Dryman M Taylor, McTeague Lisa M, Olino Thomas M, Heimberg Richard G
Department of Psychology, Temple University.
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina.
J Consult Clin Psychol. 2017 Oct;85(10):988-999. doi: 10.1037/ccp0000232. Epub 2017 Jun 26.
Internet-delivered cognitive-behavioral therapy (ICBT) has been established as both efficacious and effective in reducing symptoms of social anxiety. However, most research has been conducted in controlled settings, and little is known regarding the utility of such programs in an open-access format. The present study examined the use, adherence, and effectiveness of Joyable, an open-access, Internet-delivered, coach-supported CBT-based intervention for social anxiety.
Participants were 3,384 registered users (Mage [SD] = 29.82 [7.89]; 54% male) that created an account between 2014 and 2016. Characteristics of use, factors related to attrition and adherence, and within-group outcomes were examined. The primary outcome measure was the Social Phobia Inventory.
On average, participants remained in the program for 81.02 days (SD = 60.50), during which they completed 12.14 activities (SD = 11.09) and 1.53 exposures (SD = 3.18). About half (57%) had contact with a coach. Full adherence to the program was achieved by 16% of participants, a rate higher than previously published open-access studies of ICBT. Social anxiety symptoms were significantly reduced for participants that engaged in the program, with medium within-group effects from baseline through the cognitive restructuring module (d = 0.63-0.76) and large effects from baseline through the exposure module (d = 1.40-1.83). Response rates were high (72%). Exposures and coach contact were significant predictors of retention and outcome.
This open-access online CBT-based program is effective in reducing social anxiety symptoms and has the potential to extend Internet-based mental health services to socially anxious individuals unwilling or unable to seek face-to-face evidence-based therapy. (PsycINFO Database Record
基于互联网的认知行为疗法（ICBT）已被证实对减轻社交焦虑症状有效。然而，大多数研究是在受控环境中进行的，对于这种开放式获取形式的项目效用知之甚少。本研究考察了“愉悦”（Joyable）这一开放式获取、基于互联网、有教练支持的针对社交焦虑的认知行为疗法干预措施的使用情况、依从性和有效性。
参与者为2014年至2016年间创建账户的3384名注册用户（年龄均值[标准差]=29.82[7.89]；54%为男性）。考察了使用特征、与退出和依从相关的因素以及组内结果。主要结局指标为社交恐惧症量表。
参与者平均在该项目中停留81.02天（标准差=60.50），在此期间他们完成了12.14项活动（标准差=11.09）和1.53次暴露练习（标准差=3.18）。约一半（57%）的人与教练有过接触。16%的参与者完全依从该项目，这一比例高于此前发表的关于ICBT的开放式获取研究。参与该项目的参与者社交焦虑症状显著减轻，从基线到认知重构模块有中等程度组内效应（d=0.63 - 0.76），从基线到暴露模块有较大效应（d=1.40 - 1.83）。缓解率较高（72%）。暴露练习和与教练接触是留存率和治疗效果的显著预测因素。
这个基于开放式获取的在线认知行为疗法项目在减轻社交焦虑症状方面有效，并且有可能将基于互联网的心理健康服务扩展到那些不愿意或无法寻求面对面循证治疗的社交焦虑个体。（PsycINFO数据库记录
