工作联盟及其与基于互联网的抑郁症干预指导的联系:随机对照试验的二次分析
Raoul Haaf1, Cora Schefft1, Rico Krämer1
1Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany.
Frontiers in psychiatry
|September 26, 2024
概括
基于互联网的指导干预 (IBIs) 促进了强大的工作联盟,这对治疗成功至关重要. 在指导IBI中建立一个强大的联盟,即使在非指导的格式中,也可以提高合规性和结果,这凸显了它对常规集成的重要性.
科学领域:
- 心理健康 心理健康
- 心理治疗研究 心理治疗研究
- 数字健康数字健康
背景情况:
- 基于互联网的指导干预 (IBIs) 通常比无指导干预更有效,但根本机制尚不清楚.
- 面对面治疗中至关重要的治疗师-客户工作联盟越来越被认为是IBI有效性的关键因素.
- 这项研究分析了Selfapy的随机对照试验 (RCT),这是对抑郁症的12周认知行为治疗IBI,比较引导和未引导版本.
研究的目的:
- 检查指导IBI与非指导IBI的工作联盟的发展.
- 调查工作联盟,治疗指导和治疗结果之间的关系.
- 探讨工作联盟如何影响IBI的坚持.
主要方法:
- 一项涉及301名参与者的RCT的二次分析 (平均年龄37岁,83%是女性,平均BDI-II=30.09).
- 治疗意图分析比较工作联盟质量 (WAI-SR) 在治疗中期和后期使用重复测量ANOVA.
- 相关性和串行调解分析,以评估工作联盟,指导,坚持和结果之间的联系.
主要成果:
- 在两组中,IBIs成功地培养了工作联盟,在指导组中,治疗后联盟得分明显更高 (科恩的d = -0.38).
- 在治疗后的工作联盟得分与治疗后和随访后的症状减少在指导 (r = .25) 和无指导 (r = .15.17) 组中都有正相关.
- 连续调解分析显示,工作联盟调解了指导和后续结果之间的关系,并将指导与遵守联系起来.
结论:
- 调查结果强调了在指导IBI中工作联盟的重要性,并为其在非指导IBI中的形成提供了新的见解.
- 一个强大的工作联盟可能会增强坚持,潜在地改善引导和非引导IBI的结果.
- 该研究表明,工作联盟对于将IBI整合到常规精神卫生保健中至关重要,需要进一步调查.
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