Lost in translation? Moving contingency management and cognitive behavioral therapy into clinical practice.
Lost in translation? Moving contingency management and cognitive behavioral therapy into clinical practice.
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DOI：
10.1111/nyas.12501
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发表时间：
2014-10
影响因子：
5.2
通讯作者：
Carroll KM
中科院分区：
文献类型：
--
作者：
Carroll KM
在成瘾治疗方面，循证疗法的可用性与其在实践中的有限实施之间的差距尚未弥合。两个经验验证的行为疗法，应急管理（CM）和认知行为疗法（CBT），克服了这一挑战。两者都有相对较强的经验支持，但在临床实践中的采用程度较弱且不均匀。本综述重点介绍了如何在实践中实施的障碍，系统地解决的例子，使用行为疗法发展的阶段模型作为一个组织框架。对于CM，通过开发低成本和其他适应措施来解决成本和意识形态等障碍，使其更有利于社区。对于CBT，通过转换为标准化的计算机辅助版本，可以作为临床医生的扩展，解决了相对复杂性，缺乏训练有素的提供者和需要监督等障碍。虽然这些和其他修改使这两种干预措施更容易传播，但创新的传播仍然是一个复杂的，往往是不可预测的过程。现有的专业成瘾治疗系统可能需要进行重大改革，以全面实施CBT和CM，特别是更加注重可定义的治疗目标和基于绩效的结果。
In the treatment of addictions, the gap between the availability of evidence-based therapies and their limited implementation in practice has not yet been bridged. Two empirically validated behavioral therapies, contingency management (CM) and cognitive behavioral therapy (CBT), exemplify this challenge. Both have a relatively strong level of empirical support but each has weak and uneven adoption in clinical practice. This review highlights examples of how barriers to their implementation in practice have been addressed systematically, using the Stage Model of Behavioral Therapies Development as an organizing framework. For CM, barriers such as cost and ideology have been addressed through the development of lower-cost and other adaptations to make it more community-friendly. For CBT, barriers such as relative complexity, lack of trained providers and need for supervision have been addressed via conversion to standardized computer-assisted versions that can serve as clinician extenders. Although these and other modifications have rendered both interventions more disseminable, diffusion of innovation remains a complex, often unpredictable process. The existing specialty addiction treatment system may require significant reforms to fully implement CBT and CM, particularly greater focus on definable treatment goals and performance-based outcomes.
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影响因子：
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