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在一个试点虚拟促进学习协作中,检查个体和组织理论,以实施书面暴露疗法。

An examination of individual and organizational theory in a pilot virtual facilitated learning collaborative to implement written exposure therapy.

机构信息

National Center for PTSD, Dissemination and Training Division.

VA Boston Healthcare System, National Center for PTSD.

出版信息

Psychol Serv. 2023 Nov;20(4):820-830. doi: 10.1037/ser0000698. Epub 2022 Sep 8.

DOI:10.1037/ser0000698
PMID:36074601
Abstract

Participant training alone is typically insufficient to ensure adoption of a new treatment. This study provides preliminary data on a pilot program that implemented written exposure therapy (WET) through a virtual facilitated learning collaborative (VFLC) that combined clinician training with implementation support. Ninety-five mental health clinicians from Veterans Health Administration clinics enrolled in the VFLC. Clinicians received 6 hr of training in WET plus weekly group consultation on training cases for 12-16 weeks. Clinic leaders participated in monthly group calls with facilitators to develop and track implementation plans, address barriers, and share resources. Clinicians completed the Perceived Characteristics of Intervention Scale and Implementation Climate Scale before training and after consultation, and the Intention Scale for providers after the program. Clinicians' positive perceptions of WET increased over time, (85) = -8.80, < .001, = 0.95, and changes were moderated by how much reduction in symptoms their patients experienced, (151) = -2.13, = .035. The implementation climate for WET also improved over time, (85) = -3.55, < .001, = 0.36. Consistent with the theory of planned behavior, clinicians' intention to continue using WET after training was influenced by their perceptions and attitudes about WET, subjective norms, and perceived behavioral control. The VFLC model was feasible and associated with increases in clinicians' and leaders' support for using WET. Patient outcomes predicted the amount of change in clinicians' perceptions about WET. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

摘要

仅对参与者进行培训通常不足以确保新治疗方法的采用。本研究提供了一项试点计划的初步数据,该计划通过虚拟促进学习合作(VFLC)实施书面暴露疗法(WET),将临床医生培训与实施支持相结合。95 名来自退伍军人事务部诊所的心理健康临床医生参加了 VFLC。临床医生接受了 6 小时的 WET 培训,外加 12-16 周的每周培训案例小组咨询。诊所负责人每月与促进者进行小组电话会议,以制定和跟踪实施计划、解决障碍和共享资源。临床医生在培训前和咨询后完成了干预措施感知特征量表和实施气候量表,以及方案结束后对提供者的意图量表。临床医生对 WET 的积极看法随着时间的推移而增加,(85) = -8.80, <.001, = 0.95,并且变化受到患者症状减轻程度的调节,(151) = -2.13, =.035。WET 的实施气候也随着时间的推移而改善,(85) = -3.55, <.001, = 0.36。与计划行为理论一致,临床医生在培训后继续使用 WET 的意愿受到他们对 WET 的看法、态度、主观规范和感知行为控制的影响。VFLC 模型是可行的,并与临床医生和领导对使用 WET 的支持增加相关。患者的结果预测了临床医生对 WET 的看法的变化程度。(PsycInfo 数据库记录(c)2023 APA,保留所有权利)。

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