Maia Ana, Almeida Sílvia, Cotovio Gonçalo, Rodrigues da Silva Daniel, Viana Francisco Faro, Grácio Jaime, Oliveira-Maia Albino J
Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal.
Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.
Front Psychiatry. 2022 Aug 3;13:924370. doi: 10.3389/fpsyt.2022.924370. eCollection 2022.
Transcranial Magnetic Stimulation (TMS) is a non-invasive brain stimulation technique that was cleared by the Food and Drug Administration (FDA) for the treatment of Obsessive-Compulsive Disorder (OCD) in 2018. The approved protocol includes individualized symptom provocation before each stimulation session, to elicit a moderate level of obsessional distress. Although symptom provocation can be a delicate, demanding, and uncomfortable procedure, structured training methods for those who are going to apply it are not available. Here, we describe a model for training in symptom provocation for TMS technicians, developed at the Champalimaud Clinical Centre in Lisbon, Portugal. Our programme includes two-sessions dedicated to clinical communication and symptom provocation techniques from a theoretical and practical perspective. Additionally, supervision meetings are conducted during treatment of patients, allowing regular case discussion and redefinition of symptom provocation hierarchy, as needed. In addition to having a strong practical component, our training program is short and pragmatic, allowing for easy implementation and fluid transition to clinical practice. By sharing our experience, we hope to contribute to systematize training procedures required for symptom provocation in the context of TMS, and to qualitatively describe a methodology that can be used for implementation of TMS programmes for the treatment of OCD.
经颅磁刺激(TMS)是一种非侵入性脑刺激技术,2018年美国食品药品监督管理局(FDA)批准其用于治疗强迫症(OCD)。获批方案包括在每次刺激疗程前进行个体化症状激发,以引发中等程度的强迫性困扰。尽管症状激发可能是一个微妙、要求高且令人不适的过程,但目前尚无针对即将实施该操作的人员的结构化培训方法。在此,我们描述了一种在葡萄牙里斯本尚帕利莫德临床中心开发的TMS技术人员症状激发培训模式。我们的课程包括两部分,从理论和实践角度专门讲解临床沟通和症状激发技术。此外,在患者治疗期间会举行督导会议,以便根据需要定期进行病例讨论并重新确定症状激发等级。除了具备很强的实践部分外,我们的培训项目简短且务实,便于实施并能顺利过渡到临床实践。通过分享我们的经验,我们希望有助于使TMS背景下症状激发所需的培训程序系统化,并定性描述一种可用于实施治疗OCD的TMS方案的方法。
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