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在初级保健中提供团体心理教育认知行为疗法:与个体认知行为疗法和个体心理动力人际心理治疗的疗效比较

Delivering group psychoeducational CBT in Primary Care: comparing outcomes with individual CBT and individual psychodynamic-interpersonal psychotherapy.

作者信息

Kellett Stephen, Clarke Suzanne, Matthews Linda

机构信息

Barnsley PCT, Keresforth Centre, Barnsley, UK.

出版信息

Br J Clin Psychol. 2007 Jun;46(Pt 2):211-22. doi: 10.1348/014466506X146188.

Abstract

Within psychological services in Primary Care, service providers are expected and required to deliver clinical services that are prompt, safe and effective. However, long wait-times for treatment are common, with attendant clinical chronicity and risk issues. Evaluations of group-based treatments in Primary Care, which are clinically more efficient than individual treatments, are extremely scarce. The current evaluation attempted to appraise the effectiveness of a service innovation of introducing group-based psychoeducational cognitive-behaviour therapy (CBT; N=43), by comparing outcomes with clients treated in individual CBT (N=68) and individual psychodynamic-interpersonal psychotherapy (N=65). Group psychoeducational participants completed validated scales of psychological functioning (Beck Depression Inventory - 2, BDI-2; Brief Symptom Inventory, BSI; Inventory of Interpersonal Problems, IIP-32; and General Health Questionnaire, GHQ-12) at assessment, start of group, termination of group and 3-month follow-up, whereas participants in the individual therapies completed measures only at initiation and termination of treatment. The results indicate broad similarities between the outcomes achieved by the three services, with rates of clinically significant improvements and deteriorations comparable in the main across services. The results are discussed in terms of identified methodological limitations, service implications and models of service delivery for the psychological therapies in Primary Care.

摘要

在初级保健的心理服务中,服务提供者被期望并要求提供及时、安全且有效的临床服务。然而,治疗等待时间过长的情况很常见,随之而来的是临床慢性病和风险问题。对初级保健中基于团体的治疗的评估极为稀少,而这种治疗在临床上比个体治疗更有效率。当前的评估试图通过将基于团体的心理教育认知行为疗法(CBT;N = 43)的结果与接受个体CBT治疗的客户(N = 68)和个体心理动力人际心理治疗的客户(N = 65)的结果进行比较,来评估引入这种团体治疗服务创新的有效性。团体心理教育参与者在评估时、团体开始时、团体结束时以及3个月随访时完成了心理功能的有效量表(贝克抑郁量表-2,BDI-2;简明症状量表,BSI;人际问题量表,IIP-32;以及一般健康问卷,GHQ-12),而个体治疗的参与者仅在治疗开始和结束时完成测量。结果表明,这三种服务所取得的结果大致相似,临床上显著改善和恶化的比率在主要方面在各服务之间相当。将根据已确定的方法学局限性、服务影响以及初级保健中心理治疗的服务提供模式来讨论这些结果。

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