Aguilera Adrian, Ramos Zorangeli, Sistiva Diana, Wang Ye, Alegria Margarita
University of California, Berkeley, School of Social Welfare, 120 Haviland Hall, Berkeley, CA, MC7400, USA.
University of California, San Francisco, Department of Psychiatry, San Francisco, CA.
Cognit Ther Res. 2018 Jun;42(3):340-347. Epub 2018 Jan 6.
Homework completion in cognitive behavioral therapy (CBT) for depression is an integral ingredient in treatment that often goes unreported. Furthermore, many studies of homework completion focus on patient adherence without considering the therapists' role in reviewing and reinforcing this behavior. No studies to date have assessed the relationship between homework variables and outcomes among Latinos receiving CBT for depression. Since this population has often been difficult to engage in CBT, this study aims to assess whether homework completion and therapist review of homework are related to improved outcomes in a CBT intervention (telephone or in person) for Latinos with depression. We found that higher homework completion was significantly related to lower depression scores at the end of final treatment (as measured by PHQ-9) ( = -1.38, < 0.01). However, the significant association of homework with depression went away when clinician review of homework was included in a subsequent step of the model ( = -0.42, p = 0.45). The number of times a clinician actively reviewed homework was still significantly related to a decrease in PHQ-9 when controlling for demographic factors ( = -1.23, < 0.01). This study found that homework is a predictor of improved outcomes in CBT for depression but highlights the role of therapists reviewing homework as a predictor of lower depression symptoms among Spanish speaking Latinos from low socioeconomic backgrounds.
在抑郁症认知行为疗法(CBT)中,家庭作业的完成情况是治疗中一个不可或缺的要素,但往往未被报告。此外,许多关于家庭作业完成情况的研究都集中在患者的依从性上,而没有考虑治疗师在检查和强化这种行为方面所起的作用。迄今为止,尚无研究评估接受CBT治疗抑郁症的拉丁裔患者家庭作业变量与治疗结果之间的关系。由于这一群体往往难以参与CBT治疗,本研究旨在评估家庭作业的完成情况以及治疗师对家庭作业的检查是否与针对患有抑郁症的拉丁裔患者的CBT干预(电话或面对面)中治疗结果的改善相关。我们发现,较高的家庭作业完成率与最终治疗结束时较低的抑郁评分(通过PHQ - 9测量)显著相关(β = -1.38,p < 0.01)。然而,当在模型的后续步骤中纳入临床医生对家庭作业的检查时,家庭作业与抑郁之间的显著关联消失了(β = -0.42,p = 0.45)。在控制人口统计学因素后,临床医生积极检查家庭作业的次数仍与PHQ - 9评分的降低显著相关(β = -1.23,p < 0.01)。本研究发现,家庭作业是抑郁症CBT治疗结果改善的一个预测因素,但突出了治疗师检查家庭作业作为来自低社会经济背景的讲西班牙语的拉丁裔患者抑郁症状减轻的一个预测因素的作用。