挑战密集短期动态心理治疗社交焦虑障碍中的挑战作用：一项随机对照试验。
Challenging the role of challenge in intensive short-term dynamic psychotherapy for social anxiety disorder: A randomized controlled trial.
机构信息
Department of Psychology, University of Kurdistan, Sanandaj, Iran.
Centre for Emotions and Health, Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
出版信息
J Clin Psychol. 2020 Dec;76(12):2123-2132. doi: 10.1002/jclp.22993. Epub 2020 Jun 22.
OBJECTIVES
Intensive short-term dynamic psychotherapy (ISTDP) requires the technique of challenge to defenses when treating resistant patients. As the technique of challenge is difficult for some therapists to practice, it leads us to question whether challenge can be replaced by clarification of defenses without losing treatment effectiveness. This study compared ISTDP with two different technical emphases while treating social anxiety disorder (SAD).
METHOD
Forty-two subjects with DSM-5 SAD were randomly assigned to either a waitlist control, 10 sessions of ISTDP with the use of challenge or 10 sessions of ISTDP without the use of challenge.
RESULTS
ISTDP led to significant, sustained symptom reduction on the Liebowitz Social Anxiety Scale (LSAS-SR) compared with the control group. There were no significant outcome differences between standard ISTDP and ISTDP where challenge was restricted.
CONCLUSION
ISTDP is efficacious for SAD. ISTDP may be effective for SAD without the use of challenge elements.
目的
强化短期动力心理疗法（ISTDP）在治疗抵抗性患者时需要使用挑战防御的技术。由于对于一些治疗师来说，挑战技术难以实施，这使得我们质疑在不丧失治疗效果的情况下，是否可以用澄清防御来替代挑战。本研究在治疗社交焦虑障碍（SAD）时比较了 ISTDP 与两种不同的技术侧重点。
方法
42 名符合 DSM-5 SAD 的受试者被随机分配到等待名单对照组、10 次使用挑战的 ISTDP 组或 10 次不使用挑战的 ISTDP 组。
结果
与对照组相比，ISTDP 显著、持续地降低了 Liebowitz 社交焦虑量表（LSAS-SR）的症状，两组之间没有显著的结局差异。
结论
ISTDP 对 SAD 有效。在不使用挑战要素的情况下，ISTDP 对 SAD 可能同样有效。
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