Health services research · 2025
Use of Cognitive-Behavioral Therapy in a Nation-Wide Veterans Health Administration Sample: The Role of Clinic, Therapist, and Patient Factors.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
McGuire Alan, Flanagan Mindy, Stout Madison E, Coffing Jessica, Kukla Marina, Traylor Morgan, Myers Laura, Henry Nancy, Carter Jessica, Matthias Marianne
Аннотация
OBJECTIVE: To examine the use of CBT-CP (Cognitive-behavioral therapy for chronic pain) by CBT-CP-trained therapists to treat patients with pain over a five-year period (October 2015-February 2020).
DATA SOURCES AND STUDY SETTING: CBT-CP is a core evidence-based practice that is central to multidisciplinary chronic pain care. However, research suggests that CBT-CP is underused. The current study used national Veterans Health Administration data to examine the use of CBT-CP by CBT-CP-trained therapists to treat patients with pain over a five-year period.
STUDY DESIGN: Multilevel modeling was used to evaluate clinic, therapist, and patient-level factors as predictors of CBT-CP receipt.
DATA COLLECTION: Administrative data on 37,514 patients seen at a national sample of Veterans Health Administration locations for pain were collected from the U.S. Veterans Health Administration central data repository.
PRINCIPAL FINDINGS: Results indicated 38.4% of patients with pain seen by a CBT-CP-trained therapist received CBT-CP during the observation period. Patients were more likely to receive CBT-CP if more time elapsed since their therapist received CBT-CP training and if their therapist had a master's degree (vs. a doctorate). Patients with somatic symptom disorder and depressive disorders were more likely to receive CBT-CP, while patients with comorbid personality disorders or substance use disorders were less likely to receive CBT-CP. Patients seen in pain specialty, PTSD, biomedical, and mental health clinics were more likely to receive CBT-CP than those not seen in these clinics.
CONCLUSIONS: Findings suggest that the reach of CBT-CP is substantively related to factors at each level. Future research is needed to better understand the therapy treatment decision-making processes and to address education gaps and other factors that impede the implementation of evidence-based practices.
DATA SOURCES AND STUDY SETTING: CBT-CP is a core evidence-based practice that is central to multidisciplinary chronic pain care. However, research suggests that CBT-CP is underused. The current study used national Veterans Health Administration data to examine the use of CBT-CP by CBT-CP-trained therapists to treat patients with pain over a five-year period.
STUDY DESIGN: Multilevel modeling was used to evaluate clinic, therapist, and patient-level factors as predictors of CBT-CP receipt.
DATA COLLECTION: Administrative data on 37,514 patients seen at a national sample of Veterans Health Administration locations for pain were collected from the U.S. Veterans Health Administration central data repository.
PRINCIPAL FINDINGS: Results indicated 38.4% of patients with pain seen by a CBT-CP-trained therapist received CBT-CP during the observation period. Patients were more likely to receive CBT-CP if more time elapsed since their therapist received CBT-CP training and if their therapist had a master's degree (vs. a doctorate). Patients with somatic symptom disorder and depressive disorders were more likely to receive CBT-CP, while patients with comorbid personality disorders or substance use disorders were less likely to receive CBT-CP. Patients seen in pain specialty, PTSD, biomedical, and mental health clinics were more likely to receive CBT-CP than those not seen in these clinics.
CONCLUSIONS: Findings suggest that the reach of CBT-CP is substantively related to factors at each level. Future research is needed to better understand the therapy treatment decision-making processes and to address education gaps and other factors that impede the implementation of evidence-based practices.