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국가 차원의 근거-기반 심리서비스 제도의 필요성

Need for the Nationwide Evidence-based Psychotherapy Policy

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주제분류심리과학

초록

대한민국 국민의 30%가량은 우울 및 불안, 트라우마에 노출되고 있다. 이는 낮은 삶의 질, 사회적 고립의 심화, 생산성의 하락, 높은 사회경제적 부담을 초래하며, 세계 최고의 자살률과 최저 출생률의 요인이 되었다. 우울증과 같은 경증-중증도 정신건강 문제에 가장 효과적인 것으로 알려진 개입은, 과학적으로 검증된 치료를 전문적인 서비스 제공자가 국민의 필요에 맞도록 제공하는 근거-기반 실천(evidence based practice, EBP)이다. 국내의 심리서비스 현황을 서비스 대상자, 제공자 및 서비스의 내용으로 분석한 결과 여러 가지 이유로 근거-기반 심리서비스가 제공되지 못하고 있었다. 본 논문에서는 근거-기반 실천을 소개한 후 근거-기반의 심리서비스를 지역사회 정신건강 정책에 활용한 영국과 노르웨이의 사례를 탐색하였으며, 국가 차원의 근거-기반 심리서비스 제공을 위한 제도의 필요성을 강조하며 향후 정책 방향을 제시하였다.

Abstract

The prevalence of depression, anxiety, suicidality, and trauma remains notably high among the Korean population. This situation seriously impacts the quality of life, productivity, and social connectedness while exacerbating socioeconomic burden, leading to the world’s lowest fertility rate and highest suicide risks. Evidence-based practice (EBP) provides research-supported treatments tailored to the client’s needs by the clinician with expertise, efficacy of which is widely acknowledged in addressing these mild to moderate mental health issues. However, access to evidence-based psychological services in South Korea is severely limited. This paper introduces evidence-based practice as a foundational element for psychological services and conducts a comparative analysis of evidence-based psychotherapy policies in the United Kingdom and Norway. Finally, it underscores the urgency of implementing evidence-based practice for the entire Korean population. and proposes a blueprint for policies governing psychological services.

참고문헌 (62)

