UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK.
UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK; Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Epilepsy Behav. 2024 Aug;157:109905. doi: 10.1016/j.yebeh.2024.109905. Epub 2024 Jun 22.
Children and young people with epilepsy are more likely to experience multiple mental health problems than those without chronic physical health conditions, yet they often do not receive evidence-based (or indeed any) psychological interventions. Integrated healthcare is recommended as a solution to address these inequalities, but remains limited in the United Kingdom. This is partly due to the lack of training and availability of ongoing supervision for clinicians to ensure the safe and effective delivery of treatments. This study aimed to train and provide supervision for health professionals to deliver a modular cognitive-behavioural intervention for common mental health problems, optimised for use in paediatric epilepsy. Specifically, this study aimed to measure therapist competence and evaluate the acceptability of training and supervision.
Fifteen health professionals working in paediatric epilepsy services were trained over a six-month period. Training included face-to-face training workshops and completing at least one training case of a young person with epilepsy and anxiety, depression and/or behavioural problems under close clinical supervision. Throughout the training, health professionals were offered weekly one-hour supervisions with an experienced Clinical Psychologist. Clinical competence was assessed using a widely used measure of therapist competence in cognitive-behavioural therapy. Rates of attendance at supervision sessions and therapist ratings of satisfaction were recorded.
At the end of the six-month training, 14 health professionals reached clinical competence in delivering the mental health intervention. One person left the service and therefore did not complete the training. Overall, health professionals were satisfied with the training and supervision. However, 14 % of supervision sessions were cancelled and a further 11 % were not attended. Supervision sessions were also often shorter than the standard hour used in mental health settings (M = 41.18 min, SD = 10.30).
Our findings suggest that health professionals working in paediatric epilepsy services can be trained to deliver a psychological intervention with proficiency. However, the supervision model typically used in mental health may need adaptation to be sustainable in physical health settings. Future research is needed to evaluate the impact of training and supervision on patient outcomes and to ensure that ethical delivery of psychological interventions by health professionals without a mental health background.
患有癫痫的儿童和青少年比患有慢性身体健康问题的儿童和青少年更有可能经历多种心理健康问题，但他们往往没有接受循证（甚至任何）心理干预。综合医疗保健被推荐为解决这些不平等问题的一种方法，但在英国仍然有限。这在一定程度上是由于缺乏培训和持续监督的临床医生，以确保治疗的安全和有效。本研究旨在培训和提供监督，以向医疗保健专业人员提供针对常见心理健康问题的模块化认知行为干预措施，针对儿科癫痫进行了优化。具体来说，本研究旨在衡量治疗师的能力，并评估培训和监督的可接受性。
15 名在儿科癫痫服务机构工作的医疗保健专业人员接受了为期六个月的培训。培训包括面对面培训研讨会，并在经验丰富的临床心理学家的密切临床监督下，至少完成一名患有焦虑、抑郁和/或行为问题的青少年的培训案例。在整个培训过程中，医疗保健专业人员每周接受一次一小时的监督，由一位经验丰富的临床心理学家进行监督。使用广泛使用的认知行为疗法治疗师能力衡量标准来评估临床能力。记录监督会议的出席率和治疗师满意度评分。
在六个月的培训结束时，14 名医疗保健专业人员在提供心理健康干预方面达到了临床能力。有一人离开了服务机构，因此没有完成培训。总体而言，医疗保健专业人员对培训和监督感到满意。然而，14%的监督会议被取消，另有 11%的会议未参加。监督会议也往往比心理健康环境中使用的标准时间（M=41.18 分钟，SD=10.30）短。
我们的研究结果表明，在儿科癫痫服务机构工作的医疗保健专业人员可以接受培训，以熟练地提供心理干预。然而，通常在心理健康环境中使用的监督模式可能需要进行调整，以使其在身体健康环境中可持续。需要进一步研究来评估培训和监督对患者结果的影响，并确保没有心理健康背景的医疗保健专业人员以符合道德的方式提供心理干预。
