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认知行为疗法与音乐疗法研究的定量比较:一项方法学最佳实践分析,以指导未来针对成年精神病患者的调查。

Quantitative comparison of cognitive behavioral therapy and music therapy research: a methodological best-practices analysis to guide future investigation for adult psychiatric patients.

作者信息

Silverman Michael J

机构信息

University of Minnesota, USA.

出版信息

J Music Ther. 2008 Winter;45(4):457-506. doi: 10.1093/jmt/45.4.457.

Abstract

While the music therapy profession is relatively young and small in size, it can treat a variety of clinical populations and has established a diverse research base. However, although the profession originated working with persons diagnosed with mental illnesses, there is a considerable lack of quantitative research concerning the effects of music therapy with this population. Music therapy clinicians and researchers have reported on this lack of evidence and the difficulty in conducting psychosocial research on their interventions (Choi, 1997; Silverman, 2003a). While published studies have provided suggestions for future research, no studies have provided detailed propositions for the methodology and design of meticulous high quality randomized controlled psychiatric music therapy research. How do other psychotherapies accomplish their databases and could the music therapy field borrow from their rigorous "methodological best practices" to strengthen its own literature base? Therefore, as the National Institutes of Mental Health state the treatment of choice for evidence-based psychotherapy is cognitive behavioral therapy (CBT), aspects of this psychotherapy's literature base were analyzed. The purpose of this literature analysis was to (a) analyze and identify components of high-quality quantitative CBT research for adult psychiatric consumers, (b) analyze and identify the variables and other elements of existing quantitative psychiatric music therapy research for adult consumers, and (c) compare the two data sets to identify the best methodological designs and variables for future quantitative music therapy research with the mental health population. A table analyzing randomized and thoroughly controlled studies involving the use of CBT for persons with severe mental illnesses is included to determine chief components of high-quality experimental research designs and implementation of quantitative clinical research. The table also shows the same analyzed components for existing quantitative psychiatric music therapy research with adult consumers, thus highlighting potential areas and elements for future investigations. A second table depicts a number of potential dependent measures and their sources to be evaluated in future music therapy studies. A third table providing suggestions for future research is derived from a synthesis of the tables and is included to guide researchers and encourage the advancement and expansion of the current literature base. The body of the paper is a discussion of the results of the literature analysis derived from the tables, meta-analyses, and reviews of literature. It is hoped that this report will lead to the addition of future high-quality quantitative research to the psychiatric music therapy literature base and thus provide evidence-based services to as many persons with mental illnesses as possible.

摘要

虽然音乐治疗专业相对年轻且规模较小,但它可以治疗各种临床人群,并已建立了多样化的研究基础。然而,尽管该专业起源于与被诊断患有精神疾病的人合作,但对于音乐治疗对这一人群的影响,定量研究相当匮乏。音乐治疗临床医生和研究人员报告了证据的缺乏以及对其干预措施进行社会心理研究的困难(Choi,1997;Silverman,2003a)。虽然已发表的研究为未来研究提供了建议,但没有研究为精心设计的高质量随机对照精神科音乐治疗研究的方法和设计提供详细的命题。其他心理治疗方法是如何建立其数据库的,音乐治疗领域能否借鉴它们严格的“方法学最佳实践”来加强自身的文献基础呢?因此,正如美国国立精神卫生研究所指出的,循证心理治疗的首选治疗方法是认知行为疗法(CBT),本文分析了这种心理治疗方法文献基础的各个方面。这项文献分析的目的是:(a)分析和确定针对成年精神科患者的高质量定量CBT研究的组成部分;(b)分析和确定针对成年患者的现有定量精神科音乐治疗研究的变量和其他要素;(c)比较这两组数据集,以确定未来针对精神健康人群的定量音乐治疗研究的最佳方法设计和变量。文中包含一张分析涉及使用CBT治疗重度精神疾病患者的随机和充分对照研究的表格,以确定高质量实验研究设计的主要组成部分和定量临床研究的实施情况。该表格还展示了针对成年患者的现有定量精神科音乐治疗研究中相同的分析组成部分,从而突出了未来研究的潜在领域和要素。第二张表格描绘了一些潜在的因变量及其来源,以便在未来的音乐治疗研究中进行评估。第三张表格是综合这些表格得出的,为未来研究提供了建议,旨在指导研究人员并鼓励当前文献基础的发展和扩展。本文主体部分讨论了从表格、荟萃分析和文献综述中得出的文献分析结果。希望本报告能为精神科音乐治疗文献基础增添未来高质量的定量研究,从而为尽可能多的精神疾病患者提供循证服务。

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