Ritzert Timothy R, Forsyth John P, Sheppard Sean C, Boswell James F, Berghoff Christopher R, Eifert Georg H
University at Albany, State University of New York.
University at Albany, State University of New York.
Behav Ther. 2016 Jul;47(4):444-59. doi: 10.1016/j.beth.2016.03.001. Epub 2016 Mar 30.
Rigorous evaluations of cognitive behavioral self-help books for anxiety in pure self-help contexts are lacking. The present study evaluated the effectiveness of an Acceptance and Commitment Therapy (ACT) self-help workbook for anxiety-related concerns, with no therapist contact, in an international sample. Participants (N=503; 94% mental health diagnosis) were randomized to an immediate workbook (n=256) or wait-list condition (n=247). Assessments at pretreatment, 12weeks, 6months, and 9months evaluated anxiety and related symptoms, quality of life, and ACT treatment processes (e.g., psychological flexibility). Participants in the wait-list arm crossed over to the workbook following the 12-week assessment. The workbook condition yielded significant improvements on all assessments from pre- to posttreatment relative to wait-list, and these gains were maintained at follow-ups. The pattern observed in the wait-list condition was virtually identical to the active treatment arm after receiving the workbook, but not before. Attrition was notable, but supplemental analyses suggested dropout did not influence treatment effects for all but one measure. Overall, findings provide preliminary support for the effectiveness of this self-help workbook and suggest ACT-based self-help bibliotherapy might be a promising low-cost intervention for people experiencing significant anxiety-related concerns.
在纯自助情境下，针对焦虑症的认知行为自助书籍缺乏严格评估。本研究在一个国际样本中评估了一本接受与承诺疗法（ACT）自助工作手册对焦虑相关问题的有效性，且没有治疗师介入。参与者（N = 503；94%有心理健康诊断）被随机分为立即获得工作手册组（n = 256）或等待列表组（n = 247）。在治疗前、12周、6个月和9个月时进行评估，以评估焦虑及相关症状、生活质量和ACT治疗过程（如心理灵活性）。等待列表组的参与者在12周评估后转而使用工作手册。与等待列表组相比，工作手册组在治疗前到治疗后的所有评估中都有显著改善，且这些改善在随访中得以维持。在等待列表组中观察到的模式在接受工作手册后与积极治疗组几乎相同，但在此之前并非如此。损耗较为显著，但补充分析表明，除一项指标外，退出并未影响治疗效果。总体而言，研究结果为这本自助工作手册的有效性提供了初步支持，并表明基于ACT的自助书籍疗法可能是一种有前景的低成本干预措施，适用于有严重焦虑相关问题的人群。
