Litz Brett T, Engel Charles C, Bryant Richard A, Papa Anthony
National Center for PTSD Boston VA Healthcare System and Boston University School of Medicine, 150 South Huntington Ave., Boston, MA 01230, USA.
Am J Psychiatry. 2007 Nov;164(11):1676-83. doi: 10.1176/appi.ajp.2007.06122057.
The authors report an 8-week randomized, controlled proof-of-concept trial of a new therapist-assisted, Internet-based, self-management cognitive behavior therapy versus Internet-based supportive counseling for posttraumatic stress disorder (PTSD).
Service members with PTSD from the attack on the Pentagon on September 11th or the Iraq War were randomly assigned to self-management cognitive behavior therapy (N=24) or supportive counseling (N=21).
The dropout rate was similar to regular cognitive behavior therapy (30%) and unrelated to treatment arm. In the intent-to-treat group, self-management cognitive behavior therapy led to sharper declines in daily log-on ratings of PTSD symptoms and global depression. In the completer group, self-management cognitive behavior therapy led to greater reductions in PTSD, depression, and anxiety scores at 6 months. One-third of those who completed self-management cognitive behavior therapy achieved high-end state functioning at 6 months.
Self-management cognitive behavior therapy may be a way of delivering effective treatment to large numbers with unmet needs and barriers to care.
作者报告了一项为期8周的随机对照概念验证试验，比较一种新的由治疗师辅助的基于互联网的创伤后应激障碍（PTSD）自我管理认知行为疗法与基于互联网的支持性咨询。
来自9月11日五角大楼袭击事件或伊拉克战争的患有创伤后应激障碍的军人被随机分配到自我管理认知行为疗法组（N = 24）或支持性咨询组（N = 21）。
脱落率与常规认知行为疗法相似（30%），且与治疗组无关。在意向性治疗组中，自我管理认知行为疗法导致创伤后应激障碍症状每日登录评分和总体抑郁评分下降更明显。在完成治疗组中，自我管理认知行为疗法在6个月时导致创伤后应激障碍、抑郁和焦虑评分有更大幅度的降低。完成自我管理认知行为疗法的患者中有三分之一在6个月时达到了高端状态功能。
自我管理认知行为疗法可能是一种为大量有未满足需求和护理障碍的人提供有效治疗的方法。
