Department of Psychology, University of Sheffield, Sheffield, UK.
Cogn Behav Ther. 2021 Nov;50(6):439-451. doi: 10.1080/16506073.2020.1862292. Epub 2021 Jan 21.
Clinicians often omit or underuse several techniques while delivering therapy. These omissions can be due to unconscious factors (e.g., clinician's anxiety), or due to clinicians' deliberate decisions (e.g., modifying therapy believing that such modifications are on the patients' best interests). However, little is known about whether patients consider these modifications necessary. The main aim of this study was to explore the opinions about the important aspects of CBT according to both patients' and clinicians' perspectives. It also aimed to determine whether clinicians' anxiety influenced such preferences. To achieve these aims, two groups of participants were approached-CBT clinicians (n = 83) and CBT patients (n = 167). An online survey with a list of techniques commonly used in CBT was developed for each group, who indicated the importance they attributed to the techniques. Additionally, clinicians completed an anxiety measure. Results indicated that clinicians valued all "change-oriented" techniques and several "interpersonal engagement" techniques more than the patients. The only technique preferred by patients was "relaxation". Higher levels of clinician anxiety were associated with a lower preference for "behavioural experiments" and "exposure". In conclusion, clinicians are encouraged to plan therapy in collaboration with the patient, as well as to discuss the rationale for the implemented techniques.
临床医生在提供治疗时常会省略或低估一些技术。这些遗漏可能是由于无意识因素（例如，临床医生的焦虑），也可能是由于临床医生的刻意决定（例如，修改治疗，认为这些修改符合患者的最佳利益）。然而，人们对患者是否认为这些修改是必要的知之甚少。本研究的主要目的是探讨患者和临床医生的观点对认知行为治疗（CBT）的重要方面的看法。它还旨在确定临床医生的焦虑是否会影响这种偏好。为了实现这些目标，我们接触了两组参与者-CBT 临床医生（n=83）和 CBT 患者（n=167）。为每个组开发了一份在线调查，其中包含 CBT 中常用的技术列表，参与者会对这些技术的重要性进行打分。此外，临床医生还完成了一份焦虑量表。结果表明，临床医生比患者更重视所有“以改变为导向”的技术和一些“人际参与”技术。唯一受到患者青睐的技术是“放松”。临床医生的焦虑程度越高，对“行为实验”和“暴露”的偏好就越低。总之，临床医生应鼓励与患者共同制定治疗计划，并讨论所实施技术的基本原理。
