A brief family intervention for depression in primary care
Published online on December 26, 2016
Abstract
This study tested the feasibility and outcomes of a brief psychoeducational intervention for family members of depressed veterans in primary care. Family members of veterans enrolled in TIDES, a VA collaborative care programme for depression in primary care, were invited to participate. High enrolment rates, high treatment retention and completion, and high levels of satisfaction with the intervention indicate that the programme is feasible and acceptable to family members. Veterans showed a decrease in depression severity, improvements in symptom and occupational global functioning, and an increase in general life satisfaction. Family members' attitudes about antidepressant medication use became more positive, and their knowledge of depression increased. There were no changes in behavioural activation or in family functioning. Overall, family members and clinical staff rated the intervention very positively. Staff members did note some obstacles to implementation and made suggestions to overcome identified obstacles.
Practitioner points
The use of Motivational Interviewing was an important contributor to generating interest in the family programme
Family members involved in depression treatment evidence gains in positive attitudes towards medication use and an increased knowledge of depression
Systematic training and ongoing contact with clinicians are key factors in improving their confidence and skills in working with families and increasing their commitment to implementing the intervention
基层医疗对抑郁症的简短家庭干预
本研究测试了在基层医疗中实行一项针对抑郁退伍军人家属的简短的心理教育干预的可行性和结果。参与了TIDES(退伍军人事务部的抑郁合作照料基层医疗项目)的退伍军人家属受邀参加。干预的高参与率、高治疗维持率和完成率以及高满意度显示, 该项目是可行的、被家属接受的。退伍军人表现出抑郁严重程度降低、症状及整体职业功能的改善和普遍生活满意度的提升。家属关于使用抗抑郁药的态度变得更加积极, 且他们关于抑郁症的知识增加了。行为激活和家庭功能方面没有变化。总体来说, 家属和临床人员对此项干预都有非常积极的评价。工作人员也注意到了一些实施方面的障碍, 并提出了克服已知障碍的建议。
对实务工作者的启示
激励性访谈的运用是激发对家庭项目的兴趣的重要因素
参加抑郁治疗的家属显示出对于药物使用的积极性增加和对于抑郁症知识的增加
系统性培训和与临床医师持续的接触对于增强他们的自信、提升他们与家庭工作的技巧、增强他们实施干预的决心的关键因素
关键词:家庭治疗;抑郁症;基层医疗;退伍军人