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认知行为团体治疗社交恐惧症:向社区诊所推广的证据。

Cognitive behavioural group therapy for social phobia: evidence of transportability to community clinics.

机构信息

Centre for Clinical Interventions, Northbridge, WA, Australia.

出版信息

Behav Res Ther. 2012 Apr;50(4):258-65. doi: 10.1016/j.brat.2012.01.009. Epub 2012 Feb 8.

DOI:10.1016/j.brat.2012.01.009
PMID:22394493
Abstract

Cognitive Behavioural Group Therapy (CBGT) for social phobia has been shown to be efficacious within research units and effective within a variety of real world clinical settings. However, most effectiveness studies of CBGT for social phobia have (a) used protocols without demonstrated efficacy, (b) not included direct comparison groups, and/or (c) contained features of efficacy trials. This study addressed these limitations by using a benchmarking strategy to compare outcomes from the same CBGT protocol used in both a research unit and a community clinic. Research (N = 71) and community (N = 94) patients completed the same 12-session protocol, which resulted in significant reductions in social anxiety and life interference at post-treatment. Compared to research unit patients, community patients had more severe symptoms and life interference at pre-treatment, and were more likely to be male, use medication, have comorbid disorders, and have lower educational attainment. Importantly, degree of improvement on social anxiety symptoms and life interference did not differ across the treatment settings for either completer or intention-to-treat analyses. There was some evidence that being younger, single, and having a depression diagnosis were associated with dropout. Pre-treatment symptoms and number of diagnoses predicted post-treatment symptoms. Consistent with previous uncontrolled trials, it is concluded that CBGT is effective within community mental health clinics.

摘要

认知行为团体治疗(CBGT)已被证明在研究单位中对社交恐惧症有效,并且在各种现实临床环境中都有效。然而,大多数针对社交恐惧症的 CBGT 有效性研究存在以下问题:(a)使用的方案未经证实有效,(b)未包括直接比较组,和/或(c)包含疗效试验的特征。本研究通过使用基准策略来解决这些局限性,比较了在研究单位和社区诊所中使用相同 CBGT 方案的结果。研究(N = 71)和社区(N = 94)患者完成了相同的 12 节疗程,治疗后社交焦虑和生活干扰均显著减少。与研究单位的患者相比,社区患者在治疗前的症状和生活干扰更严重,且更可能为男性、使用药物、患有合并症,且受教育程度较低。重要的是,无论是完成治疗者还是意向治疗分析,治疗环境都不会影响社交焦虑症状和生活干扰的改善程度。有一些证据表明,年龄较小、单身和患有抑郁症与辍学有关。治疗前的症状和诊断数量预测了治疗后的症状。与之前的非对照试验一致,本研究得出结论,CBGT 在社区心理健康诊所中是有效的。

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