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探讨为寄养中的年轻人提供远程医疗创伤聚焦认知行为疗法(TF-CBT)的可行性。

Examining the Feasibility of Telehealth Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) with Young People in Foster Care.

作者信息

Martin Adrianna N, McLeigh Jill D, Lamminen Laura M

机构信息

Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas USA.

Rees-Jones Center for Foster Care Excellence, Children's Health, Dallas, Texas USA.

出版信息

J Child Adolesc Trauma. 2023 Apr 4;16(4):1-9. doi: 10.1007/s40653-023-00538-w.

Abstract

: Despite the high rate of trauma exposure among young people with child welfare involvement, various systematic and patient barriers exist that inhibit utilization of evidence-based trauma treatments. One strategy for alleviating barriers to such treatments is using telehealth. A few studies have found that the clinical outcomes of telehealth TF-CBT are comparable to those found from clinic-based, in-person treatment administration. Studies have yet to examine the feasibility of telehealth TF-CBT with young people in care. The current study sought to address this gap by examining outcomes for patients who received telehealth TF-CBT, along with factors that may have impacted successful completion, at an integrated primary care clinic exclusively serving young people in care. : Patient data were collected retrospectively from the electronic health records of 46 patients who received telehealth TF-CBT between March 2020 and April 2021, and feedback was sought via focus group from 7 of the clinic's mental health providers. A paired-sample t-test was conducted to evaluate the impact of the intervention for the 14 patients who completed treatment. : Responses from the Child and Adolescent Trauma Screen showed a significant decrease in posttraumatic stress symptoms when comparing pre-treatment scores (M = 25.64, SD = 7.85) to post-treatment scores (13.57, SD = 5.30), t(13) = 7.50, p < .001. The mean decrease in scores was 12.07 with a 95% confidence interval ranging from 8.60 to 15.55. Themes emerging from the focus group centered on home environment, caregiver participation, and systemic topics. : Findings suggest that telehealth TF-CBT with young people in care is feasible but relatively low completion rates suggest that barriers to treatment completion remain.

摘要

尽管在涉及儿童福利的年轻人中创伤暴露率很高,但存在各种系统和患者层面的障碍,阻碍了循证创伤治疗的应用。减轻此类治疗障碍的一种策略是使用远程医疗。一些研究发现,远程医疗创伤为焦点的认知行为疗法(TF-CBT)的临床结果与基于诊所的面对面治疗管理的结果相当。尚未有研究考察远程医疗TF-CBT对受照料青少年的可行性。本研究旨在通过考察在一家专门为受照料青少年提供服务的综合初级保健诊所中接受远程医疗TF-CBT的患者的治疗结果,以及可能影响成功完成治疗的因素,来填补这一空白。:从2020年3月至2021年4月期间接受远程医疗TF-CBT的46名患者的电子健康记录中回顾性收集患者数据,并通过焦点小组从该诊所的7名心理健康提供者那里寻求反馈。对完成治疗的14名患者进行配对样本t检验,以评估干预的影响。:儿童和青少年创伤筛查的结果显示,与治疗前得分(M = 25.64,SD = 7.85)相比,创伤后应激症状在治疗后得分(13.57,SD = 5.30)时有显著下降,t(13) = 7.50,p <.001。得分的平均下降为12.07,95%置信区间为8.60至15.55。焦点小组中出现的主题集中在家庭环境、照顾者参与和系统性话题上。:研究结果表明,对受照料青少年进行远程医疗TF-CBT是可行的,但相对较低的完成率表明治疗完成的障碍仍然存在。

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