tailieunhanh - báo cáo khoa học: " Employing external facilitation to implement cognitive behavioral therapy in VA clinics: a pilot study"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Employing external facilitation to implement cognitive behavioral therapy in VA clinics: a pilot study | Kauth et al. Implementation Science 2010 5 75 http content 5 1 75 Implementation Science IMPLEMENTATION SCIENCE RESEARCH ARTICLE Open Access Employing external facilitation to implement cognitive behavioral therapy in VA clinics a pilot study h z h -s I D IX -s I I b h 1 2 3 c r Cl 1111 1 4 5 D I i r1 4 5 I XX fTr XX A I 111 1 2 3 6 D r- I rd r I -5 V rd r- c4 5 fR 3 A i KYt c 3 I z d1 4 5 Michael R Kauth Greer Sullivan Dean Blevins Jeffrey A Cully Reid D Lannes Qayyim said Thomas A Teasdale1 7 8 Abstract Background Although for more than a decade healthcare systems have attempted to provide evidence-based mental health treatments the availability and use of psychotherapies remains low. A significant need exists to identify simple but effective implementation strategies to adopt complex practices within complex systems of care. Emerging evidence suggests that facilitation may be an effective integrative implementation strategy for adoption of complex practices. The current pilot examined the use of external facilitation for adoption of cognitive behavioral therapy CBT in 20 Department of Veteran Affairs VA clinics. Methods The 20 clinics were paired on facility characteristics and 23 clinicians from these were trained in CBT. A clinic in each pair was randomly selected to receive external facilitation. Quantitative methods were used to examine the extent of CBT implementation in 10 clinics that received external facilitation compared with 10 clinics that did not and to better understand the relationship between individual providers characteristics and attitudes and their CBT use. Costs of external facilitation were assessed by tracking the time spent by the facilitator and therapists in activities related to implementing CBT. Qualitative methods were used to explore contextual and other factors thought to influence implementation. Results Examination of change scores showed that facilitated therapists averaged an increase of 19 95 CI 2