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作为“组织性照顾者”的依恋知情心理保健系统:未来展望

Attachment-informed mental healthcare systems as 'organisational caregivers': ideas for the future.

作者信息

Salmoiraghi Alberto, Zarotti Nicolò

机构信息

Betsi Cadwaladr University Health Board, Bangor, UK.

Bangor University, Bangor, UK.

出版信息

BJPsych Bull. 2025 Aug;49(4):259-264. doi: 10.1192/bjb.2024.94.

Abstract

Over the past 50 years, mental health services have evolved significantly, influenced by shifts in theoretical and practical approaches to mental disorders. Key among these changes are the biopsychosocial and recovery models, which highlight resilience and quality of life in treatment. However, traditional psychiatry has often struggled to embrace these changes because of reductionist perspectives that overlook psychosocial factors, resulting in fragmented care and reduced accessibility. Proposed solutions have faced implementation barriers in absence of a coherent theoretical framework. Here, we outline how attachment theory may offer a promising framework to drive systemic change in mental health by emphasising secure emotional bonds at both the organisational and individual level. Within an attachment-informed culture, services may act as 'organisational caregivers' that promote continuity of care, independence and stronger clinical relationships. In turn, this may foster more inclusive, responsive and resilient mental healthcare systems that prioritise patients' needs and empowerment.

摘要

在过去50年里,受精神障碍理论和实践方法转变的影响,心理健康服务有了显著发展。这些变化中的关键是生物心理社会模型和康复模型,它们在治疗中强调恢复力和生活质量。然而,传统精神病学常常难以接受这些变化,因为其还原论观点忽视了心理社会因素,导致护理碎片化且可及性降低。在缺乏连贯理论框架的情况下,提出的解决方案面临实施障碍。在此,我们概述依恋理论如何通过在组织和个人层面强调安全的情感纽带,为推动心理健康领域的系统性变革提供一个有前景的框架。在一种基于依恋的文化中,服务机构可充当“组织性照顾者”,促进护理连续性、独立性和更稳固的临床关系。反过来,这可能培育出更具包容性、响应性和恢复力的精神卫生保健系统,将患者需求和赋权置于优先地位。

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