在边界人格障碍的在线辩证行为疗法中接受度,安全性和效果大小:干预试点研究:干预试点研究
Ruben Vonderlin1,2, Tali Boritz3,4, Carola Claus5
1Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
JMIR formative research
|January 14, 2025
概括
远程医疗辩证行为疗法 (DBT) 显著改善了边缘性人格障碍 (BPD) 症状和生活质量. 虽然接受得很好,但高退学率需要策略来改善在线治疗中的患者保留率.
科学领域:
- 精神病学是一个精神病学.
- 心理学 心理学 心理学
- 数字健康数字健康
背景情况:
- 远程医疗心理治疗正受到越来越多的关注,但它对情绪和行为失调患者的有效性和安全性仍然是怀疑的主题.
- 边界性人格障碍 (BPD) 的特点是显著的情绪和行为失调,往往需要密集治疗.
研究的目的:
- 为了估计症状变化的效果大小,从治疗前到治疗后进行远程医疗辩证行为疗法 (DBT).
- 评估对被诊断患有BPD的个人进行远程医疗DBT的接受,安全和可行性.
- 在远程医疗DBT环境中评估患者和治疗师的满意度以及治疗联盟的质量.
主要方法:
- 总共有39名BPD患者在3个国际地点接受了一年的门诊远程医疗DBT.
- 使用BPD症状,解离和生活质量的前后测量来计算效应大小.
- 安全性通过自杀企图和自我伤害事件进行评估,以及患者和治疗师报告的接受度,满意度和可用性.
主要成果:
- 在BPD症状 (d=1.13-1.44) 和生活质量 (d=0.65-1.24) 中观察到显著的和大的前后效应大小.
- 自伤行为显著下降 (80%至28%),尽管分离性症状的变化很小.
- 接受度,可行性和满意度很高,但学率很高 (38%),治疗师可用性评级中等.
结论:
- 远程医疗DBT在减少BPD症状和改善生活质量方面表现出显著的有效性,这表明它是可行的治疗选择.
- 远程医疗格式通常得到很好的接受和可行性,但高退学率需要注意和潜在的干预策略.
- 需要进一步的研究,包括随机对照试验,将远程医疗DBT与面对面的格式进行比较,以确认疗效并优化治疗交付.
相关概念视频
Borderline Personality Disorder
36
Borderline Personality Disorder is a complex and multifaceted mental health condition characterized by pervasive instability in interpersonal relationships, self-image, emotions, and impulse control. This instability manifests in extreme emotional reactions, fear of abandonment, and self-destructive behaviors. The disorder significantly impacts daily functioning, often leading to distress in both personal and professional domains.
Genetic and Environmental Contributions
Borderline Personality...
Genetic and Environmental Contributions
Borderline Personality...
36
Modeling in Therapy
44
Modeling, a key technique in therapy, uses observational learning to help clients acquire and practice new skills by watching therapists demonstrate desired behaviors. This approach, rooted in Albert Bandura's concept of vicarious learning, plays a significant role in therapeutic interventions for various psychological conditions, including social anxiety, ADHD, and depression.
Participant Modeling
Participant modeling involves therapists demonstrating calm and effective behaviors in...
Participant Modeling
Participant modeling involves therapists demonstrating calm and effective behaviors in...
44
Behavior Therapy
40
Behavior therapy incorporates diverse techniques rooted in classical conditioning principles to address maladaptive behaviors and anxiety disorders. These methods aim to reduce avoidance behaviors, foster adaptive coping mechanisms, and alter associations between stimuli and responses, making them effective in a wide range of therapeutic contexts.
Exposure therapy is a cornerstone of behavioral treatment for anxiety disorders. It involves systematic exposure to feared stimuli, either in real...
Exposure therapy is a cornerstone of behavioral treatment for anxiety disorders. It involves systematic exposure to feared stimuli, either in real...
40
Elements Crucial for Effective Psychotherapy
34
Research has highlighted several critical factors that influence the effectiveness of psychotherapy, such as the therapeutic alliance, the therapist, and the client.
The Therapeutic Alliance
The therapeutic alliance refers to the relationship between the therapist and the client. The alliance strengthens when the therapist and the client engage in a nurturing, supportive, trusting, empathetic, and respectful relationship, improving therapeutic outcomes. Therapists must monitor this relationship...
The Therapeutic Alliance
The therapeutic alliance refers to the relationship between the therapist and the client. The alliance strengthens when the therapist and the client engage in a nurturing, supportive, trusting, empathetic, and respectful relationship, improving therapeutic outcomes. Therapists must monitor this relationship...
34
Rational Emotive Behavior Therapy
42
Cognitive-behavioral therapies (CBTs) are grounded in the belief that our thoughts profoundly influence our emotions and actions. Advocates of CBT emphasize three core assumptions: first, that cognitions are identifiable and measurable; second, that they are central to psychological functioning; and third, that irrational or maladaptive beliefs can be replaced with rational and adaptive ones. This transformative approach to therapy has paved the way for specific models such as Albert...
42
Self-Help Support Groups
26
Self-help support groups are voluntary, community-based organizations that provide a platform for individuals with shared concerns to exchange support, insights, and practical strategies for coping with life challenges. Typically led by group members or paraprofessionals, these groups form a cornerstone of mental health care, especially in reaching populations that are underserved by traditional healthcare systems.
Accessibility and Cost-Effectiveness
One of the primary strengths of self-help...
Accessibility and Cost-Effectiveness
One of the primary strengths of self-help...
26


