Implementing therapist-guided internet-delivered cognitive behaviour therapy for obsessive–compulsive disorder in the UK’s IAPT programme: A pilot trial

IF 3.8 3区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Clinical Psychology Pub Date : 2022-03-22 DOI:10.1111/bjc.12365

Oskar Flygare, Lina Lundström, Erik Andersson, David Mataix-Cols, Christian Rück

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引用次数: 1

Abstract

Objectives

Digital therapies such as internet-delivered cognitive behaviour therapy (ICBT) can improve treatment access for patients with common mental disorders, but are rarely used in the Improving Access to Psychological Therapies (IAPT) programme in the United Kingdom. The objective of this study was to evaluate an evidence-based ICBT intervention for obsessive-compulsive disorder (OCD-NET) in three IAPT services in an open trial.

Methods

Consecutively referred patients with a primary diagnosis of OCD (n = 474) were offered OCD-NET. Symptoms of OCD, depression, anxiety, and level of functioning were measured weekly throughout treatment.

Results

In the full intention to treat sample (n = 474), the intervention was associated with large reductions in self-reported OCD symptoms (d = 1.77), anxiety (d = 1.55) and depression (d = 0.8), as well as improvements in functional impairment (d = 0.51 to 0.72). Further, 35% of participants were in recovery at their last assessment, 25% achieved reliable improvement and 15% met criteria for both recovery and improvement. Among participants completing at least 4 modules (n = 261), corresponding to an adequate ‘dose’ of treatment, the rates of recovery (44%), reliable improvement (34%) and reliable recovery (21%) were higher. A majority of participants were satisfied with the online treatment and found the online materials helpful.

Conclusions

OCD-NET is an effective treatment when delivered in regular care within the IAPT system. Challenges associated with implementing ICBT in regular health care are discussed.

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在英国的IAPT项目中实施治疗师指导的网络认知行为治疗强迫症:一项试点试验

数字疗法，如互联网提供的认知行为疗法(ICBT)可以改善普通精神障碍患者的治疗可及性，但很少用于英国的改善心理治疗可及性(IAPT)项目。本研究的目的是在一项公开试验中评估三家IAPT服务机构对强迫症(OCD-NET)的循证ICBT干预。方法对474例首发诊断为强迫症的转诊患者进行OCD- net治疗。在整个治疗过程中，每周测量强迫症症状、抑郁、焦虑和功能水平。在完全意向治疗样本(n = 474)中，干预与自我报告的强迫症症状(d = 1.77)、焦虑(d = 1.55)和抑郁(d = 0.8)的大幅减少以及功能障碍的改善(d = 0.51至0.72)相关。此外，35%的参与者在最后一次评估中恢复，25%达到可靠的改善，15%达到恢复和改善的标准。在完成至少4个模块(n = 261)的参与者中，相应于适当的“剂量”治疗，恢复率(44%)，可靠改善(34%)和可靠恢复(21%)更高。大多数参与者对在线治疗感到满意，并认为在线材料很有帮助。结论在IAPT系统内的常规护理中，OCD-NET是一种有效的治疗方法。讨论了在常规卫生保健中实施ICBT所面临的挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British Journal of Clinical Psychology PSYCHOLOGY, CLINICAL-

CiteScore

5.80

自引率

3.20%

发文量

期刊介绍： The British Journal of Clinical Psychology publishes original research, both empirical and theoretical, on all aspects of clinical psychology: - clinical and abnormal psychology featuring descriptive or experimental studies - aetiology, assessment and treatment of the whole range of psychological disorders irrespective of age group and setting - biological influences on individual behaviour - studies of psychological interventions and treatment on individuals, dyads, families and groups