1 Boston University, Boston, MA, USA.
Behav Modif. 2019 Jul;43(4):518-543. doi: 10.1177/0145445518774914. Epub 2018 May 10.
Most patients in community practice attend significantly fewer sessions than are recommended by treatment protocols that have demonstrated efficacy in addressing emotional disorders. Personalized interventions that target the core processes thought to maintain a wide range of disorders may serve to increase treatment efficiency, addressing this gap. This study sought to evaluate the feasibility and acceptability of the personalized delivery of a mechanistically transdiagnostic intervention, the Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders. Using an AB phase change design in accordance with the single-case reporting guideline for behavioral interventions (SCRIBE), 18 individuals with heterogeneous emotional disorders were randomly assigned to receive UP treatment modules ordered according to either their pretreatment strengths or weaknesses. Results support the feasibility of reordering the treatment modules as the majority of patients presented with marked differences in skill levels, as well as the acceptability of this approach as patients in both conditions reported satisfaction with their assigned treatment order. Furthermore, the majority of patients demonstrated symptom improvement consistent with previously reported effects of the standard-order UP. Finally, there is preliminary evidence to suggest that those in the strengths condition displayed improvements in outcomes earlier in treatment than those in the weaknesses condition. Taken together, these findings offer preliminary support for improving treatment efficiency through the utilization of a personalized, strengths-based, transdiagnostic approach.
大多数在社区实践中接受治疗的患者接受的治疗次数明显少于已证明对情绪障碍有效治疗方案所建议的次数。针对被认为维持广泛障碍的核心过程的个性化干预措施可能有助于提高治疗效率,从而解决这一差距。本研究旨在评估个性化传递一种基于机制的跨诊断干预措施(统一治疗方案)治疗情绪障碍的可行性和可接受性。该研究采用与行为干预 SCRIBE 单一案例报告指南一致的 AB 相变化设计,将 18 名患有不同情绪障碍的个体随机分配到按照治疗前的优势或劣势顺序接受 UP 治疗模块。结果支持重新安排治疗模块的可行性,因为大多数患者在技能水平上存在明显差异,同时这种方法也具有可接受性,因为两种情况下的患者都对其分配的治疗顺序表示满意。此外,大多数患者表现出与之前报告的标准顺序 UP 效果一致的症状改善。最后,有初步证据表明,与劣势条件相比,优势条件下的患者在治疗早期的治疗结果得到了改善。综上所述,这些发现为通过利用个性化、基于优势的跨诊断方法来提高治疗效率提供了初步支持。