Psychological therapies are highly effective interventions for a range of mental health conditions and often preferred by many patients over medication. Unfortunately, most people who could benefit from these therapies do not receive them. This is true even in the United States, which enjoys relatively high numbers of mental health professionals. The lack of access is further compounded by structural inequities, such as income, geography, and race. The low and inequitable access to one of the most effective interventions for mental health conditions is, arguably, one of the most significant barriers to addressing the growing burden of mental health conditions globally. There are several reasons which might contribute to this inequity, notably the historical reliance on complex treatment protocols designed in settings which serve a nonrepresentative group of persons with mental health problems and, consequently, an emphasis on specialist providers and in-person protocols. These factors lead to long and expensive training, variable quality of delivery, and enhanced costs and challenges to patient engagement. In contrast to medication, the lack of a commercial incentive to promote psychological therapies means that there are no market forces which fuel their scaling up. Given there will never be enough psychologists to serve the large unmet and growing mental health needs in the population, we consider stepped and collaborative models that leverage the range of expertise offered by diverse providers, to offer a pathway to scale up a person-centered approach for psychological treatments. In this article, we highlight three innovations that address some barriers and the potential roles of clinical psychologists to broaden the reach of psychological therapies. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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心理治疗的民主化：创新和心理学家的作用。

心理治疗是针对一系列心理健康状况的高效干预措施，通常比药物治疗更受许多患者的青睐。不幸的是，大多数可以从这些疗法中受益的人并没有接受这些疗法。即使在心理健康专业人员数量相对较多的美国也是如此。收入、地理位置和种族等结构性不平等进一步加剧了缺乏机会的情况。可以说，对心理健康状况最有效的干预措施之一的获取机会少且不公平，是解决全球日益增长的心理健康状况负担的最重要障碍之一。有几个原因可能会导致这种不平等，特别是历史上对复杂治疗方案的依赖，这些方案是在为具有精神健康问题的非代表性群体提供服务的环境中设计的，因此强调了专家提供者和面对面的方案。这些因素导致培训时间长且费用昂贵、交付质量参差不齐、成本增加以及患者参与面临的挑战。与药物治疗相比，缺乏推广心理治疗的商业激励意味着没有市场力量来推动其规模扩大。鉴于永远不会有足够的心理学家来满足人们大量未满足和不断增长的心理健康需求，我们考虑采用阶梯式协作模型，利用不同提供者提供的专业知识，提供一条扩大以人为本的方法的途径用于心理治疗。在本文中，我们重点介绍了解决一些障碍的三项创新，以及临床心理学家在扩大心理治疗范围方面的潜在作用。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。