忠诚问题:适应性实施策略的集群研究中的学校提供者坚持和能力
Allison E Meyer1, Seo Youn Choi2, Siena Tugendrajch3,4
1Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Evidence-based practice in child and adolescent mental health
|November 5, 2024
概括
学校心理健康专业人员需要支持,以有效地提供认知行为疗法 (CBT). 虽然指导提高了能力,但促进提高了坚持,这表明这两者对于学校的基于证据的实践至关重要.
科学领域:
- 实施科学 实施科学
- 学校心理健康 在学校心理健康
- 儿童和青少年精神病学 儿童和青少年精神病学
背景情况:
- 学校是解决年轻人的心理健康需求的关键环境.
- 基于学校的心理健康专业人员 (SPs) 需要支持高准确度的认知行为疗法 (CBT) 交付.
- 坚持和能力对于学校有效的心理健康干预至关重要.
研究的目的:
- 评估学校专业人员的CBT遵守和能力.
- 检查辅导和便利化实施支持对坚持和能力的影响.
- 确定哪些支持策略最好地解决基于证据的实践交付障碍.
主要方法:
- 一个集群随机实施试验评估了超过43周的CBT遵守和能力.
- 两种支持策略 - - 辅导和促进 (对于反应较慢的学校) - - 被比较.
- 测量了坚持,然后用研究结束能力分数进行三角化.
主要成果:
- 只有27.8%的SP实现了合规标准,而暴露提供是一个主要的挑战.
- 辅导并没有显著改善坚持,但在特定技能领域提高了竞争力.
- 便利化增加了缓慢响应的学校的坚持,但没有影响能力.
结论:
- 很大一部分专业医生很难达到CBT遵守基准.
- 辅导可能更有效地提高SP的CBT技能,而便利化则有助于遵守.
- 辅导和促进的结合很可能是必要的,以建立一个有能力的学校心理健康工作人员.
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