弥合反实施差距:自然主义心理治疗中经验和理性决策规则的比较
Stephan Ramsperger1, Michael Witthöft1, Anne-Kathrin Bräscher1
1Department for Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany.
概括
使用常规结果监测的反系统可以识别心理治疗中患有治疗失败风险的患者. 经验模型,特别是近邻方法,显示出改善临床实践实施的希望.
科学领域:
- 心理治疗的研究研究.
- 临床心理学 临床心理学
- 医疗服务研究 医疗服务研究
背景情况:
- 心理治疗中的反系统可以改善治疗结果.
- 在临床实践中,实施会话反系统是具有挑战性的.
研究的目的:
- 评估反系统的决策规则,使用常规结果监测和减少评估频率.
- 使用不同的反决策规则,识别患有治疗失败风险的患者.
主要方法:
- 利用3758名患者的数据,在门诊环境中接受认知行为疗法 (CBT) 治疗.
- 基于预期的治疗反应,最近的邻居,可靠的变化指数和百分比改善的反决策规则.
- 评估检测有治疗失败风险的患者作为主要终点.
主要成果:
- 根据所有规则确定患有风险的患者的可靠改善率明显较低,可靠恶化率更高.
- 最接近邻居的方法在可靠地检测恶化病例方面表现出最高的灵敏度.
- 经验模型表现优于理性规则,百分比改进规则显示了令人满意的结果.
结论:
- 经验反模型在识别心理治疗中有治疗失败风险的患者方面是有效的.
- 低频反系统显示出与会话对会话系统相比,更容易进行临床实施的潜力.
- 最接近的邻居和百分比改善规则对CBT的常规结果监测有希望.
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