O'Donnell Meaghan Louise, Lau Winnie, Fredrickson Julia, Gibson Kari, Bryant Richard Allan, Bisson Jonathan, Burke Susie, Busuttil Walter, Coghlan Andrew, Creamer Mark, Gray Debbie, Greenberg Neil, McDermott Brett, McFarlane Alexander C, Monson Candice M, Phelps Andrea, Ruzek Josef I, Schnurr Paula P, Ugsang Janette, Watson Patricia, Whitton Shona, Williams Richard, Cowlishaw Sean, Forbes David
Phoenix Australia Centre for Posttraumatic Mental Health, The University of Melbourne, Carlton, VIC, Australia.
Department of Psychiatry, University of Melbourne, Carlton, VIC, Australia.
Front Psychiatry. 2020 Jun 26;11:483. doi: 10.3389/fpsyt.2020.00483. eCollection 2020.
In the aftermath of disaster, a large proportion of people will develop psychosocial difficulties that impair recovery, but for which presentations do not meet threshold criteria for disorder. Although these adjustment problems can cause high distress and impairment, and often have a trajectory towards mental health disorder, few evidence-based interventions are available to facilitate recovery.
This paper describes the development and pilot testing of an internationally developed, brief, and scalable psychosocial intervention that targets distress and poor adjustment following disaster and trauma.
The Skills fOr Life Adjustment and Resilience (SOLAR) program was developed by an international collaboration of trauma and disaster mental health experts through an iterative expert consensus process. The resulting five session, skills-based intervention, deliverable by community-based or frontline health or disaster workers with little or no formal mental health training (known as coaches), was piloted with 15 Australian bushfire survivors using a pre-post with follow up, mixed-methods design study.
Findings from this pilot demonstrated that the SOLAR program was safe and feasible for non-mental health frontline workers (coaches) to deliver locally after two days of training. Participants' attendance rates and feedback about the program indicated that the program was acceptable. Pre-post quantitative analysis demonstrated reductions in psychological distress, posttraumatic stress symptoms, and impairment.
This study provides preliminary evidence that the delivery of the SOLAR program after disaster by trained, frontline workers with little or no mental health experience is feasible, acceptable, safe, and beneficial in reducing psychological symptoms and impairment among disaster survivors. Randomized controlled trials of the SOLAR program are required to advance evidence of its efficacy.
在灾难过后，很大一部分人会出现心理社会方面的困难，这些困难会阻碍恢复进程，但其表现未达到疾病的阈值标准。尽管这些适应问题会导致高度痛苦和功能受损，且往往会发展为精神健康障碍，但几乎没有基于证据的干预措施可促进恢复。
本文描述了一种国际开发的、简短且可扩展的心理社会干预措施的开发和试点测试，该干预措施针对灾难和创伤后的痛苦及适应不良。
生活调整与恢复技能（SOLAR）项目由创伤和灾难心理健康专家通过反复的专家共识过程进行国际合作开发。由此产生的为期五节的基于技能的干预措施，可由几乎没有或没有接受过正规心理健康培训的社区或一线卫生或灾难工作者（称为指导者）实施，采用前后测及随访的混合方法设计研究，对15名澳大利亚丛林火灾幸存者进行了试点。
该试点的结果表明，SOLAR项目对非心理健康一线工作者（指导者）来说，在经过两天培训后在当地实施是安全可行的。参与者的出勤率和对该项目的反馈表明该项目是可接受的。前后测定量分析显示心理痛苦、创伤后应激症状和功能受损有所减轻。
本研究提供了初步证据，表明由几乎没有或没有心理健康经验的受过培训的一线工作者在灾难后实施SOLAR项目是可行的、可接受的、安全的，并且在减轻灾难幸存者的心理症状和功能受损方面是有益的。需要对SOLAR项目进行随机对照试验以进一步证明其疗效。
