Dickson Kelsey S, Kenworthy Lauren, Anthony Laura, Brookman-Frazee Lauren
San Diego State University, San Diego, CA.
Child and Adolescent Services Research Center, San Diego, CA.
Evid Based Pract Child Adolesc Ment Health. 2023;8(1):39-54. doi: 10.1080/23794925.2021.2013142. Epub 2022 Jan 10.
Executive functioning is considered a key transdiagnostic factor underlying multiple mental health conditions. Evidence-based interventions targeting executive functioning skills exist and there are ongoing efforts to implement these interventions in routine community-based care. However, there is limited research characterizing therapist perspectives regarding addressing executive functioning within community-based mental health services. The current mixed-methods study aims to characterize mental health therapist perspectives regarding the role of executive functioning in youth clinical presentation and the psychotherapy process and outcomes as well as their experience and training related to executive functioning. Forty-three therapists completed a survey about their perspectives about executive functioning and 14 participated in subsequent focus groups to expand survey results. Results indicated that therapists perceive executive functioning challenges as impacting a large portion of children on their caseload, present across multiple mental health conditions, and that executive functioning is frequently a focus of psychotherapy. Therapists also identified executive functioning challenges as a barrier to therapy engagement and effectiveness. However, therapists reported limited knowledge and training as well as significant motivation for executive functioning training, including executive functioning interventions. Findings confirm the significant role of executive functioning in youth presenting for mental health services and the psychotherapy process and outcomes. Findings also highlight the need for further translation of evidence-based interventions and tools. Challenges as well as potential solutions to inform ongoing and future work seeking to translate and implement evidence-based executive functioning interventions in community mental health services are discussed.
执行功能被认为是多种心理健康状况背后的关键跨诊断因素。针对执行功能技能的循证干预措施已经存在，并且正在努力将这些干预措施应用于常规的社区护理中。然而，关于治疗师在社区心理健康服务中处理执行功能方面的观点的研究有限。当前的混合方法研究旨在描述心理健康治疗师对执行功能在青少年临床表现、心理治疗过程和结果中的作用的看法，以及他们与执行功能相关的经验和培训情况。43名治疗师完成了一项关于他们对执行功能看法的调查，14名治疗师参加了随后的焦点小组以扩展调查结果。结果表明，治疗师认为执行功能挑战影响了他们大量病例中的儿童，这些挑战存在于多种心理健康状况中，并且执行功能经常是心理治疗的重点。治疗师还将执行功能挑战视为治疗参与和效果的障碍。然而，治疗师报告说他们的知识和培训有限，同时对执行功能培训，包括执行功能干预，有很大的积极性。研究结果证实了执行功能在寻求心理健康服务的青少年、心理治疗过程和结果中的重要作用。研究结果还强调了进一步转化循证干预措施和工具的必要性。讨论了在社区心理健康服务中寻求转化和实施循证执行功能干预措施的当前和未来工作中所面临的挑战以及潜在的解决方案。
