在VA环境中扩大对基于证据的心理治疗的准入:实施简要的认知行为治疗抑郁症计划
Joseph Mignogna1,2, Derrecka Boykin3,4,5, Raquel D Gonzalez3,4
1Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States.
Frontiers in health services
|November 1, 2023
概括
实施简短的认知行为疗法 (CBT) 改善了退伍军人的心理健康,特别是农村地区的退伍军人. 这种以证据为基础的心理治疗 (EBP) 计划提高了获得机会,并显示出显著的症状减少.
科学领域:
- 心理健康服务研究 心理健康服务研究
- 实施科学 实施科学
- 卫生服务管理卫生服务管理
背景情况:
- 获得基于证据的心理治疗 (EBP) 是有限的,特别是农村退伍军人.
- 简短的认知行为疗法 (CBT) 是抑郁症的有效EBP.
- 需要专门的计划来向服务不足的人群传播EBP.
研究的目的:
- 改善各种退伍军人获得简短的CBT的机会,重点是农村人口.
- 在退伍军人卫生管理局 (VHA) 设置中实施和传播简短的CBT.
- 评估简要CBT实施的采用,有效性和维持情况.
主要方法:
- 一个多方面的实施计划培训和支持VHA提供者提供简短的CBT.
- 宣传工作的目标是服务于农村退伍军人的社区门诊 (CBOC) 的提供者.
- 评估遵循RE-AIM框架,重点关注采用,有效性和维护.
主要成果:
- 超过40个VHA设施采用了该计划,65.1%的接触的提供者完成了培训.
- 688名退伍军人,包括174名来自农村地区的退伍军人,接受了2,186次简短的CBT课程.
- 退伍军人完成至少三次会议显示显著的平均抑郁症症状减少4.6点.
结论:
- 简短的CBT的实施导致了对退伍军人的快速采用和显著的临床影响.
- 有针对性的农村外展和远程心理健康方法改善了农村退伍军人的EBP可用性.
- 这一举措证明了向服务不足的退伍军人群体传播EBP的成功模式.
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