Adapting psychotherapy in collaborative care for treating opioid use disorder and co-occurring psychiatric conditions in primary care.
Adapting psychotherapy in collaborative care for treating opioid use disorder and co-occurring psychiatric conditions in primary care.
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在协作护理中采用心理治疗，治疗阿片类药物使用障碍和初级护理中并发的精神疾病。
DOI：
10.1037/fsh0000791
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Newman,
中科院分区：
文献类型：
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作者：
French,Rachel;Worley,Julie;Lowenstein,Margaret;Bogner,HillaryR;Calderbank,Tara;DePhilippis,Dominick;Forrest,Andrew;ConnollyGibbons,MaryBeth;Harris,RebeccaArden;Heywood,Saida;Kampman,Kyle;Mandell,DavidS;McKay,JamesR;Newman,
阿片类药物使用障碍(OUD)和精神疾病通常是同时发生的，但很少用循证治疗方法进行治疗，导致结果很差。这些情况分别对治疗的开始、保留和成功构成了挑战。当个体有精神疾病时，这些挑战就变得更加复杂。方法认识到这些个体的复杂需求，护理上的差距，以及初级保健弥合这些差距的潜力，我们开发了一个心理治疗计划，在合作护理模式(CoCM)的传统元素的基础上，整合了针对药物使用、抑郁和焦虑的简短、循证的心理治疗。在这篇文章中，我们描述了这一初级保健环境中的心理治疗计划，作为协作服务纲要的一部分。结果患者接受了最多12次循证心理治疗和病例管理，其基础是一份结构化的治疗手册，该手册通过动机增强指导治疗；针对抑郁、焦虑和/或物质使用障碍的认知行为治疗；和/或行为激活组件。讨论新的，需要综合治疗来促进对有精神障碍和精神疾病的个人的服务提供，这些计划必须得到严格的评估。我们将我们的团队在一个大型初级保健网络中测试我们的心理治疗计划的努力描述为正在进行的三臂随机对照试验的一部分。(心理信息数据库记录(C)2023 APA，保留所有权利)
IntroductionOpioid use disorder (OUD) and psychiatric conditions commonly co-occur yet are infrequently treated with evidence-based therapeutic approaches, resulting in poor outcomes. These conditions, separately, present challenges to treatment initiation, retention, and success. These challenges are compounded when individuals have OUD and psychiatric conditions.MethodRecognizing the complex needs of these individuals, gaps in care, and the potential for primary care to bridge these gaps, we developed a psychotherapy program that integrates brief, evidence-based psychotherapies for substance use, depression, and anxiety, building on traditional elements of the Collaborative Care Model (CoCM). In this article, we describe this psychotherapy program in a primary care setting as part of a compendium of collaborative services.ResultsPatients receive up to 12 sessions of evidence-based psychotherapy and case management based on a structured treatment manual that guides treatment via Motivational Enhancement; Cognitive Behavioral Therapies for depression, anxiety, and/or substance use disorder; and/or Behavioral Activation components.DiscussionNovel, integrated treatments are needed to advance service delivery for individuals with OUD and psychiatric conditions and these programs must be rigorously evaluated. We describe our team’s efforts to test our psychotherapy program in a large primary care network as part of an ongoing three-arm randomized controlled trial.(PsycInfo Database Record (c) 2023 APA, all rights reserved)