Becker Kimberly D, Chorpita Bruce F
Department of Psychology, University of South Carolina.
Department of Psychology, University of California, Los Angeles.
J Clin Child Adolesc Psychol. 2023 Mar-Apr;52(2):284-309. doi: 10.1080/15374416.2023.2169926. Epub 2023 Feb 14.
The field has spent more than 50 years investing in the quality of youth mental healthcare, with intervention science yielding roughly 1,300 efficacious treatments. In the latter half of this period, concurrent efforts in implementation science have developed effective methods for supporting front-line service organizations and therapists to begin to bridge the science to service gap. However, many youths and families still do not benefit fully from these strategic investments due to low treatment engagement: nearly half of youths in need of services pursue them, and among those who do, roughly another half terminate prematurely. The negative impact of low engagement is substantial, and is disproportionally and inequitably so for many. We contend that to build a robust and "finished" bridge connecting science and service, the field must go beyond its two historical foci of designing interventions and preparing therapists to deliver them, to include an intentional focus on the youths and families who participate in these interventions and who work with those therapists. In this paper, we highlight the significance of treatment engagement in youth mental healthcare and discuss the current state of the literature related to four priorities: conceptualization, theory, measurement, and interventions. Next, we offer an example from our own program of research as one illustration for advancing these priorities. Finally, we propose recommendations to act on these priorities.
在青少年心理健康护理质量方面，该领域已经投入了50多年的时间，干预科学产生了大约1300种有效的治疗方法。在这一时期的后半段，实施科学方面的同步努力已经开发出有效的方法，以支持一线服务机构和治疗师开始弥合科学与服务之间的差距。然而，由于治疗参与度低，许多青少年和家庭仍然没有充分从这些战略投资中受益：近一半需要服务的青少年寻求服务，而在那些寻求服务的青少年中，大约又有一半过早终止治疗。参与度低的负面影响是巨大的，而且对许多人来说，这种影响是不成比例和不公平的。我们认为，要建立一座坚固且“完善”的连接科学与服务的桥梁，该领域必须超越其两个历史重点，即设计干预措施和培训治疗师来实施这些措施，转而有意关注参与这些干预措施并与那些治疗师合作的青少年和家庭。在本文中，我们强调了治疗参与度在青少年心理健康护理中的重要性，并讨论了与四个优先事项相关的文献现状：概念化、理论、测量和干预措施。接下来，我们提供我们自己研究项目中的一个例子，作为推进这些优先事项的一个例证。最后，我们针对这些优先事项提出建议。
