Brief, modular, transdiagnostic, cognitive-behavioral intervention for anxiety in veteran primary care: Development, provider feedback, and open trial.
Brief, modular, transdiagnostic, cognitive-behavioral intervention for anxiety in veteran primary care: Development, provider feedback, and open trial.
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DOI：
10.1037/ser0000622
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发表时间：
2023-08
影响因子：
2.3
通讯作者：
Maisto, Stephen A.
中科院分区：
文献类型：
--
作者：
Shepardson, Robyn L.;Funderburk, Jennifer S.;Weisberg, Risa B.;Maisto, Stephen A.
焦虑在初级保健中治疗不足，大多数治疗是药物治疗而不是行为治疗。使用初级保健行为健康（PCBH）模式整合行为健康提供者（BHP）可以帮助解决这一治疗差距，但需要适用于PCBH实践的简短干预措施。我们开发了一个模块化的，认知行为焦虑干预，模块化焦虑技能培训（MAST），这是以证据为基础的，transdiagnosis，可行的PCBH，以病人为中心。MAST包括六个30分钟的课程，强调技能培训。本文介绍了MAST的基本原理和发展，以及试点工作，在退伍军人健康管理局（VA），以定制和完善MAST提供给退伍军人在VA初级保健（MAST-V），以提高可行性VA BHP和可接受的退伍军人。我们使用了一个收敛的混合方法设计与并发数据收集。在第一阶段，我们采访了五位BHP，以获得对治疗手册的反馈。BHP评估MAST-V与PCBH高度兼容，并提供了增强可行性的建议。在第二阶段，我们进行了一项开放试验，其中六名经历临床显著焦虑的退伍军人收到并提供了所有九个可能模块的反馈;我们还评估了心理健康症状和功能的变化以及治疗满意度和可信度。退伍军人发现MAST-V是高度可接受的，并且临床前后结果非常有希望，具有较大的效应量。这项初步试验的结果为MAST-V的可行性、可接受性和有效性提供了初步支持，并建议进行进一步的随机临床试验。
Anxiety is undertreated in primary care, and most treatment provided is pharmacological rather than behavioral. Integrating behavioral health providers (BHPs) using the Primary Care Behavioral Health (PCBH) model can help address this treatment gap, but brief interventions suitable for use in PCBH practice are needed. We developed a modular, cognitive-behavioral anxiety intervention, Modular Anxiety Skills Training (MAST), that is evidence-based, transdiagnostic, feasible for PCBH, and patient-centered. MAST comprises up to six 30-minute sessions emphasizing skills training. This article describes the rationale for and development of MAST as well as pilot work in the Veterans Health Administration (VA) to tailor and refine MAST for delivery to Veterans in VA primary care (MAST-V) to improve feasibility for VA BHPs and acceptability to Veterans. We used a convergent mixed methods design with concurrent data collection. In phase one, we interviewed five BHPs to obtain feedback on the treatment manual. BHPs assessed MAST-V to be highly compatible with PCBH and provided suggestions to enhance feasibility. In phase two, we conducted an open trial in which six Veterans experiencing clinically significant anxiety received and provided feedback on all nine possible modules; we also assessed changes in mental health symptoms and functioning as well as treatment satisfaction and credibility. Veterans found MAST-V to be highly acceptable, and pre-post clinical outcomes were very promising with large effect sizes. Findings from this initial pilot provide preliminary support for the feasibility, acceptability, and efficacy of MAST-V and suggest further research with a randomized clinical trial is warranted.
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影响因子：
5.8
作者：
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通讯作者：
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DOI：
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