MacGregor Alastair D, Hayward Linda, Peck David F, Wilkes Peter
New Craigs Hospital, Inverness, UK.
Behav Cogn Psychother. 2009 Jan;37(1):1-9. doi: 10.1017/S135246580800492X.
Computer-guided CBT has been shown to be a potentially useful way of closing the gap between the demand and supply for CBT. Moreover, this approach has additional benefits in terms of less travel times for treatment, accessibility in remote and unusual locations, increased confidentiality, easier disclosure of sensitive information, and more egalitarian therapist-client interactions. Research on computerized CBT has concentrated on clinical outcomes, but the views of clients on this treatment approach have been relatively neglected.
The aims were to assess client satisfaction, professionals' views, and ease of programme use after completion of treatment via an internet-based CBT programme for panic and phobic anxiety (FearFighter).
A feasibility and effectiveness study of FearFighter was conducted in remote and rural areas of Scotland. Treatment data are available for 35 clients at post-treatment, of whom 29 completed an 18-item set of rating scales designed to assess satisfaction, including ease of use, accessibility, how far needs were met, whether changes to the programme were required, the benefits and drawbacks of not having a therapist, and quality of support. Open-ended questions were included. Referring agencies were also asked to rate their views on FearFighter.
Clients reported moderate to high levels of improvement and of overall satisfaction; very few difficulties in logging on to and using the programme were encountered. Similar levels of satisfaction with the programme were reported by referrers.
It is concluded that computer-guided CBT is acceptable to clients and to professionals, and that it could play a valuable part in a "stepped care" system of delivering CBT.
计算机辅助认知行为疗法(CBT)已被证明是缩小CBT供需差距的一种潜在有效方法。此外,这种方法还有其他益处,比如减少治疗的出行时间、偏远及特殊地点也可进行治疗、保密性增强、更易披露敏感信息以及治疗师与来访者之间的互动更加平等。关于计算机化CBT的研究主要集中在临床疗效上,而来访者对这种治疗方法的看法相对被忽视了。
旨在通过一个针对惊恐和恐惧性焦虑的基于互联网的CBT项目(“恐惧斗士”),评估治疗结束后来访者的满意度、专业人员的看法以及项目使用的便捷性。
在苏格兰的偏远和农村地区对“恐惧斗士”进行了一项可行性和有效性研究。有35名来访者的治疗后数据可供使用,其中29人完成了一套18项的评定量表,旨在评估满意度,包括使用便捷性、可及性、需求满足程度、是否需要对项目进行调整、没有治疗师的利弊以及支持质量。还设置了开放式问题。转诊机构也被要求对他们对“恐惧斗士”的看法进行评分。
来访者报告有中度到高度的改善及总体满意度;登录和使用该项目时遇到的困难极少。转诊机构对该项目的满意度也处于相似水平。
得出的结论是,计算机辅助CBT为来访者和专业人员所接受,并可能在提供CBT的“阶梯式护理”系统中发挥重要作用。