Liberman R P, McCann M J, Wallace C J
Br J Psychiatry. 1976 Nov;129:490-6. doi: 10.1192/bjp.129.5.490.
Generalization of improvement in the behavioural treatment of psychotic patients must be planned in after-care settings, and for durability over time. The transfer of clinical gains is not an automatic by-product of treatment with severely and chronically impaired mental patients. Treatment strategies that facilitate generalization from hospital to community are illustrated in a case study using empirical data. Systematic and specific treatment programmes were co-ordinated between a state hospital ward and a community-based day hospital. Setting step-wise and limited goals is a feature of successful outcomes. Maintaining consistency in reinforcement contingencies from hospital to community settings, using natural reinforcers, pinpointing functional behaviours as therapeutic goals, over-learning, and training natural caregivers are methods that promote generalization.
必须在后续护理环境中规划精神病患者行为治疗改善效果的推广,并确保其长期持续性。对于严重且慢性精神障碍患者而言,临床治疗成果的转移并非治疗的必然附带产物。一项使用实证数据的案例研究展示了有助于从医院推广至社区的治疗策略。一家州立医院病房与一家社区日间医院之间协调了系统且具体的治疗方案。设定逐步且有限的目标是成功治疗结果的一个特点。在从医院到社区的环境中保持强化条件的一致性、使用自然强化物、将功能性行为确定为治疗目标、过度学习以及培训自然护理人员,这些都是促进推广的方法。