Zlotnik Deborah M, Yoon Alexandra, Harlan Michelle, Mackey Eleanor
Children's National Hospital, Washington, DC, USA.
George Mason University, Fairfax, VA, USA.
Acad Psychiatry. 2025 Feb;49(1):50-55. doi: 10.1007/s40596-024-02023-4. Epub 2024 Aug 17.
Dialectical behavior therapy (DBT) is an evidence-based treatment for patients with suicidality and emotion dysregulation. There is increasing evidence of using DBT in psychiatric inpatient units for youth. On inpatient units, the majority of treatment is provided by psychiatry trainees, often with limited therapy experience. The study's objective was to assess the impact of a 1-h weekly DBT training for a range of medical trainees rotating through a child and adolescent acute inpatient unit.
Participants were 55 medical students, psychiatry residents, and child and adolescent psychiatry fellows who rotated on an inpatient unit for youth and participated in a 1-h DBT didactic. There was one group who attended less than four sessions and the other attended 5 or more sessions. A pre- and post-method design was used to collect data on participants' confidence, competence, and knowledge of DBT and working with suicidal youth.
Comparing pre- and post-data for all participants, the DBT training was found to lead to significant benefits for trainees' comfort with therapy, prioritizing therapy during inpatient care, knowledge of DBT, comfort with DBT, and confidence in treating children and adolescents with suicidality. There were no significant differences in the type of trainee or dose of training.
This study supports the benefit of a brief DBT didactic to provide training to a wide range of trainees to improve therapeutic care in an inpatient psychiatric unit for youth.
辩证行为疗法(DBT)是一种针对有自杀倾向和情绪调节障碍患者的循证治疗方法。越来越多的证据表明,DBT可用于青少年精神科住院病房。在住院病房中,大部分治疗由精神科实习生提供,他们通常治疗经验有限。本研究的目的是评估为在儿童和青少年急性住院病房轮转的一系列医学实习生提供每周1小时DBT培训的效果。
参与者为55名医学生、精神科住院医师以及在青少年住院病房轮转并参加1小时DBT教学的儿童和青少年精神科研究员。其中一组参加的课程少于4节,另一组参加了5节或更多节。采用前后测设计收集参与者对DBT以及与有自杀倾向青少年打交道的信心、能力和知识的数据。
比较所有参与者的前后数据发现,DBT培训使实习生在治疗方面的舒适度、在住院护理期间优先安排治疗、对DBT的了解、对DBT的舒适度以及治疗有自杀倾向儿童和青少年的信心均有显著提升。在实习生类型或培训剂量方面没有显著差异。
本研究支持简短的DBT教学对广泛的实习生进行培训以改善青少年住院精神科病房治疗护理的益处。