心理治疗的持续时间：与英国常规实践中的康复和改善率的关系。[已更正]。
Duration of psychological therapy: relation to recovery and improvement rates in UK routine practice. [corrected].
机构信息
William B. Stiles, PhD, Department of Psychology, Miami University, Oxford, Ohio, and Department of Psychology, Appalachian State University, Boone, North Carolina, USA; Michael Barkham, PhD, Centre for Psychological Services Research, Department of Psychology, University of Sheffield, UK; Sue Wheeler, PhD, Institute for Lifelong Learning, University of Leicester, UK
William B. Stiles, PhD, Department of Psychology, Miami University, Oxford, Ohio, and Department of Psychology, Appalachian State University, Boone, North Carolina, USA; Michael Barkham, PhD, Centre for Psychological Services Research, Department of Psychology, University of Sheffield, UK; Sue Wheeler, PhD, Institute for Lifelong Learning, University of Leicester, UK.
出版信息
Br J Psychiatry. 2015 Aug;207(2):115-22. doi: 10.1192/bjp.bp.114.145565. Epub 2015 May 7.
BACKGROUND
Previous studies have reported similar recovery and improvement rates regardless of treatment duration among patients receiving National Health Service (NHS) primary care mental health psychological therapy.
AIMS
To investigate whether this pattern would replicate and extend to other service sectors, including secondary care, university counselling, voluntary sector and workplace counselling.
METHOD
We compared treatment duration with degree of improvement measured by the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) for 26 430 adult patients who scored above the clinical cut-off point at the start of treatment, attended 40 or fewer sessions and had planned endings.
RESULTS
Mean CORE-OM scores improved substantially (pre-post effect size 1.89); 60% of patients achieved reliable and clinically significant improvement (RCSI). Rates of RCSI and reliable improvement and mean pre- and post-treatment changes were similar at all tested treatment durations. Patients seen in different service sectors showed modest variations around this pattern.
CONCLUSIONS
Results were consistent with the responsive regulation model, which suggests that in routine care participants tend to end therapy when gains reach a good-enough level.
背景
此前的研究报告表明，在接受国民保健服务（NHS）初级保健心理健康心理治疗的患者中，无论治疗持续时间如何，其康复和改善率都相似。
目的
调查这种模式是否会复制并扩展到其他服务领域，包括二级保健、大学咨询、志愿部门和工作场所咨询。
方法
我们比较了 26430 名成年患者的治疗持续时间与通过临床常规评估-结果衡量标准（CORE-OM）衡量的改善程度，这些患者在治疗开始时的得分高于临床临界值，参加了 40 次或更少的治疗次数，并计划结束治疗。
结果
平均 CORE-OM 评分显著提高（治疗前后效应量为 1.89）；60%的患者达到了可靠且具有临床意义的改善（RCSI）。在所有测试的治疗持续时间内，RCSI 和可靠改善的比率以及平均治疗前后的变化都相似。在不同服务领域接受治疗的患者在这种模式下略有差异。
结论
结果与响应调节模型一致，该模型表明，在常规护理中，参与者往往会在收益达到足够好的水平时结束治疗。
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