  1. (2022)[URL]
  2. "법정부 재난심리지원 안내" (2022), 국가트라우마센터[URL]
  3. "“1시간에 10만원, 우울증 상담해드려요”...상담자격증 반나절이면취득?" (2023)[URL]
  4. "행복한 삶, 건강한 사회를 위한 정신건강 종합대책" (2016), 관계부처 합동[URL]
  5. "“무료 심리상담 해드려요” 그럴 듯 포장해 사이비 포교" (2023)[URL]
  6. 정신질환의 사회경제적 비용에관한 연구: 정신질환에 대한 근거기반심리치료의 경제적 타당성 분석을 중심으로, "김태종", 국민경제자문회의, ~ (2023)
  7. "트라우마 상담 95% 종결..유족한테 청소년 상담사를?" (2023)[URL]
  8. "제2차 정신건강복지기본계획(2021~2025)" (2021), 보건복지부 정신건강정책과[URL]
  9. "2023년 지역사회서비스 투자사업 안내" (2023), 보건복지부[URL]
  10. "서울시 고립․은둔 청년 실태조사" (2023), 서울시[URL]
  11. "심리상담 1시간에 10만원?...더 마음 상하기전 알아야 할 4가지" (2023)[URL]
  12. 이상훈, "The Mental Health Workforce in Korea: Current State and Policy Implications", 보건복지포럼, 2020(4), pp.43~54 (2020), 한국보건사회연구원[DOI]
  13. "(기획보도)저출산과 우리 사회의 변화" (2023), 통계청[URL]
  14. "코로나19국민 정신건강 실태조사" (2022), 한국트라우마스트레스학회[URL]
  15. 건강보장정책 수립을 위한 주요 질병의 사회경제적 비용 분석, "현경래", 국민건강보험공단 건강보험정책연구원, ~ (2017)
  16. Ghazi I. Al Jowf, "To Predict, Prevent, and Manage Post-Traumatic Stress Disorder (PTSD): A Review of Pathophysiology, Treatment, and Biomarkers", International Journal of Molecular Sciences, 24(6), pp.5238~ (2023), MDPI AG[DOI]
  17. APA Presidential Task Force on Evidence-Based Practice, "Evidence-based practice in psychology", American Psychologist, 61(4), pp.271~285 (2006), American Psychological Association (APA)[DOI]
  18. Borwin Bandelow, "Treatment of anxiety disorders", Dialogues in Clinical Neuroscience, 19(2), pp.93~107 (2017), Informa UK Limited[DOI]
  19. Michael Barkham, "Person-centred experiential therapy versus cognitive behavioural therapy delivered in the English Improving Access to Psychological Therapies service for the treatment of moderate or severe depression (PRaCTICED): a pragmatic, randomised, non-inferiority trial", The Lancet Psychiatry, 8(6), pp.487~499 (2021), Elsevier BV[DOI]
  20. "Black, Asian and Minority Ethnic service user positive practice guide 2019" (2019)[URL]
  21. Edward Chesney, "Risks of all-cause and suicide mortality in mental disorders: a meta-review", World Psychiatry, 13(2), pp.153~160 (2014), Wiley[DOI]
  22. 최진영, "OECD 회원국 심리사 제도를 활용한 대한민국 정신건강 체계 효과성 제고 방안", 한국심리학회지:일반, 41(3), pp.221~242 (2022), 한국심리학회[DOI]
  23. David M. Clark, "Realizing the Mass Public Benefit of Evidence-Based Psychological Therapies: The IAPT Program", Annual Review of Clinical Psychology, 14(1), pp.159~183 (2018), Annual Reviews[DOI]
  24. "The ISTSS expert consensus treatment guidelines for complex PTSD in adults" (2012)[URL]
  25. "Psychological therapies"[URL]
  26. Afsana Faheem, "‘Not a cure, but helpful’-exploring the suitability of evidence-based psychological interventions to the needs of Black, Asian and Minority Ethnic (BAME)communities", The Cognitive Behaviour Therapist, 16 (2023), Cambridge University Press (CUP)[DOI]
  27. Peter Fonagy, "The outcome of psychodynamic psychotherapy for psychological disorders", Clinical Neuroscience Research, 4(5-6), pp.367~377 (2005), Elsevier BV[DOI]
  28. Jonathan Gruber, "The impact of mental health support for the chronically ill on hospital utilisation: Evidence from the UK", Social Science & Medicine, 294, pp.114675~ (2022), Elsevier BV[DOI]
  29. Leslie S. Greenberg, "A guide to conducting a task analysis of psychotherapeutic change", Psychotherapy Research, 17(1), pp.15~30 (2007), Informa UK Limited[DOI]
  30. Alex Gyani, "Enhancing recovery rates: Lessons from year one of IAPT", Behaviour Research and Therapy, 51(9), pp.597~606 (2013), Elsevier BV[DOI]
  31. Hewlett, E., "Making Mental Health Count: The Social and Economic Costs of Neglecting Mental Health Care, OECD Health Policy Studies" (2014), OECD Publishing
  32. Steven D. Hollon, "Enduring Effects for Cognitive Behavior Therapy in the Treatment of Depression and Anxiety", Annual Review of Psychology, 57(1), pp.285~315 (2006), Annual Reviews[DOI]
  33. 홍은택, "국내 심리서비스 관련 민간자격 현황 연구", 한국심리학회지: 임상심리 연구와 실제, 9(3), pp.481~505 (2023), 한국임상심리학회
  34. Hee Sun Kim, "Regulations governing psychologists: An international survey.", Professional Psychology: Research and Practice, 53(6), pp.541~552 (2022), American Psychological Association (APA)[DOI]
