Therapist competence in global mental health: Development of the ENhancing Assessment of Common Therapeutic factors (ENACT) rating scale
Therapist competence in global mental health: Development of the ENhancing Assessment of Common Therapeutic factors (ENACT) rating scale
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DOI：
10.1016/j.brat.2015.03.009
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发表时间：
2015-06-01
影响因子：
4.1
通讯作者：
Patel, Vikram
中科院分区：
文献类型：
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作者：
Kohrt, Brandon A.;Jordans, Mark J. D.;Patel, Vikram
缺乏可靠和有效的治疗师能力的措施是一个障碍，传播和实施心理治疗在全球精神卫生。我们开发了增强常见治疗因素评估（ENACT）评级量表，用于在不同文化和获得心理健康资源的环境中进行培训和监督。我们在尼泊尔采用了四步流程：（1）项目生成：我们从56个现有工具中提取了1081个项目（分为104个领域）;与尼泊尔治疗师的角色扮演生成了11个额外的领域。(2)项目相关性：从115个领域中，尼泊尔治疗师选择了49个治疗重要性和高度可理解性的领域。(3)道具效用：我们通过对角色扮演录像带、患者会话记录以及初级保健工作者在心理治疗和心理健康差距行动计划（mhGAP）培训中的现场观察，对ENACT量表进行了试点。(4)专家（组内相关系数，ICC（2，7）= 0.88（95%置信区间（CI）0.81-0.93），N = 7）和非专家（ICC（1，3）0.67（95% CI 0.60-0.73），N = 34）的评估者间可靠性可接受。总而言之，ENACT量表是对心理治疗中常见因素的18项评估，包括与跨文化背景的非专家共享任务的举措。需要进一步的研究来评估治疗质量的应用以及与患者结局的关联。2015作者爱思唯尔有限公司出版
Lack of reliable and valid measures of therapist competence is a barrier to dissemination and implementation of psychological treatments in global mental health. We developed the ENhancing Assessment of Common Therapeutic factors (ENACT) rating scale for training and supervision across settings varied by culture and access to mental health resources. We employed a four-step process in Nepal: (1) Item generation: We extracted 1081 items (grouped into 104 domains) from 56 existing tools; role-plays with Nepali therapists generated 11 additional domains. (2) Item relevance: From the 115 domains, Nepali therapists selected 49 domains of therapeutic importance and high comprehensibility. (3) Item utility: We piloted the ENACT scale through rating role-play videotapes, patient session transcripts, and live observations of primary care workers in trainings for psychological treatments and the Mental Health Gap Action Programme (mhGAP). (4) Inter-rater reliability was acceptable for experts (intraclass correlation coefficient, ICC(2,7) = 0.88 (95% confidence interval (CI) 0.81-0.93), N = 7) and non-specialists (ICC(1,3) 0.67 (95% CI 0.60-0.73), N = 34). In sum, the ENACT scale is an 18-item assessment for common factors in psychological treatments, including task-sharing initiatives with non-specialists across cultural settings. Further research is needed to evaluate applications for therapy quality and association with patient outcomes. 2015 The Authors. Published by Elsevier Ltd.