Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
J Psychiatr Ment Health Nurs. 2012 Oct;19(8):681-9. doi: 10.1111/j.1365-2850.2011.01840.x. Epub 2011 Nov 1.
There is increasing interest in mental health nurses delivering structured short-term evidence-based psychotherapies such as cognitive behavioural therapy (CBT) and interpersonal psychotherapy (IPT); however, while there is evidence of the efficacy of psychotherapy for depression, there is limited understanding of the treatment processes. Data were drawn from audio tapes of CBT and IPT sessions for treatment of depression. The transcripts of the initial, middle and final psychotherapy sessions of 40 clients were analysed. A thematic analysis was conducted to identify what was occurring in the sessions, how the client was describing psychotherapy and how the client was describing improvement or lack of improvement in depressive symptoms. There were differences in descriptions of therapy and the experience of depression between clients who responded and those who did not respond to therapy that were related to improvement in symptoms but not to the specific therapy. These differences were in the client's engagement with the language of therapy, sense of optimism about the particular model of psychotherapy, ability to examine their own role in the problem and desire to engage with new ways of being in their lives. Clients who responded to CBT or IPT had flexibility to develop new ways of thinking and acting, the ability to accept responsibility for their role in the identified problem and were willing to risk change.
越来越多的人关注精神科护士提供结构化的短期循证心理治疗，如认知行为疗法（CBT）和人际心理治疗（IPT）；然而，虽然有证据表明心理治疗对抑郁症有效，但对治疗过程的理解有限。数据来自于抑郁症 CBT 和 IPT 治疗的音频磁带。对 40 名患者的初始、中期和最终心理治疗会议的记录进行了分析。采用主题分析来确定会议中发生了什么，患者如何描述心理治疗以及患者如何描述抑郁症状的改善或无改善。对治疗和抑郁经历的描述存在差异，那些对治疗有反应和没有反应的患者与症状改善有关，但与特定的治疗无关。这些差异在于患者对治疗语言的参与程度、对特定心理治疗模式的乐观程度、检查自己在问题中角色的能力以及与新的生活方式接触的愿望。对 CBT 或 IPT 有反应的患者具有发展新思维和行为方式的灵活性，能够为自己在确定问题中的角色承担责任，并愿意冒险改变。
