Implementing Cognitive Behavioral Therapy in the real world: A case study of two mental health centers
Implementing Cognitive Behavioral Therapy in the real world: A case study of two mental health centers
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DOI：
10.1186/1748-5908-3-14
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发表时间：
2008-02-29
影响因子：
7.2
通讯作者：
Burns, Barbara J.
中科院分区：
文献类型：
--
作者：
Kramer, Teresa L.;Burns, Barbara J.
背景：美国儿童和青少年的行为健康服务。S.缺乏可获得性、可用性和质量。基于证据的干预情绪和行为障碍，可以提高质量，但很少有研究系统地研究其实施在常规care setting.Methods：使用定量和定性数据，我们评估了多方面的实施策略，实施认知行为疗法（CBT）为抑郁症青少年到两个公共资助的精神卫生保健中心。在研究的持续时间和变量影响implementationwere explored.Results的实施程度：35名临床医生有资格参加，25（71%）被随机分为干预（n = 11）或常规护理（n = 14）。9名干预临床医生完成了CBT培训。16名青少年与6名干预临床医生一起参加了CBT;其中一半接受了至少6次CBT手动会话。CBT的采用和持续使用的多重障碍，确定临床医生在定性interviews.Conclusion：战略，以实施循证干预到常规的临床设置，应包括多方法，实施前的临床环境评估，并解决多个障碍，最初的摄取以及长期的可持续性。
Background: Behavioral health services for children and adolescents in the U. S. are lacking in accessibility, availability and quality. Evidence-based interventions for emotional and behavioral disorders can improve quality, yet few studies have systematically examined their implementation in routine care settings.Methods: Using quantitative and qualitative data, we evaluated a multi-faceted implementation strategy to implement cognitive-behavioral therapy (CBT) for depressed adolescents into two publicly-funded mental healthcare centers. Extent of implementation during the study's duration and variables influencing implementation were explored.Results: Of the 35 clinicians eligible to participate, 25 (71%) were randomized into intervention (n = 11) or usual care (n = 14). Nine intervention clinicians completed the CBT training. Sixteen adolescents were enrolled in CBT with six of the intervention clinicians; half of these received at least six CBT manually-based sessions. Multiple barriers to CBT adoption and sustained use were identified by clinicians in qualitative interviews.Conclusion: Strategies to implement evidence-based interventions into routine clinical settings should include multi-method, pre-implementation assessments of the clinical environment and address multiple barriers to initial uptake as well as long-term sustainability.