Craske Michelle G, Rose Raphael D, Lang Ariel, Welch Stacy Shaw, Campbell-Sills Laura, Sullivan Greer, Sherbourne Cathy, Bystritsky Alexander, Stein Murray B, Roy-Byrne Peter P
Department of Psychology, University of California, Los Angeles, California, USA.
Depress Anxiety. 2009;26(3):235-42. doi: 10.1002/da.20542.
This article describes a computer-assisted cognitive behavioral therapy (CBT) program designed to support the delivery of evidenced-based CBT for the four most commonly occurring anxiety disorders (panic disorder, posttraumatic stress disorder, generalized anxiety disorder, and social anxiety disorder) in primary-care settings. The purpose of the current report is to (1) present the structure and format of the computer-assisted CBT program, and (2) to present evidence for acceptance of the program by clinicians and the effectiveness of the program for patients.
Thirteen clinicians using the computer-assisted CBT program with patients in our ongoing Coordinated Anxiety Learning and Management study provided Likert-scale ratings and open-ended responses about the program. Rating scale data from 261 patients who completed at least one CBT session were also collected.
Overall, the program was highly rated and modally described as very helpful. Results indicate that the patients fully participated (i.e., attendance and homework compliance), understood the program material, and acquired CBT skills. In addition, significant and substantial improvements occurred to the same degree in randomly audited subsets of each of the four primary anxiety disorders (N=74), in terms of self ratings of anxiety, depression, and expectations for improvement.
Computer-assisted CBT programs provide a practice-based system for disseminating evidence-based mental health treatment in primary-care settings while maintaining treatment fidelity, even in the hands of novice clinicians.
本文介绍了一种计算机辅助认知行为疗法（CBT）程序，该程序旨在支持在初级保健环境中为四种最常见的焦虑症（惊恐障碍、创伤后应激障碍、广泛性焦虑障碍和社交焦虑障碍）提供循证CBT。本报告的目的是：（1）介绍计算机辅助CBT程序的结构和形式；（2）展示该程序被临床医生接受的证据以及该程序对患者的有效性。
在我们正在进行的“协同焦虑学习与管理”研究中，13名使用计算机辅助CBT程序治疗患者的临床医生提供了关于该程序的李克特量表评分和开放式反馈。还收集了261名至少完成一次CBT治疗的患者的量表评分数据。
总体而言，该程序获得了高度评价，多数人认为非常有帮助。结果表明，患者充分参与（即出勤和完成家庭作业），理解程序内容，并掌握了CBT技能。此外，在随机抽取的四种主要焦虑症患者亚组（N = 74）中，焦虑、抑郁的自评以及改善期望方面均出现了同等程度的显著且实质性的改善。
计算机辅助CBT程序提供了一个基于实践的系统，用于在初级保健环境中传播循证心理健康治疗，同时保持治疗的保真度，即使是新手临床医生也能做到。
