Mental Health Services, Stolpegaard Psychotherapy Centre, Capital Region of Denmark.
Department of Psychology, University of Copenhagen.
J Consult Clin Psychol. 2017 May;85(5):484-494. doi: 10.1037/ccp0000173. Epub 2017 Mar 23.
To investigate the effect of client feedback in group psychotherapy on attendance and treatment outcome for patients with eating disorders.
We conducted a randomized clinical trial with central randomization stratified for diagnosis and treatment type according to a computer-generated allocation sequence concealed to the investigators. One-hundred and 59 adult participants, diagnosed with bulimia nervosa, binge eating disorder, or eating disorder not otherwise specified according to DSM-IV, were included. Eighty participants were allocated to the experimental group, and 79 participants to the control group. Both groups received 20-25 weekly group psychotherapy sessions. In the experimental group, participants gave and received feedback about therapy progress and alliance, measured before and after each session using the Outcome Rating Scale and the Group Session Rating Scale. The primary outcome was rate of attendance to treatment sessions; the secondary outcome was severity of eating disorder symptoms measured with the Eating Disorder Examination interview. Exploratory outcomes were psychological distress measured with the Symptom Checklist-90-R and the Outcome Rating Scale, social functioning measured with the Sheehan Disability Scale, and episodes of self-harm and suicide measured with a modified version of the Self-Harm Inventory.
Feedback compared with control did not affect the rate of attendance (0.59 vs. 0.58; p = .96), the severity of symptoms (2.03 vs. 2.02; p = .46), or any of the exploratory outcomes (p values from 0.06 to 0.67).
Feedback neither increased attendance nor improved outcomes for outpatients in group psychotherapy for eating disorders. The results are discussed from different perspectives. (PsycINFO Database Record
探究团体心理治疗中来访者反馈对饮食障碍患者就诊率和治疗效果的影响。
我们进行了一项随机临床试验，采用中央随机化，根据隐藏于研究者之外的计算机生成的分配序列，按照诊断和治疗类型进行分层。共纳入 159 名符合 DSM-IV 诊断标准的成年来访者，包括神经性贪食症、暴食障碍或其他特定或未特定的进食障碍。80 名参与者被分配到实验组，79 名参与者被分配到对照组。两组均接受 20-25 次每周的团体心理治疗。在实验组中，参与者在每次治疗前后使用治疗结果评定量表和团体治疗评定量表对治疗进展和联盟情况进行自评和他评。主要结局是就诊率；次要结局是使用进食障碍检查访谈评估的饮食障碍严重程度。探索性结局包括使用症状清单-90-R 和治疗结果评定量表评估的心理困扰、用希恩残疾量表评估的社会功能以及使用自我伤害量表的改良版评估的自伤和自杀事件。
与对照组相比，反馈并未影响就诊率（0.59 比 0.58；p =.96）、症状严重程度（2.03 比 2.02；p =.46）或任何探索性结局（p 值范围为 0.06 至 0.67）。
在团体心理治疗中，反馈既没有增加饮食障碍门诊患者的就诊率，也没有改善他们的治疗效果。该结果从不同视角进行了讨论。
