分析在治疗师内部和治疗师之间的认知行为疗法中对泛性焦虑症治疗的积极关心结果的关联
Anuj H P Mehta1, Michael J Constantino1, Alice E Coyne2
1Department of Psychological and Brain Sciences, University of Massachusetts Amherst.
Psychotherapy (Chicago, Ill.)
|October 9, 2025
概括
治疗师对患者的积极看法显著预测了一般性焦虑症治疗中更好的结果. 这种效应在个体治疗师水平上最强,而不是在不同治疗师之间.
科学领域:
- 心理学 心理学 心理学
- 临床心理学 临床心理学
- 心理治疗研究 心理治疗研究
背景情况:
- 积极的看法 (PR) 是一个关键的治疗联盟因素,与心理治疗中的患者改善有关.
- 之前的研究还没有完全区分PR对治疗结果的治疗师内部和治疗师之间的影响.
- 了解这些组成部分对于解释PR在治疗有效性中的确切作用至关重要.
研究的目的:
- 在治疗师内部和治疗师之间,研究积极的看法与治疗结果之间的关联.
- 检查治疗师之间的PR差异是否会缓和治疗师内部的PR结果联系.
- 为了确定治疗方式 (CBT与集成MI-CBT) 是否缓和了PR-结果关联.
主要方法:
- 患有泛性焦虑症的成年人被随机分配到认知行为疗法 (CBT) 或激励面试-综合性CBT (MI-CBT).
- 患者 (N=101) 被19个不同的治疗师 (10个CBT,9个MI-CBT) 治疗.
- 多层结构方程建模分析了15次会议和基线/治疗后的患者评级的PR和结果 (担忧,痛苦).
主要成果:
- 发现了一个显著的治疗师内部关联:更高的早期积极评价预测了更低的治疗后焦虑和痛苦.
- 没有观察到PR和结果之间的治疗师之间的显著关联.
- 无论是治疗师之间的PR水平还是治疗条件都没有缓解治疗师内部的PR结果关系.
结论:
- 治疗师应优先考虑在治疗期间培养患者的积极态度,因为这与个体患者的进步密切相关.
- 积极评价的有效性似乎主要是个体治疗师-病人动态,而不是治疗师的一般特征.
- 这些发现强调了治疗关系质量的重要性,无论使用的具体治疗方法如何.
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