Institute of Psychiatry, Box PO77, King's College London, De Crespigny Park, London SE5 8AF, UK.
J Behav Ther Exp Psychiatry. 2013 Mar;44(1):98-104. doi: 10.1016/j.jbtep.2012.07.013. Epub 2012 Aug 17.
The dissemination and delivery of psychological therapies for people with psychosis has been limited by workforce and organisational factors. 'Low Intensity' (LI) delivery, whereby staff are trained to deliver brief, focused, manualised interventions, may be one way of improving access. In this study, we piloted a new LI intervention specifically for people with psychosis, aimed at helping people to reach a personal recovery goal, whilst targeting anxious avoidance or depression-related inactivity. Frontline mental health workers were trained to deliver the intervention. We report here on the impact of the intervention on therapeutic outcomes.
Twelve people with psychosis and either anxious avoidance or low mood, who wanted to work towards a personal goal, completed the intervention and a battery of assessments of mood, functioning and psychotic symptoms.
Eleven out of the twelve participants achieved their personal goals. The results of a series of Friedman K related sample tests revealed significant improvements in depression, clinical distress, activity levels, negative symptoms and delusions across the three time points, and no change in hallucinations, or anxious avoidance. Staff and participant satisfaction was high.
The study is a small uncontrolled pilot study. Outcomes should therefore be interpreted with caution, pending replication.
The new LI intervention shows preliminary evidence of effectiveness and is a feasible model of therapy delivery for people with psychosis. The results suggest that frontline mental health workers can be trained relatively easily to deliver the intervention. A larger, randomised controlled trial is warranted to determine the effectiveness of the intervention and training programme.
心理治疗在精神疾病患者中的传播和实施受到劳动力和组织因素的限制。“低强度”（LI）治疗，即培训工作人员提供简短、集中、规范化的干预措施，可能是改善治疗途径的一种方法。在这项研究中，我们为精神疾病患者试点了一种新的 LI 干预措施，旨在帮助人们实现个人康复目标，同时针对焦虑回避或与抑郁相关的不活动。一线心理健康工作者接受了该干预措施的培训。我们在此报告该干预措施对治疗结果的影响。
12 名有焦虑回避或情绪低落的精神疾病患者，希望为个人目标而努力，完成了干预措施和一系列情绪、功能和精神病症状评估。
12 名参与者中有 11 人实现了个人目标。一系列弗里德曼 K 相关样本检验的结果显示，抑郁、临床困扰、活动水平、阴性症状和妄想在三个时间点都有显著改善，而幻觉或焦虑回避没有变化。工作人员和参与者的满意度很高。
该研究是一项小型的非对照试点研究。因此，在等待复制结果之前，应谨慎解释结果。
新的 LI 干预措施初步显示出有效性，是一种针对精神疾病患者的可行的治疗实施模式。结果表明，一线心理健康工作者可以相对容易地接受培训来提供干预措施。需要进行更大规模的随机对照试验来确定干预措施和培训计划的有效性。
