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首页> 外文期刊>The American psychologist >The Occasional Case Against Broad Dissemination and Implementation Retaining a Role for Specialty Care in the Delivery of Psychological Treatments
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The Occasional Case Against Broad Dissemination and Implementation Retaining a Role for Specialty Care in the Delivery of Psychological Treatments

机译：反对广泛传播和实施的偶尔情况在心理治疗的提供中仍保留特殊护理的作用

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Mental illness imposes a staggering public health burden in the United States. Although the past 40 years have witnessed tremendous advances in the identification of evidence-based practices (EBPs) in psychological treatments, gaps persist between treatment in experimental settings and services available in the community. In response, considerable attention and large financial commitments have focused in recent years on broad dissemination and implementation efforts designed to improve the quality of psychological services delivered by a variety of generalist practitioners across practice settings. Increasingly, under the influence of the Patient Protection and Affordable Care Act, it is envisioned that these generalists will practice in integrated primary care settings. These advances hold enormous potential, and yet, given the tremendous diversity of mental health problems and human suffering, broad dissemination and implementation efforts to generalists alone may not be sufficient to adequately address the burden of mental illness. Some EBPs may prove too complex for universal dissemination, and the time and expense required for quality dissemination and implementation preclude large-scale training in the treatment of low base rate disorders. As dissemination and implementation efforts work to ensure a quality generalist mental health care workforce, herein we highlight the vital need for available specialty care in the delivery of psychological treatments. Given traditional barriers that interfere with the accessibility of specialty care, we propose the transformative potential of a specialty behavioral telehealth care, workforce, transacting with the generalist practitioner workforce to collectively ensure the highest qudlity and timely delivery of needed treatments to affected individuals.
机译：精神疾病在美国造成了惊人的公共健康负担。尽管在过去40年中，在心理治疗的循证实践（EBP）识别方面取得了巨大进步，但实验环境中的治疗与社区提供的服务之间仍然存在差距。作为响应，近年来，相当多的关注和大量的财务承诺集中在广泛的传播和实施上，这些努力旨在提高在实践环境中各种通才医生提供的心理服务的质量。越来越多地，在《患者保护和负担得起的医疗法案》的影响下，可以预见这些通才将在综合的初级医疗机构中执业。这些进步具有巨大的潜力，但是，鉴于精神健康问题和人类苦难的千差万别，仅对通才的广泛传播和实施努力可能不足以充分解决精神疾病的负担。某些EBP可能证明对于普遍传播而言过于复杂，并且质量传播和实施所需的时间和费用使得无法进行大规模培训以治疗低基频疾病。随着传播和实施工作的努力，以确保高质量的精神卫生保健工作人员的素质，在此我们强调在提供心理治疗方面对可用专科治疗的迫切需求。考虑到传统障碍妨碍了专科护理的可及性，我们提出了具有特殊行为的远程医疗保健，员工队伍，与通才医生队伍进行交易的变革潜力，以共同确保最高质量并及时向受影响的个人提供所需治疗。

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