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消除二级保健心理学中的等候名单:解决国民保健服务的盲点。

Waiting list eradication in secondary care psychology: Addressing a National Health Service blind spot.

机构信息

Faculty of Health Sciences, University of Hull, Hull, UK.

Psychological Services, NAViGO Health and Social Care CiC, Grimsby, UK.

出版信息

Clin Psychol Psychother. 2021 Jul;28(4):969-977. doi: 10.1002/cpp.2551. Epub 2021 Jan 11.

Abstract

OBJECTIVES

Waiting times for secondary care psychological therapy remain a 'blind spot' in serious mental illness (SMI) provision, and their reduction is a priority within the National Health Service (NHS) Five Year Forward View. The paper describes the eradication of waiting times within a community-based NHS service and the effectiveness of strategies whilst examining help-seeking behaviour, compliance and therapeutic need.

METHODS

Analyses are reported for treatment compliance and therapeutic outcomes for 208 waiting-list cohort individuals seen by the SMI psychology service over an 18-month period between October 2014 and March 2016.

RESULTS

No significant clinical or demographic differentiation between individuals who successfully completed therapy compared to those who disengaged was observed. Despite an average 2.20-year waiting time, this alone did not significantly impact engagement with psychological treatment and all psychological therapies provided led to a significant clinical improvement and no individuals who completed therapy required re-referral at 12-month follow-up.

CONCLUSIONS

If imposed appropriately over a suitable time frame evidence-based practice coupled with effective operationalization can result in efficient needs-led psychological provision within SMI and secondary care. Potentially debilitating waiting times for service users and other referring professionals can be avoided, whilst psychology provision retains a flexible, formulation-based and person-centred approach.

摘要

目的

二级护理心理治疗的等待时间仍然是严重精神疾病(SMI)服务中的一个“盲点”,在国民保健服务(NHS)五年展望中,减少等待时间是当务之急。本文描述了在以社区为基础的 NHS 服务中消除等待时间的情况,并在考察寻求帮助行为、依从性和治疗需求的同时,评估了策略的有效性。

方法

报告了在 2014 年 10 月至 2016 年 3 月的 18 个月期间,SMI 心理学服务为 208 名等候名单队列个体提供治疗的治疗依从性和治疗结果的分析。

结果

与未完成治疗的个体相比,成功完成治疗的个体在临床或人口统计学上没有显著差异。尽管平均等待时间为 2.20 年,但这并没有显著影响对心理治疗的参与,所有提供的心理治疗都导致了显著的临床改善,并且没有完成治疗的个体在 12 个月的随访中需要重新转介。

结论

如果在适当的时间框架内适当实施,结合有效的实施,基于证据的实践可以在 SMI 和二级护理中实现高效的以需求为导向的心理服务。可以避免服务使用者和其他转介专业人员潜在的致残性等待时间,同时保持心理学服务的灵活性、基于制定的方案和以人为中心的方法。

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