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远程心理疗法对退伍军人的有效性:通过视频会议和电话提供服务的荟萃分析。

The effectiveness of telepsychology with veterans: A meta-analysis of services delivered by videoconference and phone.

机构信息

Department of Psychology.

Department of Educational, School, and Counseling Psychology.

出版信息

Psychol Serv. 2022 May;19(2):294-304. doi: 10.1037/ser0000522. Epub 2021 Feb 4.

Abstract

Veterans face a variety of stressors due to their military service and are more likely to develop psychological problems as a result. Research suggests that as many as half of veterans with mental health conditions go untreated due to barriers including lack of accessibility to services and stigma. The present study builds on previous research by using meta-analytic techniques to determine the effectiveness of telepsychology-delivered therapy with veterans. Empirical studies were included if they reported veteran-related outcome data on a psychological intervention used to treat a mental health condition remotely using either videoconferencing or telephone. Twenty-seven studies including 2,648 total participants (1,667 in treatment conditions and 981 in control conditions) met our inclusion criteria and were incorporated into our analysis. Twenty-five studies provided pre-post data to evaluate various therapy outcomes, and 18 studies used a randomized clinical trials (RCTs) design that allowed a comparison between telehealth and traditional in-person therapy. Publication bias was evaluated using correlations between sample and effect sizes for posttraumatic stress disorder (PTSD) and depression for pretest-posttest and RCT designs; risk was determined to be minimal. Weighted average pre-post effect sizes were moderate-to-strong for depression and trauma, and videoconferencing was more effective than telephone for depression ( = 0.86 and 0.46, respectively) and trauma ( = 1.00 and 0.51, respectively). Weighted average effect sizes computed from RCT studies suggest telepsychology is similarly effective as services provided face-to-face. More research is needed for telepsychology-delivered treatments for other mental health conditions faced by veterans. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

退伍军人由于服兵役而面临各种压力,因此更有可能出现心理问题。研究表明,由于服务可及性和污名化等障碍,多达一半有心理健康问题的退伍军人得不到治疗。本研究在前人研究的基础上,采用荟萃分析技术来确定远程心理治疗对退伍军人的疗效。如果研究报告了使用远程心理治疗方法治疗心理健康问题的退伍军人相关结果数据,包括使用视频会议或电话进行远程心理治疗的实证研究,则将其纳入分析。共有 27 项研究(共 2648 名参与者,治疗组 1667 名,对照组 981 名)符合纳入标准,并纳入分析。其中 25 项研究提供了治疗前后的数据,以评估各种治疗结果;18 项研究采用了随机临床试验(RCT)设计,允许在远程治疗和传统面对面治疗之间进行比较。使用 PTSD 和抑郁的预测试-后测试和 RCT 设计的样本和效应大小之间的相关性评估发表偏倚;风险被确定为最小。抑郁和创伤的加权平均预-后效应大小为中等到强,视频会议治疗抑郁(=0.86 和 0.46)和创伤(=1.00 和 0.51)的效果均优于电话。从 RCT 研究计算的加权平均效应大小表明,远程心理治疗与面对面服务同样有效。需要更多的研究来确定远程心理治疗对退伍军人面临的其他心理健康问题的疗效。(PsycInfo 数据库记录(c)2022 APA,保留所有权利)。

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