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认知行为疗法和心理动力疗法中关注患者现有资源与优势:一项系统评价与荟萃分析

Focusing on Patients' Existing Resources and Strengths in Cognitive-Behavioral Therapy and Psychodynamic Therapy: A Systematic Review and Meta-Analysis.

作者信息

Munder Thomas, Karcher Anna, Yadikar Öznur, Szeles Tanja, Gumz Antje

机构信息

Psychologische Hochschule Berlin (PHB) Am Köllnischen Park 2 D-10179 Berlin Germany Psychologische Hochschule Berlin (PHB).

Institut und Poliklinik für Psychosomatische Medizin und Psychotherapie Universitätsklinikum Hamburg-Eppendorf Germany.

出版信息

Z Psychosom Med Psychother. 2019 Jun;65(2):144-161. doi: 10.13109/zptm.2019.65.2.144.

DOI:10.13109/zptm.2019.65.2.144
PMID:31154930
Abstract

: Integrating a stronger focus on patients' existing strengths in traditional psychotherapy approaches is suggested by recent developments in psychological science, positive psychology, and psychotherapy research. However, the empirical status of treatments focusing on patients' existing strengths is unclear. The aim of this study was to conduct a systematic review (PROSPERO registration CRD42017054362) of studies on adaptations of traditional treatment approaches (e. g., cognitive-behavior therapy or psychodynamic therapy) explicitly focused on using patients' existing resources and strengths (hereafter, resource-focused treatments; RFT). : Extensive systematic literature search yielded k = 11 treatment comparisons from 10 studies contrasting RFTs with either an alternative psychotherapeutic approach or wait list. Effect sizes controlling for pre-treatment differences (g) and standard Hedges's g effect sizes (g) were aggregated with random-effects methods : Across 8 direct comparisons, RFTs were superior to other psychotherapeutic approaches, as indicated by small to moderate (g = -0.349, 95 % CI -0.576, -0.122, p = .003, I2 = 46.50 %) and small effect sizes (gPOWC = -0.190, 95 % CI -0.355, -0.025, p = .024, I = 0.00 %) in favor of RFTs. Sensitivity analyses corroborated results. Many included studies were characterized by limited sample size, risk of bias or researcher allegiance. : This meta-analysis showed preliminary evidence for the benefits of RFTs and suggests an intensification of further research efforts. The evidence was most convincing for hypnotherapeutic-systemic interventions as an add-on for cognitive-behavioral therapy.

摘要

心理学、积极心理学和心理治疗研究的最新进展表明,在传统心理治疗方法中应更加强调关注患者现有的优势。然而,专注于患者现有优势的治疗方法的实证状况尚不清楚。本研究的目的是对关于传统治疗方法(如认知行为疗法或心理动力疗法)的适应性研究进行系统综述(PROSPERO注册号CRD42017054362),这些研究明确侧重于利用患者现有的资源和优势(以下简称以资源为中心的治疗;RFT)。广泛的系统文献检索从10项研究中得出了k = 11项治疗比较,这些研究将RFT与另一种心理治疗方法或等待名单进行了对比。控制治疗前差异的效应量(g)和标准赫奇斯g效应量(g)采用随机效应方法进行汇总。在8项直接比较中,RFT优于其他心理治疗方法,小到中等效应量(g = -0.349,95%CI -0.576,-0.122,p = .003,I2 = 46.50%)和小效应量(gPOWC = -0.190,95%CI -0.355,-0.025,p = .024,I = 0.00%)表明RFT更具优势。敏感性分析证实了结果。许多纳入研究的特点是样本量有限、存在偏倚风险或研究者偏向。这项荟萃分析显示了RFT益处的初步证据,并建议加大进一步研究的力度。对于催眠系统干预作为认知行为疗法的附加疗法,证据最有说服力。

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