部分住院儿童和青少年统一协议:使用实施科学框架指导适应

IF 2.9 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Cognitive and Behavioral Practice Pub Date : 2023-08-01 DOI:10.1016/j.cbpra.2022.04.006
Sarah M. Kennedy, Daniel P. Wilkie, Lauren Henry, Jami Moe-Hartman, Kayin President, Kaila Townson, Laura G. Anthony, Jessica L. Hawks
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引用次数: 0

摘要

越来越普遍的部分住院治疗计划和其他急性心理健康治疗计划可能有助于将儿童和青少年从住院精神病护理中转移出来,并为生活在资源匮乏地区的个人提供集中剂量的干预。然而,关于PHP在解决青少年情绪问题(如焦虑、抑郁、易怒)和功能损伤方面的有效性的研究相对较少。此外,最初设计以门诊每周形式提供的循证治疗可能需要进行重大调整,以适合在急性心理健康环境中提供,这与每周门诊护理在项目结构、患者敏锐度和人员配备方面有很大不同。在这份干预发展和适应报告中,我们提出了将治疗情绪障碍的跨诊断方法——《儿童和青少年情绪障碍跨诊断治疗统一协议》(UP-C/a)——用于基于医院的一般精神病部分住院计划的基本原理。我们使用实施科学框架来描述我们对治疗适应和测试的迭代方法,并详细描述在最初实施和试点测试之前对部分住院的UP-C/A进行的积极、有计划的适应。提供了三个案例(儿童、青春期前和青少年),以说明如何在急性心理健康环境中密集使用UP-C/a等跨诊断护理方法来解决情绪和行为问题,包括安全问题。
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The Unified Protocols for Children and Adolescents in Partial Hospitalization: Using Implementation Science Frameworks to Guide Adaptation

Partial hospitalization programs (PHPs) and other acute mental health treatment programs, which are becoming increasingly common, may help divert children and adolescents from inpatient psychiatric care and provide a concentrated dose of intervention to individuals living in low-resource areas. However, there have been relatively few examinations of the effectiveness of PHPs in addressing emotional concerns (e.g., anxiety, depression, irritability) and functional impairment in youth. Further, evidence-based treatments originally designed for delivery in an outpatient weekly format may require significant adaptation to be appropriate for delivery in acute mental health settings, which differ significantly from weekly outpatient care in program structure, patient acuity, and staffing. In this intervention development and adaptation report, we present the rationale for adapting a transdiagnostic approach to treating emotional disorders—the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A)—for a hospital-based, general psychiatric partial hospitalization program. We use implementation science frameworks to describe our iterative approach to treatment adaptation and testing and to describe in detail proactive, planned adaptations to the UP-C/A for partial hospitalization that occurred prior to initial implementation and pilot testing. Three case examples (child, preadolescent, adolescent) are presented to illustrate how a transdiagnostic approach to care such as the UP-C/A can be used intensively in an acute mental health setting to address emotional and behavioral concerns, including safety.

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来源期刊
Cognitive and Behavioral Practice
Cognitive and Behavioral Practice PSYCHOLOGY, CLINICAL-
CiteScore
4.80
自引率
3.40%
发文量
118
审稿时长
84 days
期刊介绍: Cognitive and Behavioral Practice is a quarterly international journal that serves an enduring resource for empirically informed methods of clinical practice. Its mission is to bridge the gap between published research and the actual clinical practice of cognitive behavior therapy. Cognitive and Behavioral Practice publishes clinically rich accounts of innovative assessment and diagnostic and therapeutic procedures that are clearly grounded in empirical research. A focus on application and implementation of procedures is maintained.
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