Faculty of Life and Social Sciences, National eTherapy Centre, Swinburne University, Hawthorn, Victoria 3122, Australia.
Cogn Behav Ther. 2009;38(2):100-13. doi: 10.1080/16506070802561132.
Internet-based interventions with therapist support have proven effective for treating a range of mental health conditions. This study examined whether frequency of therapist contact affected treatment outcomes. Fifty-seven people with panic disorder (including 32 with agoraphobia) were randomly allocated to an 8-week Internet-based cognitive behavioural treatment intervention (Panic Online) with either frequent (three e-mails per week) or infrequent (one e-mail per week) support from a psychologist. Posttreatment, intention-to-treat analyses revealed that both treatments were effective at improving panic disorder and agoraphobia severity ratings, panic-related cognitions, negative affect, and psychological and physical quality of life domains, with no differences between conditions. High end-state functioning was achieved by 28.6% of the frequent and infrequent participants, respectively. Therapist alliance, treatment credibility, and satisfaction also did not differ between groups, despite significantly greater therapist time invested in the frequent contact condition. The results provide evidence that the effectiveness of Internet-based mental health interventions may be independent of the frequency of therapist support and may, therefore, be more cost-effective than previously reported.
基于互联网的干预措施，辅以治疗师的支持，已被证明对治疗多种心理健康状况有效。本研究探讨了治疗师接触的频率是否会影响治疗效果。57 名惊恐障碍患者（包括 32 名伴有广场恐怖症的患者）被随机分配到一项为期 8 周的基于互联网的认知行为治疗干预措施（Panic Online）中，该干预措施由心理学家提供频繁（每周 3 封电子邮件）或不频繁（每周 1 封电子邮件）的支持。治疗后，意向治疗分析显示，两种治疗方法均能有效改善惊恐障碍和广场恐怖症严重程度评分、与惊恐相关的认知、负性情绪以及心理和生理生活质量领域，且两组间无差异。分别有 28.6%的频繁和不频繁参与者达到了高终点功能状态。尽管在频繁接触组中治疗师投入的时间明显更多，但治疗师联盟、治疗可信度和满意度在两组之间也没有差异。研究结果表明，基于互联网的心理健康干预措施的有效性可能与治疗师支持的频率无关，因此可能比之前报告的更具成本效益。