  35. Marit Knapstad, "Effectiveness of Prompt Mental Health Care, the Norwegian Version of Improving Access to Psychological Therapies: A Randomized Controlled Trial", Psychotherapy and Psychosomatics, 89(2), pp.90~105 (2019), S. Karger AG[DOI]
  36. Michael J. Lambert, "Outcome in psychotherapy: The past and important advances.", Psychotherapy, 50(1), pp.42~51 (2013), American Psychological Association (APA)[DOI]
  37. "The depression report: a new deal for depression and anxiety disorders" (2006)[URL]
  38. R. Layard, "Cost-benefit analysis of psychological therapy", National Institute Economic Review, 202, pp.90~98 (2007), Cambridge University Press (CUP)[DOI]
  39. Layard, R., "Thrive: Power of Evidence-Based Psychological Therapies" (2014), Penguin UK
  40. Hyeon-Seung Lee, "Deterioration of mental health despite successful control of the COVID-19 pandemic in South Korea.", Psychiatry Research, 295, pp.113570~ (2021), Elsevier BV[DOI]
  41. 이연주, "정신건강전문요원의 역할에 대한 정신건강증진시설 현장의 요구: 대안적 임상심리 자격 제도에 대한 필요성", 한국심리학회지: 임상심리 연구와 실제, 9(3), pp.563~586 (2023), 한국임상심리학회
  42. R. Kathryn McHugh, "Patient Preference for Psychological vs Pharmacologic Treatment of Psychiatric Disorders", The Journal of Clinical Psychiatry, 74(06), pp.595~602 (2013), Physicians Postgraduate Press, Inc[DOI]
  43. 임민경, "근거기반실천과 심리치료", 한국심리학회지:일반, 32(1), pp.251~270 (2013), 한국심리학회
  44. "RPH-håndboka: anbefalinger basert på nasjonale retningslinjer og ti års erfaringer med rask psykisk helsehjelp" (2022)[URL]
  45. "The improving access to psychological therapies manual" (2018)[URL]
  46. "Depression: management of depression in primary and secondary care, Clinical Guideline 23" (2004)[URL]
  47. "Anxiety: Management of Anxiety (panic disorder, with or without agoraphobia, and Generalised Anxiety Disorder) in Adults in Primary, Secondary and Community Care-Quick Reference Guide, Clinical Guideline22" (2004)[URL]
  48. "Korea’s increase in suicides and psychiatric bed numbers is worrying, says OECD" (2014)[URL]
  49. OECD, "Health at a Glance: Europe 2016: State of Health in the EU Cycle" (2018), OCED Publishing
  50. OECD, "Tackling the mental health impact of the COVID-19 crisis: An integrated, whole-of-society response" (2021), OECD Publishing
  51. OECD, "A New Benchmark for Mental Health Systems: Tackling the Social and Economic Costs of Mental Ill-Health" (2021), OECD Publishing
  52. "Health Status (Edition 2022)" (2023)[URL]
  53. Lars-Göran Öst, "Cognitive behavior therapy for adult anxiety disorders in routine clinical care: A systematic review and meta-analysis.", Clinical Psychology: Science and Practice, 30(3), pp.272~290 (2023), American Psychological Association (APA)[DOI]
  54. Lawrence T. Park, "Depression in the Primary Care Setting", New England Journal of Medicine, 380(6), pp.559~568 (2019), Massachusetts Medical Society[DOI]
  55. David A. Richards, "Improving access to psychological therapies: Phase IV prospective cohort study", British Journal of Clinical Psychology, 48(4), pp.377~396 (2009), Wiley[DOI]
  56. Rob Saunders, "Latent variable mixture modelling and individual treatment prediction", Behaviour Research and Therapy, 124, pp.103505~ (2020), Elsevier BV[DOI]
  57. Veronica Toffolutti, "The employment and mental health impact of integrated Improving Access to Psychological Therapies: Evidence on secondary health care utilization from a pragmatic trial in three English counties", Journal of Health Services Research & Policy, 26(4), pp.224~233 (2021), SAGE Publications[DOI]
  58. David F. Tolin, "Is cognitive–behavioral therapy more effective than other therapies?A meta-analytic review", Clinical Psychology Review, 30(6), pp.710~720 (2010), Elsevier BV[DOI]
  59. F. A. Torvik, "Diagnostic and genetic overlap of three common mental disorders in structured interviews and health registries", Acta Psychiatrica Scandinavica, 137(1), pp.54~64 (2017), Wiley[DOI]
  60. Nicola J Wiles, "Long-term effectiveness and cost-effectiveness of cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: follow-up of the CoBalT randomised controlled trial", The Lancet Psychiatry, 3(2), pp.137~144 (2016), Elsevier BV[DOI]
  61. 유득권, "한국의 공공 정신건강서비스 현황 및 심리사법안의 방향성 고찰", 한국심리학회지: 임상심리 연구와 실제, 9(3), pp.507~533 (2023), 한국임상심리학회

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