Psychotherapy process variables in implementation of CBT for inflammatory bowel disease:Therapist competence, fidelity, and patient themes

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy Pub Date : 2025-01-31 DOI:10.1016/j.brat.2025.104702

Melissa Hunt, Chung Sang Tse, Lily Suh, Ella Yang, Camillia Bui, Alana Davis, Ray Siddiqi, Venus Tian

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引用次数: 0

Abstract

Objective

Inflammatory Bowel Diseases (IBD) are a group of chronic immune-mediated digestive disorders that can cause significant psychological distress and disability. IBD-informed cognitive behavioral therapy (CBT) may reduce psychiatric co-morbidity and improve health related quality of life. We herein examine the psychotherapy process variables relevant to implementation of a manualized CBT for IBD protocol delivered by therapists with no prior knowledge of IBD.

Method

In the ADEPT Trial (Addressing Disability Effectively with Psychosocial Telemedicine - NCT05635292), 30 patients with IBD received up to 8 sessions of manualized CBT for IBD delivered via telehealth by one of 5 licensed PhD level clinical psychologists skilled in CBT but naïve to IBD prior to the study. All treating psychologists received training in IBD-informed CBT. Videos of the CBT sessions were rated by trained raters for psychotherapy process variables including therapist competence, fidelity to the manual, therapeutic relationship, and the content of patient themes. We also evaluated the association between process variables and outcome, measured as reductions in the IBD-Disability Index.

Results

All general therapists were highly competent in delivering IBD-informed CBT after training and showed fidelity to the treatment manual. Fidelity to teaching deep diaphragmatic breathing was associated with greater reductions in disability. Patient themes were associated with baseline disability and outcome.

Conclusions

IBD-informed CBT can be delivered successfully by CBT therapists with no prior knowledge of IBD as a flexible modular therapy manual applied to a medically complex patient population.

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炎症性肠病CBT实施中的心理治疗过程变量：治疗师能力、忠诚度和患者主题

炎症性肠病（IBD）是一组慢性免疫介导的消化系统疾病，可引起严重的心理困扰和残疾。ibd知情认知行为疗法（CBT）可以减少精神合并症和改善健康相关的生活质量。我们在此研究了与IBD手动CBT治疗方案实施相关的心理治疗过程变量，该方案由没有IBD先验知识的治疗师提供。方法在ADEPT试验（通过心理社会远程医疗有效地解决残疾问题- NCT05635292）中，30名IBD患者接受了多达8次IBD手动CBT治疗，由5名具有CBT技能的博士级临床心理学家中的一名通过远程医疗提供，但在研究之前对IBD有naïve。所有治疗心理学家都接受了ibd认知行为疗法的培训。CBT课程的视频由训练有素的评分员对心理治疗过程变量进行评分，包括治疗师的能力、对手册的忠实度、治疗关系和患者主题的内容。我们还评估了过程变量和结果之间的关系，以ibd残疾指数的降低来衡量。结果所有的普通治疗师在培训后都能很好地提供ibd知情的CBT，并忠实于治疗手册。忠实地教授深膈呼吸与残疾的更大减少有关。患者主题与基线残疾和结果相关。结论：在没有IBD先验知识的情况下，CBT治疗师可以成功地将sibd告知的CBT作为一种灵活的模块化治疗手册，应用于医学复杂的患者群体。

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

Behaviour Research and Therapy PSYCHOLOGY, CLINICAL-

CiteScore

7.50

自引率

7.30%

发文量

148

期刊介绍： The major focus of Behaviour Research and Therapy is an experimental psychopathology approach to understanding emotional and behavioral disorders and their prevention and treatment, using cognitive, behavioral, and psychophysiological (including neural) methods and models. This includes laboratory-based experimental studies with healthy, at risk and subclinical individuals that inform clinical application as well as studies with clinically severe samples. The following types of submissions are encouraged: theoretical reviews of mechanisms that contribute to psychopathology and that offer new treatment targets; tests of novel, mechanistically focused psychological interventions, especially ones that include theory-driven or experimentally-derived predictors, moderators and mediators; and innovations in dissemination and implementation of evidence-based practices into clinical practice in psychology and associated fields, especially those that target underlying mechanisms or focus on novel approaches to treatment delivery. In addition to traditional psychological disorders, the scope of the journal includes behavioural medicine (e.g., chronic pain). The journal will not consider manuscripts dealing primarily with measurement, psychometric analyses, and personality assessment.