实施认知矫正对精神病患者的国际经验。

International Experience of Implementing Cognitive Remediation for People With Psychotic Disorders.

机构信息

The University of Queensland Medical School, Brisbane, Australia.

Metro South Addiction and Mental Health Service, Brisbane, Australia.

出版信息

Schizophr Bull. 2024 Aug 27;50(5):1017-1027. doi: 10.1093/schbul/sbae071.

Abstract

BACKGROUND

Cognitive remediation (CR) is an effective therapy for the cognitive impact of mental illness, especially schizophrenia. Global efforts are being made to implement CR into routine mental health services with the aim of improving functional outcomes for the population of people recovering from mental illness. Implementation and dissemination of CR in heterogeneous settings require knowledge gleaned from formal implementation research and pragmatic experiential learning. This article describes cross-cultural approaches to CR implementation, focusing on initiatives in France, the United States, Australia, and Japan.

METHOD

Key leaders in the implementation of CR in France, the United States, Australia, and Japan were asked to describe the implementation and dissemination process in their settings with respect to the categories of context, implementation, outcomes, facilitators, and barriers.

RESULTS

All 4 sites noted the role of collaboration to leverage the implementation of CR into mental health rehabilitation services. In France, high-level, government organizational backing enhanced the dissemination of CR. Academic and clinical service partnerships in the United States facilitated the dissemination of programs. The advocacy from service users, families, and carers can aid implementation. The support from international experts in the field can assist in initiating programs but maintenance and dissemination require ongoing training and supervision of staff.

CONCLUSIONS

CR is an effective intervention for the cognitive impact of schizophrenia. Programs can be implemented in diverse settings globally. Adaptations of CR centering upon the core components of effective CR therapy enhance outcomes and enable programs to integrate into diverse settings.

摘要

背景

认知矫正(CR)是一种治疗精神疾病认知影响的有效疗法,尤其是精神分裂症。全球正在努力将 CR 纳入常规心理健康服务,以改善精神疾病康复人群的功能结果。在异质环境中实施和传播 CR 需要从正式的实施研究和实用的经验学习中获取知识。本文介绍了 CR 实施的跨文化方法,重点介绍了法国、美国、澳大利亚和日本的举措。

方法

要求法国、美国、澳大利亚和日本的 CR 实施的主要领导者描述他们在各自环境中的实施和传播过程,涉及背景、实施、结果、促进因素和障碍等类别。

结果

所有 4 个地点都指出了合作的作用,以促进 CR 融入心理健康康复服务。在法国,政府高层的组织支持加强了 CR 的传播。美国的学术和临床服务伙伴关系促进了项目的传播。服务使用者、家庭和护理人员的倡导可以帮助实施。该领域的国际专家的支持可以协助启动项目,但需要对员工进行持续的培训和监督,以维持和传播。

结论

CR 是治疗精神分裂症认知影响的有效干预措施。该方案可以在全球不同环境中实施。以有效的 CR 治疗为核心的 CR 改编可以提高疗效,并使方案能够融入不同的环境。

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