Change processes associated with functional improvement in a web-based version of Skills Training in Affective and Interpersonal Regulation (webSTAIR) for trauma-exposed veterans.
Kathryn S Macia, Eve B Carlson, Daniel M Blonigen, Jan Lindsay, Marylène Cloitre
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引用次数: 0
Abstract
Objective: In spite of the evidence that both symptom reduction and functional improvement are important for supporting recovery from trauma, psychotherapy process research has largely focused on mechanisms of symptom reduction. A better understanding of how change occurs in treatments that emphasize functional improvement rather than trauma processing is critical for optimizing effective, patient-centered care.
Method: This study involved secondary analysis of data collected in three multisite trials of a 10-module web-based version of Skills Training in Affective and Interpersonal Regulation, a skills-focused transdiagnostic intervention. The sample included 314 trauma-exposed veterans (38% male; 64% non-Hispanic White) who screened positive for elevated symptoms of posttraumatic stress disorder and/or depression. Latent change score modeling examined prospective relationships between changes from pre-to-mid and mid-to-post treatment in four potential mechanisms (emotion regulation, interpersonal problems, posttraumatic stress disorder symptoms, and depression symptoms) and the association of these changes with overall functional improvement (at posttreatment and follow-up).
Results: Emotion regulation change during the first half of treatment predicted interpersonal and symptom improvements during the second half of treatment, but not vice versa. Changes in each potential mechanism were uniquely associated with functional improvement and together statistically accounted for 78% additional variance in functional improvement beyond what was associated with baseline functioning and covariates.
Conclusions: Results support emotion regulation as an early mechanism of transdiagnostic therapeutic change in web-based version of Skills Training in Affective and Interpersonal Regulation and highlight the relevance of all four potential mechanisms to functional improvement. The study contributes to an understanding of how change occurs in skills-focused interventions for trauma-exposed individuals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
期刊介绍：
The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.
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