在针对抑郁症状的个性化网络认知行为疗法的指导下,治疗师做了什么:内容分析

IF 4.1 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Victoria Aminoff , Laura Luisa Bielinski , Matilda Berg , Thomas Berger , Gerhard Andersson
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引用次数: 0

摘要

治疗师支持的基于互联网的认知行为疗法(ICBT)对有抑郁症状的个体有效。然而,目前尚不清楚治疗师在指导量身定制的ICBT时如何采取行动。本研究考察了指导性ICBT中治疗师的行为,治疗师选择参与者模块,重点关注行为和行为与抑郁症状和负面治疗效果的关联比例。方法采用内容分析的方法,对6名治疗师发给62名参与者的1055条信息进行分析。比例z检验用于比较当前研究中的治疗师行为与非定制ICBT研究中报告的治疗师行为。治疗师行为频率与抑郁症状和负面影响的变化之间的关系采用Spearman's rho相关进行评估。计算抑郁症状的剩余改变评分。结果除两种行为外,在之前的非定制ICBT研究中发现的治疗师行为在本研究中均被观察到。澄清框架和管理方面的某些行为比针对抑郁症状的非定制ICBT更常见。其他行为,如移情话语,则不太常见。强化语气的频率与抑郁症状的减轻显著相关(rs = - 0.33, p = 0.033),不支持语气的频率与负面影响显著相关(rs = 0.35, p = 0.022)。尽管行为的比例不同,但几乎所有在以前的非定制ICBT研究中观察到的治疗师行为也存在于个性化定制ICBT中。此外,结果表明,强化可能与改善治疗结果有关,而治疗师不支持的语气可能与负面影响有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
What therapists do during guidance in individually tailored internet-based cognitive behavioral therapy for depressive symptoms: A content analysis

Introduction

Therapist-supported internet-based cognitive behavioral therapy (ICBT) can be effective for individuals with depressive symptoms. However, it remains unclear how therapists act when guiding individually tailored ICBT. This study examined therapist behaviors in guided ICBT where therapists choose participant modules, focusing on the proportions of behaviors and behaviors' associations with depressive symptoms and negative treatment effects.

Methods

Content analysis was employed to examine 1055 messages sent from six therapists to 62 participants. Z-tests for proportions were used to compare therapist behaviors in the current study to those reported in studies on non-tailored ICBT. The association between therapist behavior frequencies and changes in depressive symptoms and negative effects were assessed using Spearman's rho correlation. Residual change scores were calculated for depressive symptoms.

Results

All but two therapist behaviors identified in prior research on non-tailored ICBT were observed in this study. Certain behaviors such as clarifying the framework and administrative aspects were more common than in non-tailored ICBT for depressive symptoms. Other behaviors, such as empathetic utterances, were less common. The frequency of reinforcing correlated significantly with a decrease in depressive symptoms (rs = −0.33, p = .033) and unsupportive tone correlated significantly with negative effects (rs = 0.35, p = .022).

Discussion

Almost all therapist behaviors observed in previous studies on non-tailored ICBT are also present in individually tailored ICBT, although the proportions of behaviors differ. Furthermore, the results indicate that reinforcing may be associated with improved treatment outcomes, while therapist unsupportive tone could be linked to negative effects.
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来源期刊
CiteScore
6.50
自引率
9.30%
发文量
94
审稿时长
6 weeks
期刊介绍: Official Journal of the European Society for Research on Internet Interventions (ESRII) and the International Society for Research on Internet Interventions (ISRII). The aim of Internet Interventions is to publish scientific, peer-reviewed, high-impact research on Internet interventions and related areas. Internet Interventions welcomes papers on the following subjects: • Intervention studies targeting the promotion of mental health and featuring the Internet and/or technologies using the Internet as an underlying technology, e.g. computers, smartphone devices, tablets, sensors • Implementation and dissemination of Internet interventions • Integration of Internet interventions into existing systems of care • Descriptions of development and deployment infrastructures • Internet intervention methodology and theory papers • Internet-based epidemiology • Descriptions of new Internet-based technologies and experiments with clinical applications • Economics of internet interventions (cost-effectiveness) • Health care policy and Internet interventions • The role of culture in Internet intervention • Internet psychometrics • Ethical issues pertaining to Internet interventions and measurements • Human-computer interaction and usability research with clinical implications • Systematic reviews and meta-analysis on Internet interventions
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