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首页> 美国卫生研究院文献>Schizophrenia Bulletin >SU132. Adopting Technology and a Stepped Care Approach to Advance the Implementation of Cognitive Behavioral Therapy for Psychosis (CBTp) in Community Mental Health Settings: Introducing the CBTp Project Echo Clinic
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SU132. Adopting Technology and a Stepped Care Approach to Advance the Implementation of Cognitive Behavioral Therapy for Psychosis (CBTp) in Community Mental Health Settings: Introducing the CBTp Project Echo Clinic

机译：SU132。采用技术和分步护理方法以促进在社区心理健康环境中对精神病（CBTp）进行认知行为疗法的实施：介绍CBTp项目回声诊所

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>Background: Despite national guidelines recommending CBT for psychosis (CBTp) as standard of care for individuals with psychotic disorders (Dixon et al, 2009), CBTp remains under-implemented in the United States, as fewer than 0.1% of mental health care workers in the United States are competent in the intervention (Mueser and Noordsy, 2005; Mueser, 2015). Since 2014, investigators at the University of Washington have implemented a CBTp workforce development initiative, which has led to the certification of 60 clinicians in CBTp. >Methods: This presentation will describe 2 implementation model enhancements designed to improve uptake and sustainment of CBTp at community mental health agencies: (1) a stepped care approach to CBTp implementation and service delivery and (2) adaptation of a biomedical telehealth consultation platform. >Results: Stepped care approaches have been appropriated for psychological therapies as a way of bridging the significant gap between the demand for evidence-based care and the available supply (Bower and Gilbody, 2005). As applied to CBTp, the stepped care model engages mental health providers with a spectrum of skills and abilities in varying levels of CBTp interventions, which are then administered based on clients’ needs and preferences. To accomplish the goal of broadening the reach of CBTp implementation while simultaneously enhancing engagement and learning strategies, a platform called Project ECHO (Extension for Community Healthcare Outcomes) was adopted to connect Washington State mental health clinicians—particularly those in rural areas—with expertise in evidence-based care for individuals with psychosis. Project ECHO is a service delivery and outcomes research collaboration aimed at building professional capacity to improve health care for underserved populations with the most challenging health problems (Arora et al, 2011). Video interface facilitates iterative guided practice and regular didactics, enabling clinicians to build proficiency in CBTp more quickly, resulting in both enhanced clinical outcomes and localized and self-sustaining expertise. >Conclusion: The empirical rationale for each of these enhancements will be provided, and preliminary implementation data will be reported on 2 large, multisite community mental health agencies in Washington State.
机译：>背景：尽管国家指南建议将CBT用于精神病（CBTp）作为治疗精神病患者的标准（Dixon等，2009），但CBTp在美国仍未得到充分实施，少于0.1美国有％的精神卫生工作者有能力进行干预（Mueser and Noordsy，2005; Mueser，2015）。自2014年以来，华盛顿大学的研究人员实施了CBTp劳动力发展计划，该计划已使60名CBTp临床医生获得了认证。 >方法：本演示文稿将介绍2种实施模型增强功能，旨在改善社区精神卫生机构对CBTp的吸收和维持：（1）CBTp实施和服务提供的分步护理方法，以及（2）适应CBTp的方法生物医学远程医疗咨询平台。 >结果：阶梯式护理已被用于心理治疗，以弥合对循证护理的需求与可用医疗之间的巨大差距（Bower和Gilbody，2005年）。在应用于CBTp的过程中，阶梯式护理模型使精神卫生保健提供者具有不同水平的CBTp干预措施中的各种技能和能力，然后根据客户的需求和偏好进行管理。为了实现扩大CBTp实施范围并同时提高参与度和学习策略的目标，采用了一个名为ECHO项目（社区医疗保健成果扩展）的平台，以将华盛顿州的精神卫生临床医生（尤其是农村地区的临床医生）与精神病患者的循证护理。 ECHO项目是一项服务提供和成果研究合作，旨在建立专业能力来改善服务水平最高，健康问题最棘手的人群的医疗服务（Arora等，2011）。视频界面有助于反复指导实践和常规教学，使临床医生能够更快地建立CBTp的水平，从而提高临床效果以及本地化和自我维持的专业知识。 >结论：将提供每种增强功能的经验依据，并将在华盛顿州的两个大型，多站点社区精神卫生机构中报告初步实施数据。

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