The Central Role of Relationships With Trauma-Informed Integrated Care for Children and Youth
The Central Role of Relationships With Trauma-Informed Integrated Care for Children and Youth
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DOI：
10.1016/j.acap.2017.01.013
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发表时间：
2017-09-01
影响因子：
3.1
通讯作者：
Wissow, Lawrence S.
中科院分区：
文献类型：
--
作者：
Brown, Jonathan D.;King, Melissa A.;Wissow, Lawrence S.
目的：初级保健在儿童心理健康问题的一级和二级预防中起着至关重要的作用。越来越多的试验表明，初级保健提供者有能力通过将心理健康服务纳入其日常工作并将其工作与心理健康保健系统结合起来，提供具体应对健康社会和情感发展风险的护理。本文描述了各种整合方案的共同要素，这些要素似乎对它们的成功至关重要。方法：叙述性回顾，结合之前3次系统综述的结论。结果：信任，患者与提供者之间以及合作提供者之间的个人关系，是成功的创伤信息整合护理的关键要素。患者提供者关系对于披露敏感问题、让患者参与护理以及设计响应患者个人需求的护理至关重要。对以患者为中心的护理和心理治疗的研究提出了建立和维持这些关系的方法。反过来，提供者关系对于协调各种提供者的工作和解决创伤预防和治疗所需的服务至关重要。这些关系可以在不同的组织结构中形成，但建立它们可能需要员工培训、工作流程的重新设计以及组织结构和目标的支持。结论：在患者提供者、临床站点、系统和政策层面的各种干预措施可以促进关系，并为护理提供基础，能够促进一般的社会和情绪健康，特别是创伤预防和治疗。
OBJECTIVE; Primary care plays an essential role in the primary and secondary prevention of children's mental health problems. A growing series of trials have shown the capacity of primary care providers to deliver care that specifically addresses risks to healthy social and emotional development by incorporating mental health services into their routines and integrating their work with the mental health care system. In this article elements common to various integration schemes that seem essential to their success are described.METHODS: Narrative review, combining conclusions from 3 previous systematic reviews.RESULTS: Trusting, personal relationships between patients and providers, and among collaborating providers, are a critical element of successful trauma-informed integrated care. Patient provider relationships are essential to disclosure of sensitive concerns, to engaging patients in care, and to designing care that is responsive to individual patient needs. Studies of patient-centered care and psychotherapy suggest ways that these relationships can be built and maintained. Provider provider relationships are, in turn, essential to coordinating the work of the range of providers and services needed to address trauma prevention and treatment. These relationships can form within a variety of organizational structures but building them might require staff training, redesign of work flows, and support from organizational structures and goals.CONCLUSIONS: A variety of interventions at the patient provider, clinical site, system, and policy levels can foster relationships and provide the foundation for care capable of addressing promotion of social and emotional well-being in general and trauma prevention and treatment in particular.