Children's Hospital of Orange County, Orange, California.
NYU Langone, New York City, New York.
J Am Acad Child Adolesc Psychiatry. 2024 Oct;63(10):956-960. doi: 10.1016/j.jaac.2024.04.014. Epub 2024 Jun 5.
Youth mental health is a major public health concern. Adolescents experiencing mental health crises are increasingly presenting to high-intensity settings such as inpatient and partial hospitalization programs. These services offer a multimodal approach involving medication management, cognitive-behavioral therapy (CBT), and dialectical behavior therapy (DBT). Treating these distressed youth in intense settings is challenging due to their high acuity, limited lengths of stay, and frequent lack of resources. However, CBT/DBT are typically evaluated in outpatient settings, leaving clinicians in high-intensity programs to adapt models with limited guidance. While traditional CBT/DBT interventions are not new or unfamiliar, and various literature reviews report their effectiveness, few reports offer specific guidance and practical tips for implementing these procedures. This Clinical Perspectives article highlights the necessary adaptations of traditional CBT/DBT for these intense settings in which high acuity, shorter stays, limited resource allocation, and a lack of staff involvement/training are limiting factors.
青少年心理健康是一个重大的公共卫生问题。越来越多经历心理健康危机的青少年出现在高强度的环境中，如住院和部分住院计划。这些服务提供了一种多模式的方法，包括药物管理、认知行为疗法（CBT）和辩证行为疗法（DBT）。由于这些患病青年的病情严重、住院时间有限且经常缺乏资源，在高强度环境中治疗他们具有挑战性。然而，CBT/DBT 通常在门诊环境中进行评估，这使得高强度项目中的临床医生不得不适应缺乏指导的模式。虽然传统的 CBT/DBT 干预措施并不新鲜或不熟悉，并且各种文献综述报告了它们的有效性，但很少有报告为在这些高强度环境中实施这些程序提供具体的指导和实用技巧。这篇临床观点文章强调了传统 CBT/DBT 在这些高强度环境中的必要适应性，这些环境中存在高发病率、较短的住院时间、有限的资源分配以及缺乏工作人员的参与/培训等限制因素。
