作为一个人,我只是扮演了更多的角色。心理治疗师为患有抑郁症的疗养院居民提供心理治疗的经验。

Laura Carlotta Nagel,Natalie Baumeister,Tanja Müller,Ulrich Stangier
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引用次数: 0

摘要

背景与目标疗养院缺乏心理治疗的原因可能是组织障碍,也可能是从业人员对这一患者群体和环境持保留态度。本研究旨在通过定性探讨心理治疗师为疗养院中被诊断患有抑郁症的居民提供认知行为疗法(CBT)的经验,为实践提供参考。研究设计与方法对在 DAVOS 项目(疗养院中的抑郁症:改善治疗的群组随机阶梯式合作病例管理方法)中提供治疗的六名心理治疗师进行了系统的结构化访谈,并对访谈内容进行了记录和转录,然后采用演绎-归纳内容分析法对访谈内容进行了分析、结果治疗师遇到了各种困难,包括实际问题(如多专业合作)和生存问题(如面对自己的死亡)。参与者表示,通过在 DAVOS 项目中的工作,他们纠正了对老年人(需要照顾)的一些刻板印象。然而,在他们的报告中仍有老年歧视的证据。在访谈中,对老年患者有丰富经验的心理治疗师更多地探讨了生存问题,而新手治疗师则倾向于更多地关注实际困难。讨论与启示为确保在疗养院更有效地实施心理治疗,似乎有必要解决促进跨学科合作、无干扰治疗室和远程辅助治疗的重要环境因素。此外,还需要提供更多针对特定环境的培训、有关死亡和自杀的有针对性的监督,以及针对年龄和老年人在养老院中的刻板形象的干预措施。
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I simply have more of a role as a human being. Psychotherapists' Experience Delivering Psychotherapy to Nursing Home Residents with Depression.
BACKGROUND AND OBJECTIVES The lack of psychotherapy in nursing homes can be explained by organisational obstacles but also by practitioners' reservations about this patient group and setting. This study aimed to inform practice by qualitatively exploring the experiences of psychotherapists delivering cognitive behavioural therapy (CBT) to residents of nursing homes diagnosed with depression. RESEARCH DESIGN AND METHODS Semi-structured interviews with six psychotherapists, who had delivered treatment within the DAVOS project (Depression in the nursing home: a cluster-randomized stepped-wedge collaborative case management approach to improve treatment) were recorded, transcribed, and analysed using a deductive-inductive content analysis. RESULTS Therapists experienced various difficulties, including practical (e.g., multi-professional collaboration) and existential issues (e.g., confrontation with their own mortality). Participants described correcting some stereotypical images of older people (in need of care) through their work within the DAVOS project. However, evidence of ageism was still included in their reports. In the interviews, psychotherapists more experienced with older patients addressed more existential issues, whereas more novice therapists tended to focus more on practical difficulties. DISCUSSION AND IMPLICATIONS To ensure a more effective implementation of psychotherapeutic treatment in nursing homes, it appears necessary to address important contextual factors that facilitate interdisciplinary collaboration, interference free treatment rooms and tele-assisted sessions. Further, more setting-specific training, targeted supervision regarding death and suicide, and interventions that address stereotypical images of age and older people in residential care are needed.
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