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通过社区组织进行哀伤辅导的效果:一项自然主义、对照试验。

Effectiveness of bereavement counselling through a community-based organization: A naturalistic, controlled trial.

机构信息

Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.

Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands.

出版信息

Clin Psychol Psychother. 2017 Nov;24(6):O1512-O1523. doi: 10.1002/cpp.2113. Epub 2017 Aug 29.

Abstract

This controlled, longitudinal investigation tested the effectiveness of a bereavement counselling model for adults on reducing complicated grief (CG) symptoms. Participants (N = 344; 79% female; mean age: 49.3 years) were adult residents of Scotland who were bereaved of a close relation or partner, experiencing elevated levels of CG, and/or risks of developing CG. It was hypothesized that participants who received intervention would experience a greater decline in CG levels immediately following the intervention compared to the control participants, but the difference would diminish at follow-up (due to relapse). Data were collected via postal questionnaire at 3 time points: baseline (T), post-intervention (T + 12 months), and follow-up (T + 18 months). CG, post-traumatic stress, and general psychological distress were assessed at all time points. Multilevel analyses controlling for relevant covariates were conducted to examine group differences in symptom levels over time. A stepwise, serial gatekeeping procedure was used to correct for multiple hypothesis testing. A main finding was that, contrary to expectations, counselling intervention and control group participants experienced a similar reduction in CG symptoms at postmeasure. However, intervention participants demonstrated a greater reduction in symptom levels at follow-up (M = 53.64; d = .33) compared to the control group (M = 62.00). Results suggest community-based bereavement counselling may have long-term beneficial effects. Further longitudinal treatment effect investigations with extensive study intervals are needed.

摘要

本对照性纵向研究旨在检验丧亲辅导模式对成年人减轻复杂性悲伤(CG)症状的有效性。研究对象为苏格兰的成年丧亲者(79%为女性,平均年龄 49.3 岁),他们经历了亲人或伴侣的离世,CG 症状明显或有 CG 风险。研究假设接受辅导的参与者与对照组相比,在辅导结束后 CG 水平会有更大的下降,但在随访时(因复发)会有所减少。数据通过邮寄问卷在三个时间点收集:基线(T)、干预后(T+12 个月)和随访(T+18 个月)。在所有时间点评估 CG、创伤后应激和一般心理困扰。采用多层次分析控制相关协变量,以检验随时间症状水平的组间差异。采用逐步、串行的门控程序对多重假设检验进行校正。主要发现是,与预期相反,辅导干预组和对照组在随访时 CG 症状的减轻程度相似。然而,与对照组(M=62.00)相比,干预组在随访时(M=53.64;d=.33)症状水平的降低更为显著。结果表明,基于社区的丧亲辅导可能具有长期的有益效果。需要进一步进行具有广泛研究间隔的纵向治疗效果研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4008/5763344/440fceb6f92b/CPP-24-O1512-g001.jpg

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