Stokes Bryony, Fraser Elizabeth, Stokes Sheldon, Saric Natasha, Kriegel Liat, Oluwoye Oladunni
Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University.
Department of Medicine, University of Washington School of Medicine.
Psychol Serv. 2024 Aug;21(3):399-405. doi: 10.1037/ser0000844. Epub 2024 Feb 15.
Engagement in services is a core element to successful outcomes for service users and programs. In coordinated specialty care (CSC) programs, designed for individuals experiencing first-episode psychosis, engagement has only been measured programmatically and not by service component. This qualitative study sought to explore provider perspectives on service user engagement in service components of CSC. Semistructured interviews were conducted with 20 service providers from five community-based early intervention programs for psychosis in the United States. Interviews were recorded and transcribed verbatim, and thematic analysis was used to analyze the data collected. Provider participants described barriers and facilitators that contribute to disengagement or engagement in four service components within early intervention programs: individual psychotherapy, family education and support, medication management, and vocational services. Barriers identified included substance use, stigma, trauma, and external pressures. Identified barriers to engagement in CSC were both unique to individual components and cut across them. By better understanding the complexity of barriers and their intersections within and across CSC components, there can be more effective policy and program development to reduce disengagement and hopefully increase positive outcomes for service users. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
参与服务是服务使用者和项目取得成功结果的核心要素。在为首次发作精神病患者设计的协调专科护理(CSC)项目中,参与度仅通过项目层面进行衡量,而非按服务组成部分进行衡量。这项定性研究旨在探讨提供者对CSC服务组成部分中服务使用者参与度的看法。对来自美国五个社区精神病早期干预项目的20名服务提供者进行了半结构化访谈。访谈进行了录音并逐字转录,采用主题分析法对收集到的数据进行分析。提供者参与者描述了导致早期干预项目中四个服务组成部分(个体心理治疗、家庭教育与支持、药物管理和职业服务)出现脱离或参与的障碍和促进因素。确定的障碍包括物质使用、耻辱感、创伤和外部压力。确定的CSC参与障碍既有各组成部分特有的,也有贯穿各组成部分的。通过更好地理解障碍的复杂性及其在CSC各组成部分内部和之间的交叉点,可以制定更有效的政策和项目,以减少脱离情况,并有望为服务使用者增加积极结果。(PsycInfo数据库记录(c)2024美国心理学会,保留所有权利)