Team Functioning in School Mental Health Teams Implementing CBT

学校心理健康团队的运作 实施 CBT

• 批准号: 8718493
• 负责人: Courtney Lynn Benjamin Wolk
• 金额: $ 5.6万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-01 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8718493
• 关键词: Address; Area; Attention; Attitude; Behavior; Child; Climate; Cognitive Therapy; Collaborations; Communication; Communities; Consultations; Contracts; Disruptive Behavior Disorder; Evidence based practice; Failure; Funding; Goals; Healthcare; Inpatients; Lead; Leadership; Learning; Licensure; Literature; Medical; Medical Care Team; Mental Health; Mental Health Services; Mentorship; Methods; Modeling; Monitor; Outcome; Participant; Patients; Perception; Performance; Persons; Philadelphia; Readiness; Request for Applications; Research; Schools; Science; Scientist; Services; System; Testing; Therapeutic; Training; Work; Youth; base; behavioral health; design; evidence base; heuristics; implementation research; implementation science; improved; member; neglect; organizational climate; patient safety; public health relevance; skills; tool

PROJECT SUMMARY/ABSTRACT Children obtain more mental health services through schools than through any other public system or agency. In Philadelphia, similar to many other urban school districts, school-based mental health care often is provided by school therapeutic support (STS) teams. The Philadelphia STS model, a common school-based mental health model, shares features with community mental health team models. In an effort to improve STS services in Philadelphia, the Philadelphia Department of Behavioral Health has contracted with the Beck Initiative to provide lead clinicians with extensive training and consultation in the broad application of cognitive- behavioral therapy (CBT), including for disruptive behavior disorders. STS clinicians may struggle to implement CBT due in part to challenges obtaining support from other members of the STS team. Current training models focus on EBP training for clinicians and neglect the functioning of the teams they operate within. This overall lack of attention to the broader team system may be contributing to failure to use EBPs in schools, as training alone has been shown to be insufficient. Participants for the proposed study will be drawn from STS teams in the Philadelphia community mental health network. In collaboration with stakeholders, Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS"), an evidence-based approach for improving team functioning in health care settings, will be adapted for use with school mental health teams. Second, the adapted TeamSTEPPS" will be pilot tested. Feasibility and acceptability of the adapted TeamSTEPPS" approach, as well as the impact of the approach on team skills and behavior, will be assessed. Teams of STS paraprofessionals and clinicians in two schools participating in an ongoing implementation of CBT in Philadelphia will receive the adapted TeamSTEPPS" approach, to be compared with two schools in which the lead clinicians receive CBT training as usual without TeamSTEPPS". Mixed methods will be used to examine contextual predictors of implementation, such as implementation climate, organizational readiness for change and attitudes toward teamwork in STS teams and their relationship to feasibility and acceptability. This project extends our understanding of strategies to improve EBP implementation among school-based mental health care teams and has broader implications for mental health treatment teams in other settings such as community mental health. The proposed research will coincide with advanced training opportunities and mentorship to develop expertise in implementation science.

项目总结/摘要 儿童通过学校获得的心理健康服务比通过任何其他公共系统或 社在费城，与许多其他城市学区类似，以学校为基础的精神卫生保健往往是 由学校治疗支援队提供。费城STS模式，一种基于学校的 心理健康模型与社区心理健康团队模型具有共同特征。为了改善STS 在费城的服务中，费城行为健康部与贝克签订了合同， 主动为主要临床医生提供广泛的认知应用培训和咨询， 行为疗法（CBT），包括破坏性行为障碍。STS临床医生可能难以实施 CBT部分原因是从STS团队的其他成员那里获得支持的挑战。目前的培训模式 专注于临床医生的EBP培训，而忽视了他们所在团队的运作。这一总体 缺乏对更广泛的团队系统的关注可能是导致学校未能使用EBP的原因， 单靠这些是不够的。建议研究的参与者将来自 费城社区心理健康网络与利益相关者合作，团队战略和 提高绩效和患者安全的工具（TeamSTEPPS），一种基于证据的方法， 改进保健机构中的团队运作，将适用于学校心理健康团队。 第二，将对经过调整的TeamSTEPPS”进行试点测试。适应的可行性和可接受性 TeamSTEPPS”方法，以及该方法对团队技能和行为的影响， 评估。两所学校的STS辅助专业人员和临床医生团队正在参与一项 在费城实施CBT将采用经过调整的TeamSTEPPS方法， 有两所学校的首席临床医生在没有TeamSTEPPS的情况下照常接受CBT培训。混合 方法将被用来检查执行的上下文预测，如执行气候， STS团队的组织变革准备和对团队合作的态度，以及他们与 可行性和可接受性。这个项目扩展了我们对提高EBP策略的理解 在学校心理健康护理团队中实施，并对心理健康产生更广泛的影响 在社区精神卫生等其他环境中的治疗团队。这项研究计划将与 高级培训机会和指导，以发展执行科学方面的专门知识。