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对患有神经性厌食症的医疗补助保险青少年的家庭治疗适应性调整。

Adaptations to family-based treatment for Medicaid-insured adolescents with anorexia nervosa.

作者信息

Borges Renee, Crest Peyton, Landsverk John, Accurso Erin C

机构信息

Department of Health Professions, University of San Francisco, San Francisco, CA, United States.

Rhodes College, Memphis, TN, United States.

出版信息

Front Psychol. 2024 Sep 13;15:1389652. doi: 10.3389/fpsyg.2024.1389652. eCollection 2024.

Abstract

BACKGROUND

Family-based treatment (FBT) is the leading intervention for adolescents with anorexia nervosa (AN); however, it is under researched in socioeconomically disadvantaged and racially diverse youth.

METHODS

Semi-structured interviews were completed with ten FBT clinicians who practice in publicly-funded settings. Interview questions were focused on implementation challenges, overall acceptability and appropriateness of FBT, and naturally-occurring treatment adaptations.

RESULTS

Content analysis revealed common themes relating to the implementation of FBT in publicly-funded, community-based settings: acceptability and appropriateness, complexity and learnability, perceived core components of FBT, cultural adaptations, socioeconomic factors, logistical considerations, organizational and systemic barriers, training acceptability, participant's self-efficacy, and telehealth accommodations.

CONCLUSION

The discussed themes offer insights into the implementation of FBT for settings with limited resources, aligning with prior research on clinical adaptations for multicultural patients. Recognizing these themes can guide clinical adjustments and refine the adapted treatment model in real-world settings for patients facing systemic barriers.

摘要

背景

基于家庭的治疗(FBT)是青少年神经性厌食症(AN)的主要干预方法;然而,在社会经济条件不利和种族多样化的青少年中,对其研究较少。

方法

对在公共资助机构执业的10名FBT临床医生进行了半结构化访谈。访谈问题集中在实施挑战、FBT的总体可接受性和适用性,以及自然发生的治疗调整。

结果

内容分析揭示了在公共资助的社区环境中实施FBT的共同主题:可接受性和适用性、复杂性和可学习性、FBT的核心组成部分认知、文化适应、社会经济因素、后勤考虑、组织和系统障碍、培训可接受性、参与者的自我效能感以及远程医疗适应。

结论

所讨论的主题为资源有限环境下FBT的实施提供了见解,与先前针对多元文化患者临床适应的研究一致。认识到这些主题可以指导临床调整,并在现实环境中为面临系统障碍的患者完善适应性治疗模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9e7/11428008/04d08fcc7c46/fpsyg-15-1389652-g001.jpg

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