Owen Mary, Sellwood William, Kan Stephen, Murray John, Sarsam May
University of Liverpool, UK.
University of Lancaster, UK.
Behav Res Ther. 2015 Feb;65:76-85. doi: 10.1016/j.brat.2014.12.008. Epub 2014 Dec 23.
Individual cognitive behaviour therapy for psychosis (CBTp) is a recommended treatment in the acute phase and beyond. However, less is known about the effectiveness of group CBTp in acute care. This mixed methods study explored the implementation and effectiveness of brief group CBTp with inpatients. This prospective trial compared inpatients who received either a four week group CBTp program or treatment as usual (TAU). Participants (n = 113 at baseline) completed self-report measures of distress, confidence and symptoms of psychosis at baseline, post-intervention and one month follow up. CBTp group participants also completed a brief open-ended satisfaction questionnaire. Using complete case analysis participants who received CBTp showed significantly reduced distress at follow up compared to TAU and significantly increased confidence across the study and follow up period. However, these effects were not demonstrated using a more conservative intention-to-treat analysis. Qualitative analysis of the satisfaction data revealed positive feedback with a number of specific themes. The study suggests that brief group CBTp with inpatients may improve confidence and reduce distress in the longer term. Participants report that the groups are acceptable and helpful. However, given the methodological limitations involved in this 'real world' study more robust evidence is needed.
针对精神病的个体认知行为疗法(CBTp)是急性期及之后推荐使用的一种治疗方法。然而,关于团体CBTp在急性护理中的有效性,人们了解得较少。这项混合方法研究探讨了针对住院患者的简短团体CBTp的实施情况和有效性。这项前瞻性试验比较了接受为期四周的团体CBTp项目的住院患者和常规治疗(TAU)的住院患者。参与者(基线时n = 113)在基线、干预后和随访一个月时完成了关于痛苦、信心和精神病症状的自我报告测量。CBTp组的参与者还完成了一份简短的开放式满意度问卷。采用完整病例分析,与常规治疗相比,接受CBTp的参与者在随访时痛苦显著减轻,并且在整个研究和随访期间信心显著增强。然而,使用更保守的意向性分析时,这些效果并未得到证实。对满意度数据的定性分析揭示了一些具有特定主题的积极反馈。该研究表明,针对住院患者的简短团体CBTp可能会在长期内提高信心并减轻痛苦。参与者报告说这些团体是可以接受且有帮助的。然而,鉴于这项“现实世界”研究中存在的方法学局限性,还需要更有力的证据。