Implementation of group cognitive processing therapy in correction centers: Anticipated determinants from formative evaluation.
Implementation of group cognitive processing therapy in correction centers: Anticipated determinants from formative evaluation.
复制标题
在惩教中心实施团体认知处理疗法：形成性评估的预期决定因素。
DOI：
10.1002/jts.22898
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发表时间：
2023
影响因子：
3.3
通讯作者：
Kirchner,JoAnnE
中科院分区：
文献类型：
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作者：
Zielinski,MelissaJ;Allison,MKathryn;Smith,MolleeKSteely;Curran,Geoffrey;Kaysen,Debra;Kirchner,JoAnnE
几乎所有监狱里的人都经历过创伤，其中许多人符合创伤后应激障碍（PTSD）的标准。未经治疗的PTSD增加了释放后物质使用问题的风险，导致创伤，成瘾和监禁的良好记录循环。然而，基于证据的，以创伤为中心的创伤后应激障碍治疗很少在监狱中提供，并且很少有研究可以指导实施工作。为了准备一项有效性-实施混合II试点试验，检查监狱中的小组交付认知加工疗法（CPT），我们根据实施研究的统一框架（即，CFIR）。参与者是矫正中心的领导，治疗人员，卫生保健人员和安全人员（n= 22）和被监禁的人（n= 14; 57.1%的女性）。我们发现CPT与居民的需求和中心的可用资源、文化、现有项目和当前工作流程高度兼容。防止酷刑和其他残忍、不人道或有辱人格的待遇或处罚委员会也为所有利益攸关方所接受。潜在的障碍是CPT的相对优先级较低，与在系统层面得到加强的计划相比，有限的工作人员时间来提供CPT，有限的工作人员对PTSD的知识，以及中心的功能，可能会分散CPT组和/或培训或反治疗。总之，CPT是一种很有前途的创伤矫正治疗，但这些研究结果强调了识别和匹配潜在障碍的重要性，以有效的实施策略先验和工作在政策竞技场，以促进可持续性。
Nearly all people in prison have experienced trauma, and many meet the criteria for posttraumatic stress disorder (PTSD). Untreated PTSD increases the risk of substance use problems after release, contributing to a well‐documented cycle of trauma, addiction, and incarceration. However, evidence‐based, trauma‐focused therapy for PTSD is rarely offered in prisons, and there is little research that can guide implementation efforts. In preparation for an effectiveness–implementation hybrid II pilot trial examining group‐delivered cognitive processing therapy (CPT) in prisons, we conducted a formative evaluation using interviews structured according to the consolidated framework for implementation research (i.e., CFIR). Participants were correction center leadership, treatment staff, health care staff, and security staff (n= 22) and incarcerated persons (n= 14; 57.1% female). We found that CPT was highly compatible with residents’ needs and the centers’ available resources, culture, existing programs, and current workflow. CPT was also acceptable to all stakeholders. Potential barriers were the lower relative priority for CPT compared with programs that are reinforced at the system level, limited staff time to deliver CPT, limited staff knowledge about PTSD, and center features that could distract from CPT groups and/or training or be countertherapeutic. Taken together, CPT is a promising trauma‐focused therapy for corrections, but these findings underscore the importance of identifying and matching potential barriers to effective implementation strategies a priori and work in the policy arena to promote sustainability.