CARES Institute, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA.
Department of Psychiatry, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA.
Community Ment Health J. 2023 Oct;59(7):1409-1421. doi: 10.1007/s10597-023-01130-0. Epub 2023 May 5.
Clinicians working with youth exposed to trauma may be at increased risk for experiencing elevated levels of stress and symptoms of secondary traumatic stress, which can negatively impact clinician wellbeing and ultimately contribute to reduced access to quality care for clients. An innovative Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) training incorporating self-care practices (i.e., Practice What You Preach; PWYP) was developed to help facilitate the implementation of TF-CBT and to enhance clinicians' coping and decrease stress. The primary purpose of this study was to determine whether the PWYP-augmented training met three Objectives: (1) increase clinicians' feelings of TF-CBT competency; (2) improve clinicians' coping abilities/reduce clinicians' stress; and (3) increase clinicians' insight into the benefits and/or challenges clients may experience in treatment. An exploratory aim was also developed to identify additional facilitators and barriers of TF-CBT implementation. The written reflections of 86 community-based clinicians who participated in the PWYP-augmented TF-CBT training were examined using qualitative methods. The majority of clinicians indicated increased feelings of competency and improved coping abilities and/or stress levels; almost half mentioned increased insight into clients' experiences. The most frequently mentioned additional facilitators were related to elements of the TF-CBT treatment model. Anxiety/self-doubt was the barrier most frequently mentioned, though all clinicians who mentioned this barrier indicated it lessened or resolved over the course of the training. Incorporating self-care strategies into trainings may serve as a facilitator for TF-CBT implementation by enhancing the competency and well-being of clinicians. The additional insights into barriers and facilitators can be used to further improve the PWYP initiative and future training and implementation efforts.
临床医生在接触创伤的年轻人时，可能会面临更高的压力和二次创伤压力症状的风险，这可能会对临床医生的健康产生负面影响，并最终导致客户获得高质量护理的机会减少。一种创新的创伤焦点认知行为疗法（TF-CBT）培训，纳入了自我保健实践（即，实践你所宣扬的；PWYP），旨在帮助促进 TF-CBT 的实施，并增强临床医生的应对能力，减轻压力。本研究的主要目的是确定 PWYP 增强型培训是否符合三个目标：（1）提高临床医生对 TF-CBT 的胜任感；（2）提高临床医生的应对能力/降低临床医生的压力；（3）提高临床医生对客户在治疗中可能经历的益处和/或挑战的洞察力。还制定了一个探索性目标，以确定 TF-CBT 实施的其他促进因素和障碍。对参加 PWYP 增强型 TF-CBT 培训的 86 名社区临床医生的书面反思进行了定性分析。大多数临床医生表示他们的胜任感增强了，应对能力和/或压力水平提高了；近一半的人提到对客户体验的了解有所增加。最常提到的额外促进因素与 TF-CBT 治疗模型的要素有关。焦虑/自我怀疑是最常提到的障碍，但所有提到这一障碍的临床医生都表示，随着培训的进行，这种障碍减轻或解决了。将自我保健策略纳入培训中可以通过增强临床医生的能力和幸福感来促进 TF-CBT 的实施。对障碍和促进因素的额外了解可以用于进一步改进 PWYP 计划以及未来的培训和实施工作。
