barriers and the strategies for mitigating these obstacles were jointly identified. Specific challenges included fidelity (variability in staff's CBT competency and delivery), sustainability, and the cost of guideline implementation (data collection, time, and resources) of the CBT curriculum. We also provide details on the partnership's solutions to these major obstacles, including the development of an intensive 3-month training and coaching phase. The results of this rigorous training suggest improvement in staff's overall CBT competency and fidelity, increased participant engagement in the CBT curriculum, and enhanced data-collection procedures; yet, sustainability difficulties remained. General recommendations for long-term community research partnerships include early organizational buy-in; comprehensive needs assessments, including the organization's research building capacity; and sustained training and coaching models. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
在社区环境中,心理健康治疗的科学实践差距最为明显,而那些需求最高的患者往往在这些环境中接受治疗。实施科学和基于社区的参与式研究策略旨在通过建立合作伙伴关系来有效解决这一差距,合作伙伴关系注重科学严谨性以及临床和社会相关性研究。尽管具有重要意义,但基于社区的参与式研究实施框架具有独特的一系列挑战。本文描述了经过实证支持的实施策略,这些策略是为了解决在一项可行性试验中确定的创新认知行为理论 (CBT) 生活技能项目实施和长期可持续性方面的各种障碍而部署的。通过一个社区非营利组织和研究人员之间的既定合作伙伴关系的共同努力,共同确定了障碍以及减轻这些障碍的策略。具体挑战包括 CBT 课程的保真度(员工 CBT 能力和交付的可变性)、可持续性以及指南实施的成本(数据收集、时间和资源)。我们还提供了有关合作伙伴关系针对这些主要障碍的解决方案的详细信息,包括为期 3 个月的强化培训和辅导阶段的开发。这项严格培训的结果表明员工的整体 CBT 能力和保真度有所提高,参与者对 CBT 课程的参与度提高,数据收集程序得到加强;然而,可持续性困难仍然存在。长期社区研究合作伙伴关系的一般建议包括早期的组织认可;全面的需求评估,包括组织的研究能力建设;以及持续的培训和辅导模式。(PsycINFO 数据库记录(c)2019 APA,保留所有权利)。