临床评估与心理治疗中的技术创新。

Technological innovations in clinical assessment and psychotherapy.

作者信息

Emmelkamp Paul M G

机构信息

Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.

出版信息

Psychother Psychosom. 2005;74(6):336-43. doi: 10.1159/000087780.

Abstract

In this paper the application of computer technology and the use of the Internet in mental health care are critically reviewed. A number of on-line screening devices have been developed for anxiety disorders, mood disorders, and substance abuse disorders, with great potential for clinical practice. On line assessment is generally equivalent to clinical assessment. A number of studies have shown that self-help treatment programmes on stand-alone computers are as effective as routine clinical care. The Internet enhances the therapeutic possibilities of computers by offering feedback of therapists and more tailor-made treatment. A number of randomized clinical trials (RCTs) have shown that Internet-based treatment is more effective than no-treatment and as effective as face-to-face treatment. Research so far has been limited to anxiety disorders, burn-out, depression, headache, insomnia, tinnitus and obesity. Further, exposure through virtual reality has been found effective in a number of RCTs in specific phobias, but results with respect to the effects of the use of virtual reality techniques to other disorders are inconclusive. It is concluded that computer-driven assessment and treatment has many advantages and few disadvantages. A number of reasons are discussed which will preclude large-scale implementation of computer-driven assessment and therapy in the near future.

摘要

本文对计算机技术的应用以及互联网在精神卫生保健中的使用进行了批判性综述。已开发出多种用于焦虑症、情绪障碍和物质使用障碍的在线筛查工具,在临床实践中具有巨大潜力。在线评估通常等同于临床评估。多项研究表明,单机上的自助治疗方案与常规临床护理效果相当。互联网通过提供治疗师的反馈和更具针对性的治疗,增强了计算机的治疗可能性。多项随机临床试验(RCT)表明,基于互联网的治疗比不治疗更有效,且与面对面治疗效果相当。迄今为止的研究仅限于焦虑症、职业倦怠、抑郁症、头痛、失眠、耳鸣和肥胖症。此外,在一些针对特定恐惧症的随机临床试验中发现,通过虚拟现实进行暴露治疗是有效的,但关于使用虚拟现实技术对其他疾病的影响,结果尚无定论。结论是,计算机驱动的评估和治疗优点众多、缺点较少。文中讨论了一些原因,这些原因将阻碍在不久的将来大规模实施计算机驱动的评估和治疗。

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