心理治疗中变化过程研究的一些方法学和统计学问题。
Some methodological and statistical issues in the study of change processes in psychotherapy.
作者信息
Laurenceau Jean-Philippe, Hayes Adele M, Feldman Greg C
机构信息
University of Delaware, DE 19716-2577, USA.
出版信息
Clin Psychol Rev. 2007 Jul;27(6):682-95. doi: 10.1016/j.cpr.2007.01.007. Epub 2007 Jan 19.
Abstract
As the number of psychotherapies with demonstrated efficacy accumulates, an important task is to identify principles and processes of change. This information can guide treatment refinement, integration, and future development. However, the standard randomized control trial (RCT) design can limit the questions that can be asked and the statistical analyses that can be conducted. We discuss the importance of examining the shape of change, in addition to the importance of identifying mediators and moderators of change. We suggest methodological considerations for longitudinal data collection that can improve the kinds of therapy process questions that can be examined. We also review some data analytic approaches that are being used in other areas of psychology that have the potential to capture the complexity and dynamics of change in psychotherapy.
摘要
随着已证明具有疗效的心理治疗方法数量不断增加，一项重要任务是确定改变的原则和过程。这些信息可以指导治疗的完善、整合及未来发展。然而，标准的随机对照试验（RCT）设计可能会限制可提出的问题以及可进行的统计分析。我们讨论了除识别改变的中介因素和调节因素的重要性之外，研究改变形态的重要性。我们提出了纵向数据收集的方法学考量，这可以改进可被研究的治疗过程问题类型。我们还回顾了一些正在心理学其他领域使用的数据分析方法，这些方法有可能捕捉心理治疗中改变的复杂性和动态性。
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Multivariate Behav Res. 2002 Jan 1;37(1):127-60. doi: 10.1207/S15327906MBR3701_06.
2
The ecology of adolescent activity and experience.青少年活动和经验的生态学。
J Youth Adolesc. 1977 Sep;6(3):281-94. doi: 10.1007/BF02138940.
3
Towards an Understanding of the Process and Mechanisms of Change in Cognitive Behavioral Therapy: Linking Innovative Methodology with Fundamental Questions.迈向对认知行为疗法变化过程及机制的理解：将创新方法与基本问题相联系
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4
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Int J Behav Med. 2005;12(2):111-22. doi: 10.1207/s15327558ijbm1202_9.
5
A conceptual framework for adaptive preventive interventions.适应性预防干预的概念框架。
Prev Sci. 2004 Sep;5(3):185-96. doi: 10.1023/b:prev.0000037641.26017.00.
6
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7
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J Consult Clin Psychol. 2004 Apr;72(2):288-303. doi: 10.1037/0022-006X.72.2.288.
8
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J Child Psychol Psychiatry. 2003 Nov;44(8):1116-29. doi: 10.1111/1469-7610.00195.
9
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Annu Rev Psychol. 2003;54:579-616. doi: 10.1146/annurev.psych.54.101601.145030. Epub 2002 Jun 10.
10
Mediators and moderators of treatment effects in randomized clinical trials.随机临床试验中治疗效果的中介因素和调节因素
Arch Gen Psychiatry. 2002 Oct;59(10):877-83. doi: 10.1001/archpsyc.59.10.877.
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