Menzies Ross, O'Brian Sue, Packman Ann, Jones Mark, Helgadóttir Fjóla Dögg, Onslow Mark
Australian Stuttering Research Centre, The University of Sydney, Australia.
School of Public Health, The University of Queensland, Australia.
J Commun Disord. 2019 Jul-Aug;80:81-91. doi: 10.1016/j.jcomdis.2019.04.003. Epub 2019 May 2.
It is now well established that adults who present to speech clinics for help with stuttering will have an increased risk of having an anxiety disorder, particularly social anxiety disorder. Concomitant psychological problems are known to interfere with the maintenance of the benefits of behavioral speech treatments for stuttering. The current team has developed and trialed a cognitive behavior therapy (CBT) program designed specifically to reduce anxiety in adults who stutter, and trials have shown promise for both an in-clinic version and a standalone internet-based version. The aim of the present study is to determine whether iGlebe, the internet-based version of the team's internet CBT treatment (previously known as CBTPsych), enhances the benefits of behavioral stuttering treatment.
Participants were 32 adults seeking treatment for stuttering. The design was a two-arm randomized experimental trial with blinded outcome assessments at 6 and 12 months post-randomization. Both arms received basic speech-restructuring training to reduce stuttering, without any anxiolytic (anxiety reducing) components. The experimental arm also received 5 months access to iGlebe.
There was evidence that, at 12 months post-randomization, iGlebe added clinically significant improvements to self-reported stuttering severity and quality of life. The present experimental trial provides the first evidence that the addition of CBT to speech restructuring improves speech outcomes.
The present results will be the basis for the development of a comprehensive, internet-based treatment program for anxiety associated with stuttering. Ultimately, it may be possible for such an economical, scalable, and translatable comprehensive treatment model to supplement standard speech-language pathology treatment practices for those who stutter.
目前已明确，前往言语诊所寻求口吃治疗帮助的成年人患焦虑症的风险会增加，尤其是社交焦虑症。已知伴随的心理问题会干扰口吃行为治疗效果的维持。当前团队已开发并试验了一种认知行为疗法（CBT）项目，专门用于减轻口吃成年人的焦虑，试验表明该项目的诊所版和独立的基于互联网的版本都颇具前景。本研究的目的是确定该团队基于互联网的CBT治疗（先前称为CBTPsych）的网络版iGlebe是否能增强口吃行为治疗的效果。
参与者为32名寻求口吃治疗的成年人。该设计为双臂随机实验性试验，在随机分组后6个月和12个月进行盲法结果评估。两组均接受基本的言语重构训练以减少口吃，且均无任何抗焦虑成分。实验组还可使用iGlebe 5个月。
有证据表明，在随机分组后12个月时，iGlebe在自我报告的口吃严重程度和生活质量方面带来了具有临床意义的改善。本实验性试验首次证明，在言语重构中加入CBT可改善言语治疗效果。
本研究结果将为开发一个全面的、基于互联网的口吃相关焦虑治疗项目奠定基础。最终，这样一种经济、可扩展且可转化的综合治疗模式有可能补充针对口吃者的标准言语病理学治疗方法。
