Finch Jodie, Ford Catherine, Lombardo Chiara, Meiser-Stedman Richard
Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK.
Institute for Health and Human Development, University of East London, London, UK.
Eur J Psychotraumatol. 2020 Sep 17;11(1):1815281. doi: 10.1080/20008198.2020.1815281.
Post-Traumatic Stress Disorder (PTSD) in children and adolescents has received increasing recognition in recent decades. Despite development of treatments and improved dissemination efforts, research has identified a number of barriers to implementing these approaches. This study sought to understand what interventions mental health professionals working with children and adolescents utilised to treat PTSD, their training and supervision, their confidence in assessing and treating PTSD, and how these factors relate to clinicians characteristics (e.g. age, gender, professional background). The study comprised an internet-delivered survey of clinicians working in child and adolescent mental health services in the UK (N = 716). Many clinicians (>40%) had not received training in working with PTSD, with considerable variation between professional background. Lack of training and supervision was associated with reduced clinician confidence in treating children with PTSD (possible range 0-10; training M = 7.54, SD = 1.65, no training M = 5.49, SD = 2.29; supervision M = 7.53, SD = 1.63, no supervision M = 5.98, SD = 2.35). Evidence-based therapies for PTSD such as Trauma-Focused Cognitive-Behavioural Therapy and Eye Movement Desensitisation and Reprocessing were only endorsed modestly by clinicians (58.4% and 37.5%, respectively). Regression analyses identified that lack of training and supervision were significant barriers to the use of evidence-based interventions. Other predictors of clinician confidence and use of evidence-based interventions included profession and years of experience. Participants almost universally wanted more training in working with PTSD. Evidence-based treatments are not currently universally delivered by mental health professionals in the UK, with certain professions particularly lacking training and confidence with this condition. Training around trauma and PTSD may be an ongoing need to boost and maintain confidence in working with PTSD in youth.
近几十年来，儿童和青少年创伤后应激障碍（PTSD）越来越受到关注。尽管已经开发出了相关治疗方法，并加大了推广力度，但研究发现实施这些方法存在诸多障碍。本研究旨在了解从事儿童和青少年心理健康工作的专业人员在治疗PTSD时采用了哪些干预措施、他们接受的培训和督导情况、他们对评估和治疗PTSD的信心，以及这些因素与临床医生特征（如年龄、性别、专业背景）之间的关系。该研究通过互联网对英国儿童和青少年心理健康服务机构的临床医生进行了调查（N = 716）。许多临床医生（超过40%）没有接受过PTSD治疗方面的培训，不同专业背景之间存在很大差异。缺乏培训和督导与临床医生治疗PTSD患儿的信心降低有关（可能范围为0 - 10；接受培训的M = 7.54，标准差 = 1.65，未接受培训的M = 5.49，标准差 = 2.29；接受督导的M = 7.53，标准差 = 1.63，未接受督导的M = 5.98，标准差 = 2.35）。针对PTSD的循证疗法，如创伤聚焦认知行为疗法和眼动脱敏再处理疗法，只有少数临床医生认可（分别为58.4%和37.5%）。回归分析表明，缺乏培训和督导是使用循证干预措施的重大障碍。临床医生信心和循证干预措施使用的其他预测因素包括专业和工作年限。几乎所有参与者都希望接受更多PTSD治疗方面的培训。目前，英国心理健康专业人员并未普遍采用循证治疗方法，某些专业在这方面尤其缺乏培训和信心。围绕创伤和PTSD的培训可能是持续的需求，以增强和维持在青少年PTSD治疗方面的信心。
