Access to best-evidenced mental health support for care-experienced young people: Learnings from the implementation of cognitive therapy for PTSD.

Autor: McGuire R; Division of Psychology & Language Sciences, UCL, London, UK., Meiser-Stedman R; Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK., Smith P; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK., Schmidt D; Division of Psychology & Language Sciences, UCL, London, UK., Bjornstad G; University of Exeter Medical School, University of Exeter, Exeter, UK., Bosworth R; Norfolk & Suffolk NHS Trust, Norwich, UK., Clarke T; Norfolk & Suffolk NHS Trust, Norwich, UK., Coombes J; University of Exeter Medical School, University of Exeter, Exeter, UK., Geijer Simpson E; Population Health Sciences Institute, University of Newcastle, Newcastle, UK., Hudson K; Improvement Academy, NIHR ARC Yorkshire & Humber, Bradford Teaching Hospitals NHS Trust, Bradford, UK., Oliveira P; Anna Freud National Centre for Children & Families, London, UK., Macleod J; NIHR School for Primary Care, University of Bristol, Bristol, UK., McGovern R; Population Health Sciences Institute, University of Newcastle, Newcastle, UK., Stallard P; Department of Health, University of Bath, Bath, UK., Wood K; University of Exeter Medical School, University of Exeter, Exeter, UK., Hiller RM; Division of Psychology & Language Sciences, UCL, London, UK.; Anna Freud National Centre for Children & Families, London, UK.
Jazyk: angličtina
Zdroj: The British journal of clinical psychology [Br J Clin Psychol] 2024 Jul 16. Date of Electronic Publication: 2024 Jul 16.
DOI: 10.1111/bjc.12471
Abstrakt: Objectives: Rates of PTSD are up to 12 times higher in care-experienced young people (CEYP) compared to their peers. Trauma-focused CBTs (tf-CBT) are the best-evidenced treatment for youth with PTSD, yet, in practice, CEYP often struggle to access this treatment. We worked alongside services to understand barriers and facilitators of the implementation of cognitive therapy for PTSD (a type of tf-CBT) to CEYP.
Design: This was an active, open implementation trial.
Methods: We recruited 28 mental health teams across England, including general CAMHS, targeted CAMHS for CEYP and social care-based teams. From these teams, participants were 243 mental health professionals, from a wide variety of professional backgrounds. Following recruitment/intervention training, teams participated in rolling three monthly focus groups and individual interviews, to understand what helped and hindered implementation. Data were analysed using a framework analysis conducted using CFIR 2.0.
Results: Almost half of the teams were able to implement, but only approximately one quarter with CEYP, specifically. Universal barriers that were discussed by almost all teams particularly highlighted service structures and poor resourcing as major barriers to delivery to CEYP, as well as the complexities of the young person and their network. Unique factors that differentiated teams who did and did not implement included commissioning practices, the culture of the team, leadership engagement and style, and the development of supervision structures.
Conclusions: Findings offer key considerations for mental health teams, service leads, commissioners and policy-makers to enhance delivery of best-evidenced mental health treatments like CT-PTSD, for CEYP.
(© 2024 The Author(s). British Journal of Clinical Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)
Databáze: MEDLINE
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