Ruwaard Jeroen, Lange Alfred, Bouwman Manon, Broeksteeg Janneke, Schrieken Bart
Interapy BV, Amsterdam, The Netherlands.
Cogn Behav Ther. 2007;36(3):179-92. doi: 10.1080/16506070701381863.
The aim of this study was to assess the effects of a 7-week standardized cognitive behavioural treatment of work-related stress conducted via e-mail. A total of 342 people applied for treatment in reaction to a newspaper article. Initial screening reduced the sample to a heterogeneous (sub)clinical group of 239 participants. Participants were assigned randomly to a waiting list condition (n = 62), or to immediate treatment (n = 177). A follow-up was conducted 3 years after inception of the treatment. The outcome measures used were the Depression Anxiety Stress Scales (DASS-42) and the Emotional Exhaustion scale of the Maslach Burnout Inventory - General Survey (MBI-GS). Fifty participants (21%) dropped out. Both groups showed statistically significant improvements. Intention-to-treat analysis of covariance (ANCOVAs) revealed that participants in the treatment condition improved significantly more than those in the waiting control condition (0.001<p < or = 0.025). In the treatment group, the effects were large to moderate (0.9 (stress) > or = d > or = 0.5 (anxiety)). The between-group effects ranged from d = 0.6 (stress) to d = 0.1 (anxiety). At follow-up, the effects were more pronounced, but this result requires replication in view of high attrition at follow-up. The results warrant further research on Internet-driven standardized cognitive behavioural therapy for work-related stress. Such research should include the direct comparison of this treatment with face-to-face treatment, and should address the optimal level of therapist contact in Internet-driven treatment.
本研究的目的是评估通过电子邮件进行的为期7周的标准化认知行为疗法对工作相关压力的治疗效果。共有342人因报纸上的一篇文章申请治疗。初步筛选后，样本缩减为一个由239名参与者组成的异质性（亚）临床组。参与者被随机分配到等待名单组（n = 62）或立即治疗组（n = 177）。治疗开始3年后进行了随访。所使用的结果测量指标为抑郁焦虑压力量表（DASS - 42）和马氏倦怠量表 - 一般调查（MBI - GS）中的情感耗竭量表。50名参与者（21%）退出。两组均显示出具有统计学意义的改善。意向性分析协方差（ANCOVAs）显示，治疗组的参与者比等待对照组的参与者改善更为显著（0.001 < p ≤ 0.025）。在治疗组中，效果为大到中等（0.9（压力）≥ d ≥ 0.5（焦虑））。组间效应范围为d = 0.6（压力）至d = 0.1（焦虑）。在随访时，效果更为明显，但鉴于随访时的高损耗率，这一结果需要重复验证。这些结果为进一步研究互联网驱动的针对工作相关压力的标准化认知行为疗法提供了依据。此类研究应包括将这种治疗方法与面对面治疗进行直接比较，并应探讨互联网驱动治疗中治疗师接触的最佳水平。
