J Psychiatr Pract. 2020 Mar;26(2):89-100. doi: 10.1097/PRA.0000000000000455.
A lack of resources and cultural stigma associated with mental health treatment necessitate the development of innovative and economical individualized treatments. This study evaluated the efficacy of delivering computer-based cognitive behavioral therapy (e-CBT) presented through Microsoft PowerPoint and delivered via email in the treatment of generalized anxiety disorder (GAD) to Iranian patients, as a means of overcoming treatment barriers.
Participants (N=80) of Iranian descent were recruited through announcements on psychology websites, Iranian organization websites, weblogs, and in flyers. Participants were randomly assigned to either an e-CBT or a control group. The e-CBT group received 12 weekly modules and homework assignments through email, presented using PowerPoint. The control group received no treatment (individuals in the control group were able to pursue another treatment, but would then be excluded from the study although they could continue with the program). All emails were sent by an attending or resident psychiatrist, who also provided feedback on weekly homework via email. The Beck Anxiety Inventory was used to measure levels of anxiety before study onset and changes in levels of anxiety upon completion of the program at 12 weeks, and at 6-month and 1-year follow-up in both groups.
Beck Anxiety Inventory scores were significantly reduced in the group who received PowerPoint e-CBT modules delivered via email, compared with the control group, following 12 weeks of treatment, and the reductions were maintained at both follow-up points.
Delivery of PowerPoint e-CBT modules via email was found to be a viable method for delivering CBT to individuals with GAD and a simple method for overcoming language, cultural, and travel barriers to accessing mental health resources. This simplified approach to the individualization and delivery of treatment modules has the potential to improve access to CBT as a treatment option throughout the world.
由于缺乏资源和与心理健康治疗相关的文化耻辱感，需要开发创新和经济实惠的个体化治疗方法。本研究评估了通过 Microsoft PowerPoint 呈现并通过电子邮件提供的基于计算机的认知行为疗法（e-CBT）治疗广泛性焦虑症（GAD）的疗效，以此克服治疗障碍。
通过在心理学网站、伊朗组织网站、博客和传单上发布公告，招募具有伊朗血统的参与者。参与者被随机分配到 e-CBT 组或对照组。e-CBT 组通过电子邮件每周接收 12 个模块和作业，使用 PowerPoint 呈现。对照组未接受治疗（对照组中的个体可以寻求其他治疗，但随后将被排除在研究之外，尽管他们可以继续该计划）。所有电子邮件均由主治医生或住院医师发送，他们还通过电子邮件提供每周作业的反馈。在研究开始前和 12 周治疗结束时、6 个月和 1 年随访时，使用贝克焦虑量表（Beck Anxiety Inventory）测量两组的焦虑水平。
与对照组相比，接受通过电子邮件发送的 PowerPoint e-CBT 模块的组在 12 周的治疗后，贝克焦虑量表得分显著降低，并且在两个随访点都保持降低。
通过电子邮件发送 PowerPoint e-CBT 模块被发现是一种可行的方法，可以为患有 GAD 的个体提供 CBT，并且是克服获取心理健康资源的语言、文化和旅行障碍的简单方法。这种简化的个体化和治疗模块提供方法有可能改善世界各地对 CBT 作为治疗选择的可及性。
