National eTherapy Centre, Swinburne University of Technology, Melbourne, Victoria, Australia.
Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia.
Psychol Psychother. 2021 Sep;94(3):854-883. doi: 10.1111/papt.12332. Epub 2021 Feb 23.
The COVID-19 pandemic has resulted in a widespread adoption of videoconferencing as a communication medium in mental health service delivery. This review considers the empirical literature to date on using videoconferencing to deliver psychological therapy to adults presenting with mental health problems.
Papers were identified via search of relevant databases. Quantitative and qualitative data were extracted and synthesized on uptake, feasibility, outcomes, and participant and therapist experiences.
Videoconferencing has an established evidence base in the delivery of cognitive behavioural therapies for post-traumatic stress disorder and depression, with prolonged exposure, cognitive processing therapy, and behavioural activation non-inferior to in-person delivery. There are large trials reporting efficacy for health anxiety and bulimia nervosa compared with treatment-as-usual. Initial studies show applicability of cognitive behavioural therapies for other anxiety and eating disorders and obsessive-compulsive spectrum disorders, but there has yet to be study of use in severe and complex mental health problems. Therapists may find it more difficult to judge non-verbal behaviour, and there may be initial discomfort while adapting to videoconferencing, but client ratings of the therapeutic alliance are similar to in-person therapy, and videoconferencing may have advantages such as being less confronting. There may be useful opportunities for videoconferencing in embedding therapy delivery within the client's own environment.
Videoconferencing is an accessible and effective modality for therapy delivery. Future research needs to extend beyond testing whether videoconferencing can replicate in-person therapy delivery to consider unique therapeutic affordances of the videoconferencing modality.
Videoconferencing is an efficacious means of delivering behavioural and cognitive therapies to adults with mental health problems. Trial evidence has established it is no less efficacious than in-person therapy for prolonged exposure, cognitive processing therapy, and behavioural activation. While therapists report nonverbal feedback being harder to judge, and clients can take time to adapt to videoconferencing, clients rate the therapeutic alliance and satisfaction similarly to therapy in-person. Videoconferencing provides opportunities to integrate therapeutic exercises within the person's day-to-day environment.
新冠疫情大流行导致视频会议作为精神卫生服务提供的沟通媒介得到广泛采用。本综述考虑了迄今为止使用视频会议为患有精神健康问题的成年人提供心理治疗的实证文献。
通过搜索相关数据库确定论文。提取并综合了关于采用率、可行性、结果以及参与者和治疗师体验的定量和定性数据。
视频会议在提供创伤后应激障碍和抑郁症的认知行为疗法方面具有既定的证据基础，延长暴露、认知加工疗法和行为激活与面对面治疗无差异。有大量试验报告了针对健康焦虑和神经性贪食症的疗效，与常规治疗相比。初步研究表明认知行为疗法在其他焦虑和饮食障碍以及强迫谱系障碍方面具有适用性，但尚未研究在严重和复杂的精神健康问题中的应用。治疗师可能会发现更难以判断非言语行为，并且在适应视频会议时可能会感到不适，但患者对治疗联盟的评价与面对面治疗相似，视频会议可能具有一些优势，例如不那么具有对抗性。在将治疗融入患者自己的环境中，视频会议可能具有有用的机会。
视频会议是一种可访问且有效的治疗传递方式。未来的研究需要超越测试视频会议是否可以复制面对面治疗传递，以考虑视频会议模式的独特治疗优势。
视频会议是为有精神健康问题的成年人提供行为和认知治疗的有效手段。试验证据表明，对于延长暴露、认知加工疗法和行为激活，它与面对面治疗一样有效。虽然治疗师报告说难以判断非言语反馈，但患者需要时间来适应视频会议，但患者对治疗联盟和满意度的评价与面对面治疗相似。视频会议为在患者的日常生活环境中整合治疗练习提供了机会。
