Oskar Flygare, Lina Lundström, Erik Andersson, David Mataix-Cols, Christian Rück
{"title":"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","authors":"Oskar Flygare, Lina Lundström, Erik Andersson, David Mataix-Cols, Christian Rück","doi":"10.1111/bjc.12365","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Consecutively referred patients with a primary diagnosis of OCD (<i>n </i>= 474) were offered OCD-NET. Symptoms of OCD, depression, anxiety, and level of functioning were measured weekly throughout treatment.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In the full intention to treat sample (<i>n </i>= 474), the intervention was associated with large reductions in self-reported OCD symptoms (<i>d</i> = 1.77), anxiety (<i>d</i> = 1.55) and depression (<i>d</i> = 0.8), as well as improvements in functional impairment (<i>d</i> = 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 (<i>n </i>= 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.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":"61 4","pages":"895-910"},"PeriodicalIF":3.8000,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9790702/pdf/","citationCount":"1","resultStr":"{\"title\":\"Implementing therapist-guided internet-delivered cognitive behaviour therapy for obsessive–compulsive disorder in the UK’s IAPT programme: A pilot trial\",\"authors\":\"Oskar Flygare, Lina Lundström, Erik Andersson, David Mataix-Cols, Christian Rück\",\"doi\":\"10.1111/bjc.12365\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Consecutively referred patients with a primary diagnosis of OCD (<i>n </i>= 474) were offered OCD-NET. Symptoms of OCD, depression, anxiety, and level of functioning were measured weekly throughout treatment.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>In the full intention to treat sample (<i>n </i>= 474), the intervention was associated with large reductions in self-reported OCD symptoms (<i>d</i> = 1.77), anxiety (<i>d</i> = 1.55) and depression (<i>d</i> = 0.8), as well as improvements in functional impairment (<i>d</i> = 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 (<i>n </i>= 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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>OCD-NET is an effective treatment when delivered in regular care within the IAPT system. 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Implementing therapist-guided internet-delivered cognitive behaviour therapy for obsessive–compulsive disorder in the UK’s IAPT programme: A pilot trial
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.
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