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Symptom targeted intervention (STI) is a therapeutic model and clinical program that social workers and other mental health practitioners and medical professionals can use to assist patients with chronic diseases who are having difficulty coping, including those suffering from emotional distress, depression, anxiety, poor engagement and poor clinical outcomes. Using STI, the clinician helps the patient identify the most problematic symptom of the depression (such as depressed mood, insomnia, anxiety, rumination, irritability, negative thinking, social isolation), then together the clinician and patient address that symptom using STI’s evidence-based selection of brief cognitive, behavioral, and mindfulness techniques. The emphasis is on keeping interactions brief since mental health treatment in the primary care setting is typically time limited—although the Collaborative Care and Integrated Care models provides hope for improved and expanded mental health services in the primary care setting. STI's unique engagement process ensures that even challenging, at-risk, and non-adherent patients are likely to participate. As patients learn better coping skills, they become more engaged with their treatment and more adherent to doctors’ recommendations. ==Origins== STI was created in 2009 by licensed clinical social worker (LCSW) Melissa McCool to give clinicians a toolkit for helping depressed patients who cannot or will not seek outpatient psychotherapy. McCool originally developed STI for patients with end-stage renal disease (ESRD). Patients with ESRD and other chronic diseases often suffer from depression and it often goes undiagnosed. Studies suggest that at least 25% of dialysis patients have clinical depression and at least 35% have symptoms that put them at risk for depression. Additionally, for a variety of reasons, patients who are suffering mentally and physically from depression often go untreated. Social workers using STI with ESRD patients have reported promising outcomes.〔Dziegielewski, Sophia F. (2013). (''The changing face of health care social work: Opportunities and challenges for professional practice'' ), p. 243. New York: Springer Publishing Company. ISBN 978-0-8261-1942-1〕 The intellectual premise for STI is based on systems theory, which considers a system as a set of interacting and independent parts. If depression is a system consisting of various symptoms, when one of the symptoms improves, the entire trajectory of the depressive episode is transformed. In this sense, STI is related to Bowen’s systemic theory and its interactional dynamics. Using STI, the patient and clinician focus on one element, or symptom, helping the patient avoid feeling overwhelmed by multiple problems. The parallel process is also in effect: Clinicians may be similarly overwhelmed by attempting to tackle multiple symptoms in their depressed patients. Also central to STI is the cognitive triangle, which illustrates how one’s thoughts, feelings, and behaviors are all interconnected and dependent upon one another. If a behavior changes, thoughts and feelings change; if a thought changes, behaviors and feelings change. STI has been expanded beyond ESRD to support the many patients who are suffering from depression who receive treatment for chronic disease in outpatient clinics, hospitals, nursing homes or rehabilitation centers. Kaiser Permanente is now using STI as the main treatment modality in its Collaborative Care study.〔Johnstone, Stephanie (2013). ("Helping patients manage treatment recommendations". ) ''Renal Business Today'': 3.〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Symptom targeted intervention」の詳細全文を読む スポンサード リンク
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