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忠诚偏差和治疗质量作为人本主义心理治疗有效性的调节因素:系统评价与荟萃分析方案

Allegiance Bias and Treatment Quality as Moderators of the Effectiveness of Humanistic Psychotherapy: Protocol for a Systematic Review and Meta-Analysis.

作者信息

Schünemann Olivia, Jansen Alessa, Willutzki Ulrike, Heinrichs Nina

机构信息

University of Bremen, Bremen, Germany.

Bundespsychotherapeutenkammer Germany, Berlin, Germany.

出版信息

JMIR Res Protoc. 2019 Nov 25;8(11):e15140. doi: 10.2196/15140.

Abstract

BACKGROUND

In many countries, humanistic psychotherapy (HPT) is viewed as a broad psychotherapeutic approach and is accepted in health care systems. To qualify for reimbursement by health insurance in Germany, psychotherapy approaches have to be evaluated positively by the German Scientific Board of Psychotherapy (GSBP). The GSBP examined HPT and its subapproaches based on an application by a number of professional organizations affiliated with HPT (Work Group Humanistic Psychotherapy, WGHPT). The GSBP came to the decision that none of the HPT subapproaches provided sufficient evidence to be evaluated as evidence based. Potential reasons for the discrepancy between international recognition of HPT and GSBP's decision will be explored: researchers' allegiance may have led to a risk of bias disadvantaging HPT. Furthermore, the evaluation criteria of the GSBP did not systematically consider whether HPT was conceptualized bona fide and implemented with sufficient treatment integrity in the studies.

OBJECTIVE

This systematic review will re-examine the studies included in the review of the GSBP. Within 2 comparisons (HPT vs control and HPT vs other psychotherapeutic interventions), we will examine moderating effects of treatment quality (bona fide and treatment integrity) and allegiance on the effectiveness of HPT.

METHODS

This review is based on the prior systematic review by the GSBP. The GSBP examined randomized controlled trials (RCTs) and studies with non-RCTs of HPT interventions for individuals with mental disorders. All studies suggested by the WGHPT were included; moreover, the GSBP conducted searches in standard electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, and PSYNDEX) and handsearches in relevant systematic reviews and contacted experts. A total of 2 independent GSBP reviewers performed study screening using a structured form. On the basis of the prior work of the GSBP, all studies that were positively screened by the GSBP will be included in this review. Data will be extracted independently by 4 authors. Standardized mean difference will be calculated, and possible publication bias will be tested using funnel plots and Egger test. A priori defined subgroup or meta-regression analyses will be performed for treatment quality, allegiance, type of nonactive control, study quality, type of subapproach, and target population (children and adolescents or adults).

RESULTS

The GSBP identified 115 eligible studies that will be reanalyzed in this systematic review.

CONCLUSIONS

Results about moderator effects of treatment quality and allegiance will provide important information about their impact on the evaluation of HPT and other psychotherapy approaches and can be used for further evaluation methods.

TRIAL REGISTRATION

PROSPERO CRD42019128983; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=128983.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/15140.

摘要

背景

在许多国家,人本主义心理治疗(HPT)被视为一种广泛的心理治疗方法,并在医疗保健系统中被接受。为了符合德国医疗保险的报销条件,心理治疗方法必须得到德国心理治疗科学委员会(GSBP)的积极评价。GSBP根据一些隶属于HPT的专业组织(人本主义心理治疗工作组,WGHPT)的申请,对HPT及其子方法进行了审查。GSBP得出的结论是,没有一种HPT子方法提供了足够的证据被评估为基于证据的方法。将探讨HPT在国际上得到认可与GSBP的决定之间存在差异的潜在原因:研究人员的忠诚可能导致了不利于HPT的偏倚风险。此外,GSBP的评估标准没有系统地考虑HPT在研究中是否被真诚地概念化并以足够的治疗完整性实施。

目的

本系统评价将重新审视GSBP评价中纳入的研究。在两项比较(HPT与对照组以及HPT与其他心理治疗干预)中,我们将研究治疗质量(真诚性和治疗完整性)和忠诚对HPT有效性的调节作用。

方法

本评价基于GSBP之前的系统评价。GSBP审查了针对精神障碍患者的HPT干预的随机对照试验(RCT)和非RCT研究。WGHPT建议的所有研究均被纳入;此外,GSBP在标准电子数据库(Cochrane对照试验中心注册库、MEDLINE、PsycINFO和PSYNDEX)中进行了检索,并在相关系统评价中进行了手工检索,并联系了专家。共有2名独立的GSBP评审员使用结构化表格进行研究筛选。基于GSBP之前的工作,所有被GSBP阳性筛选的研究都将纳入本评价。数据将由4位作者独立提取。将计算标准化均数差,并使用漏斗图和Egger检验测试可能的发表偏倚。将对治疗质量、忠诚、非活性对照类型、研究质量、子方法类型和目标人群(儿童和青少年或成年人)进行预先定义的亚组或元回归分析。

结果

GSBP确定了115项符合条件的研究,将在本系统评价中重新分析。

结论

关于治疗质量和忠诚调节作用的结果将提供有关它们对HPT和其他心理治疗方法评价影响的重要信息,并可用于进一步的评价方法。

试验注册

PROSPERO CRD42019128983;https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=128983。

国际注册报告识别码(IRRID):PRR1-10.2196/15140。

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