Delgadillo Jaime, Groom Martin
Clinical Psychology Unit,University of Sheffield,Western Bank,Sheffield S10 2TN,UK.
Leeds Community Healthcare NHS Trust,Leeds IAPT,Burmantofts Health Centre,Cromwell Mount,Leeds LS9 7TA,UK.
Behav Cogn Psychother. 2017 Mar;45(2):170-184. doi: 10.1017/S1352465816000643.
Pre-treatment role induction interventions have been suggested to potentially enhance attendance and clinical outcomes in psychotherapy.
This study aimed to evaluate the effects of a programme of three transdiagnostic seminars (TDS) for patients with common mental disorders accessing cognitive behavioural therapy (CBT) in primary care. TDS included CBT psychoeducation and role induction.
A random sample of patients (n = 49) participated in TDS followed by CBT (TDS+CBT) and they were compared with matched controls (n = 49) accessing usual CBT. TDS participants rated the relevance and quality of this intervention using an acceptability questionnaire (AQ). Treatment completion (vs dropout) rates were compared across groups using chi-square tests. Post-treatment changes in depression (PHQ-9) and anxiety (GAD-7) symptoms were compared between groups using analysis of covariance controlling for potential confounders. Analyses were based on intention-to-treat principles.
Mean AQ ratings of the TDS intervention were comparable across diagnostic groups (p = .05). Treatment completion rates were significantly higher (p = .02) in the TDS+CBT group (87.8%) by comparison with usual CBT (68.8%). However, no significant differences in post-treatment symptom changes were found for depression (p = .34) or anxiety measures (p = .71).
Incorporating a psychoeducational role induction prior to CBT significantly improved treatment retention, but not overall symptom reductions.
治疗前的角色诱导干预被认为可能会提高心理治疗的出勤率和临床效果。
本研究旨在评估一项针对在初级保健机构接受认知行为疗法（CBT）的常见精神障碍患者的三个跨诊断研讨会（TDS）计划的效果。TDS包括CBT心理教育和角色诱导。
随机抽取患者样本（n = 49）参加TDS，随后接受CBT（TDS + CBT），并将他们与接受常规CBT的匹配对照组（n = 49）进行比较。TDS参与者使用可接受性问卷（AQ）对该干预的相关性和质量进行评分。使用卡方检验比较各组的治疗完成率（与退出率）。使用协方差分析控制潜在混杂因素，比较两组治疗后抑郁（PHQ - 9）和焦虑（GAD - 7）症状的变化。分析基于意向性治疗原则。
TDS干预的平均AQ评分在各诊断组之间具有可比性（p = 0.05）。与常规CBT（68.8%）相比，TDS + CBT组的治疗完成率显著更高（p = 0.02）（87.8%）。然而，在抑郁（p = 0.34）或焦虑测量（p = 0.71）方面，治疗后症状变化没有显著差异。
在CBT之前纳入心理教育角色诱导可显著提高治疗保留率，但不能整体减轻症状。
