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协作式护理中适应心理治疗以治疗初级保健中阿片类药物使用障碍和共病精神疾病。

Adapting psychotherapy in collaborative care for treating opioid use disorder and co-occurring psychiatric conditions in primary care.

机构信息

Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania.

Leonard Davis Institute for Health Economics, University of Pennsylvania.

出版信息

Fam Syst Health. 2023 Sep;41(3):377-388. doi: 10.1037/fsh0000791. Epub 2023 May 25.


DOI:10.1037/fsh0000791
PMID:37227828
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10517081/
Abstract

INTRODUCTION: Opioid use disorder (OUD) and psychiatric conditions commonly co-occur yet are infrequently treated with evidence-based therapeutic approaches, resulting in poor outcomes. These conditions, separately, present challenges to treatment initiation, retention, and success. These challenges are compounded when individuals have OUD and psychiatric conditions. METHOD: Recognizing the complex needs of these individuals, gaps in care, and the potential for primary care to bridge these gaps, we developed a psychotherapy program that integrates brief, evidence-based psychotherapies for substance use, depression, and anxiety, building on traditional elements of the Collaborative Care Model (CoCM). In this article, we describe this psychotherapy program in a primary care setting as part of a compendium of collaborative services. RESULTS: Patients receive up to 12 sessions of evidence-based psychotherapy and case management based on a structured treatment manual that guides treatment via Motivational Enhancement; Cognitive Behavioral Therapies for depression, anxiety, and/or substance use disorder; and/or Behavioral Activation components. DISCUSSION: Novel, integrated treatments are needed to advance service delivery for individuals with OUD and psychiatric conditions and these programs must be rigorously evaluated. We describe our team's efforts to test our psychotherapy program in a large primary care network as part of an ongoing three-arm randomized controlled trial. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

摘要

简介:阿片类药物使用障碍(OUD)和精神疾病通常同时发生,但很少采用循证治疗方法进行治疗,导致治疗效果不佳。这些疾病本身在治疗开始、维持和成功方面都存在挑战。当个体同时患有 OUD 和精神疾病时,这些挑战会更加复杂。

方法:鉴于这些个体的复杂需求、护理差距以及初级保健在弥补这些差距方面的潜力,我们开发了一种心理治疗方案,该方案整合了针对物质使用、抑郁和焦虑的简短、循证心理治疗方法,同时借鉴了协作护理模式(CoCM)的传统元素。在本文中,我们在初级保健环境中描述了这种心理治疗方案,作为协作服务综合手册的一部分。

结果:患者接受多达 12 次基于结构化治疗手册的循证心理治疗和病例管理,该手册通过动机增强、针对抑郁、焦虑和/或物质使用障碍的认知行为疗法以及/或行为激活部分来指导治疗。

讨论:需要新颖的综合治疗方法来推进患有 OUD 和精神疾病个体的服务提供,并且这些方案必须经过严格评估。我们描述了我们团队在一个大型初级保健网络中测试我们心理治疗方案的努力,该方案是正在进行的三臂随机对照试验的一部分。(PsycInfo 数据库记录(c)2023 APA,保留所有权利)。

相似文献

[1]
Adapting psychotherapy in collaborative care for treating opioid use disorder and co-occurring psychiatric conditions in primary care.

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[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
Impact of Co-Occurring Psychiatric Comorbidities and Substance Use Disorders on Outcomes in Adolescents and Young Adults with Opioid Use Disorder: A Retrospective Cohort Study.

Pharmaceuticals (Basel). 2025-4-23

本文引用的文献

[1]
Integrating peer support services into primary care-based OUD treatment: Lessons from the Penn integrated model.

Healthc (Amst). 2022-9

[2]
Preferences for research design and treatment of comorbid depression among patients with an opioid use disorder: A cross-sectional discrete choice experiment.

Drug Alcohol Depend. 2021-9-1

[3]
Provision of Collaborative Care Model and General Behavioral Health Integration Services in Medicare.

Psychiatr Serv. 2021-7-1

[4]
Design of CLARO (Collaboration Leading to Addiction Treatment and Recovery from other Stresses): A randomized trial of collaborative care for opioid use disorder and co-occurring depression and/or posttraumatic stress disorder.

Contemp Clin Trials. 2021-5

[5]
Addressing Common Challenges in the Implementation of Collaborative Care for Mental Health: The Penn Integrated Care Program.

Ann Fam Med. 2021

[6]
Collaborative care in the treatment of opioid use disorder and mental health conditions in primary care: A clinical study protocol.

Contemp Clin Trials. 2021-4

[7]
Overcoming Barriers to Treatment of Opioid Use Disorder.

JAMA. 2021-3-23

[8]
Racial and Ethnic Disparities in the Prevalence of Stress and Worry, Mental Health Conditions, and Increased Substance Use Among Adults During the COVID-19 Pandemic - United States, April and May 2020.

MMWR Morb Mortal Wkly Rep. 2021-2-5

[9]
Improving Payment for Collaborative Mental Health Care in Primary Care.

Med Care. 2021-4-1

[10]
Duties toward Patients with Psychiatric Illness.

Hastings Cent Rep. 2020-5

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