Using modular psychotherapy in school mental health: provider perspectives on intervention-setting fit.
Using modular psychotherapy in school mental health: provider perspectives on intervention-setting fit.
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DOI：
10.1080/15374416.2013.843460
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
McCauley E
中科院分区：
文献类型：
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作者：
Lyon AR;Ludwig K;Romano E;Koltracht J;Vander Stoep A;McCauley E
在常规护理环境中，经过充分研究的干预措施的“适宜性”或适当性是成功实施新做法的最常被引用但很少被研究的因素之一。本研究旨在解决两个探索性研究问题：(1)临床医生如何描述他们目前的学校心理健康服务提供环境？(2)临床医生如何描述模块化心理治疗与多层次学校心理健康服务提供环境之间的契合度？在为期一年的以证据为基础的模块化心理治疗方法的培训和咨询计划之后，对17名学校心理健康提供者进行了半结构化定性访谈，以评估他们对在学校健康中心系统内实施该方法的适当性的看法。使用传统的和直接的内容分析，采访被转录和编码为主题。研究结果确定了学校心理健康环境的关键要素，包括临床医生的特征、他们的实践、学校环境和服务接受者。对干预设置适当性的具体评估在临床医生和客户层面引发了许多关于实践和基于价值（例如，文化考虑）方面的评论，但在学校或组织层面的评论较少。结果表明，模块化方法可以很好地适应学校心理健康服务环境，特别是在适当性的实际方面。建议今后的研究集中于发展在执行过程的不同阶段例行评估适当性的方法。
The “fit” or appropriateness of well-researched interventions within usual care contexts is among the most commonly-cited, but infrequently researched, factors in the successful implementation of new practices. The current study was initiated to address two exploratory research questions: (1) How do clinicians describe their current school mental health service delivery context? and (2) How do clinicians describe the fit between modular psychotherapy and multiple levels of the school mental health service delivery context? Following a year-long training and consultation program in an evidence-based, modular approach to psychotherapy, semi-structured qualitative interviews were conducted with seventeen school-based mental health providers to evaluate their perspectives on the appropriateness of implementing the approach within a system of school-based health centers. Interviews were transcribed and coded for themes using conventional and directed content analysis. Findings identified key elements of the school mental health context including characteristics of the clinicians, their practices, the school context, and the service recipients. Specific evaluation of intervention-setting appropriateness elicited many comments about both practical and value-based (e.g., cultural considerations) aspects at the clinician and client levels, but fewer comments at the school or organizational levels. Results suggest that a modular approach may fit well with the school mental health service context, especially along practical aspects of appropriateness. Future research focused on the development of methods for routinely assessing appropriateness at different stages of the implementation process is recommended.