Initial evaluation of a therapist-supported online cognitive therapy self-help for patients with taboo obsessions

IF 3.8 3区 心理学 Q1 PSYCHOLOGY, CLINICAL
Klara Olofsdotter Lauri, Kristina Aspvall, Ingvill Bagøien Hustad, Karin Malmqvist, Eva Serlachius, David Mataix-Cols, Christian Rück, Volen Ivanov, Erik Andersson
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引用次数: 2

Abstract

Objectives

The current study evaluated the feasibility of an internet-delivered cognitive therapy (I-CT) in a self-help format with minimal therapist support for patients with obsessive–compulsive disorder (OCD) with primary taboo obsessions. Specifically, the aims were to investigate (1) whether participants were able to grasp and apply the internet-delivered cognitive framework to their own situation; (2) whether they had clinically meaningful reductions of OCD symptom severity; and (3) whether reduced negative appraisals (hypothesized mechanism of change in CT) preceded reductions in OCD symptom severity.

Method

Nineteen OCD patients with primary taboo obsessions, recruited from an OCD clinic or self-referrals, received the I-CT intervention for 10 weeks. I-CT did not contain any systematic exposure or response prevention.

Results

Adherence and engagement with the intervention was high. Most participants (n = 13, 68%) understood and successfully applied the cognitive model to their own situation. Within-group analyses showed large reductions in OCD symptom severity at post-treatment (bootstrapped within group d = 1.67 [95% CI; 0.67 to 2.66]) measured with the Yale–Brown Obsessive–Compulsive Scale. The gains were maintained at the 6-month follow-up. Post-hoc analyses revealed that the large reductions in OCD symptom severity were driven by the participants who understood the cognitive model. Reductions in negative appraisals predicted subsequent reductions in OCD symptom severity during treatment.

Conclusion

It is possible to adapt a purely cognitive intervention to a digital guided self-help format and to achieve both cognitive change and meaningful symptom reduction. The results require confirmation in a randomized clinical trial.

Abstract Image

一个治疗师支持的在线认知治疗对禁忌强迫症患者的初步评估
本研究评估了一种自助形式的网络认知疗法(I-CT)的可行性,该疗法对伴有原发性禁忌强迫症(OCD)的患者提供最低限度的治疗师支持。具体而言,目的是调查(1)参与者是否能够掌握和应用互联网传递的认知框架到他们自己的情况;(2)强迫症症状严重程度是否有临床意义的减轻;(3)负面评价的降低(假设的CT变化机制)是否先于强迫症症状严重程度的降低。方法从强迫症门诊或自我转诊的强迫症患者中招募19例原发性禁忌性强迫症患者,对其进行为期10周的I-CT干预。I-CT不包含任何系统的暴露或反应预防。结果对干预的依从性和参与度高。大多数参与者(n = 13,68%)理解并成功地将认知模型应用于自己的情况。组内分析显示,治疗后强迫症症状严重程度显著降低(组内自启动d = 1.67 [95% CI;0.67到2.66]),用耶鲁-布朗强迫症量表测量。在6个月的随访中,这些收益保持不变。事后分析显示,强迫症症状严重程度的大幅降低是由理解认知模型的参与者推动的。负面评价的降低预示着治疗期间强迫症症状严重程度的降低。结论将单纯的认知干预与数字引导自助模式相适应,既能实现认知改变,又能显著减轻症状。这些结果需要在随机临床试验中得到证实。
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来源期刊
CiteScore
5.80
自引率
3.20%
发文量
57
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
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