The Psychologically Informed Practice Consultation Roadmap: A Clinical Implementation Strategy.
The Psychologically Informed Practice Consultation Roadmap: A Clinical Implementation Strategy.
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心理知情实践咨询路线图：临床实施策略。
DOI：
10.1093/ptj/pzad048
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发表时间：
2023
期刊：
影响因子：
3.2
通讯作者：
Ballengee,LindsayA
中科院分区：
文献类型：
--
作者：
Main,ChrisJ;Simon,CoreyB;Beneciuk,JasonM;Greco,CarolM;George,StevenZ;Ballengee,LindsayA
心理知情实践（PiP）包括特别关注康复的社会心理障碍，但研究试验表明，在研究环境之外实施PiP存在重大困难。定性研究确定了在处理护理的社会心理方面的能力和信心问题，倾向于更倾向于处理护理的更机械的方面。在PiP中，评估和管理之间的区别并不明确。对问题的分析是干预的一部分，引导自我管理从患者的初步侦查工作开始，鼓励患者发展成功和相关的行为改变。这需要一种不同的沟通方式和重点，而一些临床医生发现这很难实现。从这个角度来看，提供PiP咨询路线图作为临床实施的指南，以建立治疗关系，发展以患者为中心的沟通，指导有效的疼痛自我管理。这些策略是通过病人学习开车的比喻来说明的，治疗师是驾驶教练，病人是学生司机。为方便起见，路线图分为7个阶段。每个阶段按照推荐的顺序代表临床咨询的各个方面，尽管路线图应被视为具有一定程度灵活性的通用指南，以适应个体差异并优化PiP干预措施。预计经验丰富的PiP临床医生会发现，随着构建模块和咨询风格变得更加熟悉，实施路线图会变得越来越容易。
Psychologically informed practice (PiP) includes a special focus on psychosocial obstacles to recovery, but research trials have revealed significant difficulties in implementing PiP outside of research environments. Qualitative studies have identified problems of both competence and confidence in tackling the psychosocial aspects of care, with a tendency to prefer dealing with the more mechanical aspects of care. In PiP, the distinction between assessment and management is not clear-cut. Analysis of the problem is part of the intervention, and guided self-management begins with the initial detective work by the patient, who is encouraged to develop successful and relevant behavior change. This requires a different style and focus of communication that some clinicians find difficult to enact. In this Perspective, the PiP Consultation Roadmap is offered as a guide for clinical implementation to establish a therapeutic relationship, develop patient-centered communication, and guide effective pain self-management. These strategies are illustrated through the metaphor of the patient learning to drive, with the therapist as a driving instructor and the patient as a student driver. For convenience, the Roadmap is depicted in 7 stages. Each stage represents aspects of the clinical consultation in a recommended order, although the Roadmap should be viewed as a general guide with a degree of flexibility to accommodate individual differences and optimize PiP interventions. It is anticipated that the experienced PiP clinician will find it progressively easier to implement the Roadmap as the building blocks and style of consultation become more familiar.