Neuhaus Edmund C, Christopher Michael, Jacob Karen, Guillaumot Julien, Burns James P
McLean Hospital, Belmont, MA 02478, USA.
J Psychiatr Pract. 2007 Sep;13(5):298-307. doi: 10.1097/01.pra.0000290668.10107.f3.
Brief, cost-contained, and effective psychiatric treatments benefit patients and public health. This naturalistic pilot study examined the effectiveness of a 2-week, cognitive-behavioral therapy (CBT) oriented partial hospital program.
Study participants were 57 patients with mood, anxiety, and/or personality disorders receiving treatment in a private psychiatric partial hospital (PH) setting. A flexible treatment model was used that adapts evidence-based CBT treatment interventions to the PH context with emphases on psychoeducation and skills training. Participants completed self-report measures at admission and after 1 and 2 weeks, to assess stabilization and functional improvements, with added attention to the acquisition of cognitive and behavioral skills. The data were analyzed using repeated measures analyses of variance and correlation.
Participants reported a decrease in symptoms and negative thought patterns, improved satisfaction with life, and acquisition and use of cognitive and behavioral skills. Skill acquisition was correlated with symptom reduction, reduced negative thought patterns, and improved satisfaction with life.
Results of this pilot study suggest that a 2-week PH program can be effective for a heterogeneous patient population with mood, anxiety, and/or personality disorders. These findings are promising given the prevalence of treatments of such brief duration in private sector PH programs subject to the managed care marketplace. Future studies are planned to test this flexible PH treatment model, with particular attention to the effectiveness of the CBT approach for the treatment of different disorders and to whether effectiveness is sustained at follow-up. Further study should also examine whether skill acquisition is a mechanism of change for symptom reduction and functional improvements.
简短、成本可控且有效的精神科治疗对患者和公共卫生有益。这项自然主义的试点研究考察了一个为期2周、以认知行为疗法(CBT)为导向的部分住院项目的有效性。
研究参与者为57名在私立精神科部分住院(PH)机构接受治疗的患有情绪、焦虑和/或人格障碍的患者。采用了一种灵活的治疗模式,该模式将循证CBT治疗干预措施应用于PH环境,重点是心理教育和技能培训。参与者在入院时以及1周和2周后完成自我报告测量,以评估病情稳定情况和功能改善情况,并特别关注认知和行为技能的获得。使用重复测量方差分析和相关性分析对数据进行分析。
参与者报告症状和消极思维模式减少,对生活的满意度提高,以及获得并使用了认知和行为技能。技能获得与症状减轻、消极思维模式减少以及生活满意度提高相关。
这项试点研究的结果表明,一个为期2周的PH项目对于患有情绪、焦虑和/或人格障碍的异质性患者群体可能是有效的。鉴于在受管理式医疗市场影响的私立部门PH项目中,此类短期治疗的普遍性,这些发现很有前景。计划开展未来研究以测试这种灵活的PH治疗模式,特别关注CBT方法对不同障碍治疗的有效性以及随访时有效性是否持续。进一步的研究还应考察技能获得是否是症状减轻和功能改善的改变机制。