Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, USA.
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, USA.
BMC Psychiatry. 2019 Dec 18;19(1):406. doi: 10.1186/s12888-019-2394-y.
CBT comprises many discrete components that vary in complexity, but implementation and training efforts often approach CBT as a single entity. We examined variability in clinician intentions to use different structural and interventional components of CBT for three different clinical groups: clients receiving CBT, clients with depression, and clients with anxiety.
Clinicians (n = 107) trained in CBT completed a one-time electronic survey. Clinicians' intentions were measured using established item stems from social psychology adapted to examine intentions to use six specific CBT components: exposure therapy, cognitive restructuring, behavioral activation, planning homework, reviewing homework, and agenda-setting.
Intentions were weakest, on average, for exposure. They were strongest, on average, for reviewing homework. A series of ANOVAs with Tukey's post-hoc tests revealed that participants intended to use exposure with clients receiving CBT (p = .015) and clients with anxiety (p < .001) significantly more than for clients with depression. Participants intended to use behavioral activation with clients with depression (p = .01) significantly more than for clients with anxiety. No other intentions to use CBT components differed among these three clinical populations.
When studying determinants of CBT use and designing interventions to increase use, implementers should consider that different CBT components may require different implementation strategies.
Not applicable.
CBT 包含许多不同的组成部分，其复杂程度各不相同，但实施和培训工作通常将 CBT 视为一个整体。我们考察了临床医生在为三个不同临床群体（接受 CBT 的患者、抑郁患者和焦虑患者）使用 CBT 的不同结构性和介入性组成部分方面的意图差异。
接受过 CBT 培训的临床医生（n=107）完成了一次性电子调查。使用社会心理学中经过验证的项目条目来衡量临床医生的意图，这些条目经过改编后可用于考察使用六种特定 CBT 成分的意图：暴露疗法、认知重构、行为激活、安排家庭作业、检查家庭作业和设定议程。
平均而言，暴露的意图最弱。平均而言，复习家庭作业的意图最强。一系列具有 Tukey 事后检验的 ANOVA 揭示了参与者打算在接受 CBT 的患者（p=.015）和焦虑患者（p<.001）中比在抑郁患者中更频繁地使用暴露。参与者打算在抑郁患者中更频繁地使用行为激活（p=.01）比在焦虑患者中更频繁地使用行为激活。在这三个临床群体中，没有其他使用 CBT 成分的意图存在差异。
在研究 CBT 使用的决定因素和设计增加使用的干预措施时，实施者应考虑到不同的 CBT 成分可能需要不同的实施策略。
不适用。
