目标:受护理的年轻人(即,在儿童福利系统中)是一个经常经历过很高的潜在创伤事件发生率的群体,包括虐待。有据可查,他们有很高的创伤相关的心理健康困难,比如创伤后应激。为了满足大量可能从支持中受益的年轻人的需求,可扩展的干预措施至关重要。但同样重要的是,它们是有效和可交付的-特别是考虑到该组和服务的复杂性。我们评估了基于CBT的五节组PTSD干预措施。主要目标是在最终试验之前了解要解决的核心程序和方案不确定性。
方法:参与者为34名10-17岁的患者,有中度到重度的创伤后应激症状,和他们的照顾者。我们跑了七个小组(四个在线),在社会护理和基于NHS的心理健康团队中交付。数据是通过预收集的,post-,3个月的随访问卷和定性访谈。
结果:在分配给干预的34名参与者中,27人(80%)参加了五次会议中的至少三次(大多数参加了全部)。护理人员出勤率较低(50%)。评估措施总体上很好地完成了。定性,大多数参与者对干预持积极态度,许多人报告说在应对等领域有所改善,睡眠,愿意谈论经验。然而,人们担心缺乏持续的支持,鉴于这是对通常有复杂需求的人群的低强度干预.
结论:干预和研究方案对大多数年轻人和护理人员来说是可以接受的。随着修改,未来的最终审判可能是可能的。然而,关键考虑因素包括:如何(以及是否)筛查PTSD;试验设计;以及嵌入高强度支持的选项(例如,通过评估阶梯式护理模式)。
OBJECTIVE: Young people in care (i.e., in the child welfare system) are a group who have often experienced very high rates of potentially traumatic events, including maltreatment. It is well-documented that they have high rates of trauma-related mental health difficulties, such as posttraumatic stress. To address the needs of the large number of young people who may benefit from support, scalable interventions are crucial. But also important is that they are effective and deliverable - particularly given the complexity of this group and services. We assessed a five-session group CBT-based intervention for PTSD. The primary goal was to understand core procedural and protocol uncertainties to address prior to a definitive trial.
METHODS: Participants were 34 10-17 year olds in care, with moderate to severe posttraumatic stress symptoms, and their caregiver. We ran seven groups (four online), delivered in social care and NHS-based mental health teams. Data were collected via pre-, post-, 3-month follow-up questionnaires and qualitative interviews.
RESULTS: Of the 34 participants allocated to the intervention, 27 (80%) attended at least three of the five sessions (most attended all). Caregiver attendance was lower (50%). There was generally good completion of assessment measures. Qualitatively, most participants were positive about the intervention, and many reported improvements in areas such as coping, sleep, and willingness to talk about experiences. However, there were important concerns about the lack of ongoing support, given this was a low-intensity intervention for a group who often had complex needs.
CONCLUSIONS: The intervention and research protocols were acceptable to most young people and carers. With modifications, a future definitive trial would likely be possible. However, key considerations include: how (and whether) to screen for PTSD; the trial design; and the option to embed high-intensity support (e.g., via assessing a stepped-care model).