A Systematic Review and Narrative Synthesis Examining the Facilitators and Barriers of Psychological Intervention Delivery in Crisis Resolution Home Treatment Teams

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL Clinical psychology & psychotherapy Pub Date : 2024-08-07 DOI:10.1002/cpp.3032

Haleemah Ahmed, Caroline Bendall, Faiza Anwar, Mariam Al-Janabi, Lisa Wood

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Abstract

Background

Mental health crisis rates in the United Kingdom are on the rise. The emergence of community mental health models, such as Crisis Resolution Home Treatment Teams (CRHTTs), offers a vital pathway to provide intensive assessment and treatment to individuals in their homes, including psychological interventions. Previous qualitative literature has identified facilitators and barriers to the implementation of psychological interventions within CRHTT settings; however, a synthesis of this literature has not yet been conducted. To address this gap, a systematic review was undertaken with the aim of identifying the reported facilitators and barriers of implementing evidence-based psychological interventions in CRHTTs.

Method

A systematic review and narrative synthesis were conducted. Studies were included if they examined the implementation of evidence-based psychological interventions in a CRHTT setting. The study population had to be 18 and over and could include healthcare professionals working in CRHTTs, service users of CRHTTs, or family and carers of CRHTT service users. Studies of any formal research methodology were included. Four databases were searched (MEDLINE, CINAHL Plus, Embase and PsycINFO), along with Google Scholar, to identify eligible studies.

Results

Six studies were identified, using mixed qualitative and quantitative methodologies, with the predominant focus being the exploration of stakeholder perspectives on care implementation within CRHTTs, encompassing aspects including but not restricted to psychological care implementation. The literature was deemed to be of moderate to high quality. Facilitators included adapting psychological therapies, prioritizing the therapeutic relationship, increasing psychological skills and training of CRHTT staff and psychologically informed CRHTT models. The barriers identified included a medical model bias within teams, resource constraints and elements pertaining to CRHTT services.

Conclusions

Further robust research in this area is imperative. We recommend that future research be implemented in the form of service evaluations and randomized controlled trials (RCTs) and that the principles of implementation science be used to assess and develop the evidence base for psychological intervention delivery in CRHTTs.

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系统性回顾和叙事综述：研究危机解决家庭治疗小组提供心理干预的促进因素和障碍。

背景：英国的心理健康危机率呈上升趋势。社区心理健康模式的出现，如危机解决家庭治疗小组（CRHTTs），为在家中为个人提供强化评估和治疗（包括心理干预）提供了重要途径。以前的定性文献已经确定了在 CRHTT 环境中实施心理干预的促进因素和障碍；但是，尚未对这些文献进行综合。为了填补这一空白，我们开展了一项系统性综述，旨在确定所报道的在 CRHTTs 中实施循证心理干预的促进因素和障碍：方法：进行了系统性综述和叙述性综合。只要研究了在 CRHTT 环境中实施循证心理干预的情况，均被纳入研究范围。研究对象必须年满 18 岁，可以包括在 CRHTT 工作的医护人员、CRHTT 的服务使用者或 CRHTT 服务使用者的家人和照顾者。采用任何正式研究方法的研究均包括在内。我们检索了四个数据库（MEDLINE、CINAHL Plus、Embase 和 PsycINFO）以及 Google Scholar，以确定符合条件的研究：结果：共确定了六项研究，采用定性和定量混合方法，主要重点是探讨利益相关者对 CRHTTs 护理实施的看法，包括但不限于心理护理实施等方面。这些文献被认为具有中等至较高的质量。促进因素包括调整心理疗法、优先考虑治疗关系、提高 CRHTT 工作人员的心理技能和培训以及以心理为基础的 CRHTT 模式。所发现的障碍包括团队内部对医疗模式的偏见、资源限制以及与 CRHTT 服务有关的因素：当务之急是在这一领域开展进一步的有力研究。我们建议，未来的研究应以服务评估和随机对照试验（RCT）的形式进行，并采用实施科学的原则来评估和发展 CRHTT 心理干预的证据基础。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.