Marziliano Allison, Applebaum Allison, Moyer Anne, Pessin Hayley, Rosenfeld Barry, Breitbart William
Department of Medicine, Center for Health Innovations and Outcomes Research, Northwell Health, New York, NY, United States.
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
Front Psychol. 2021 Feb 24;12:637519. doi: 10.3389/fpsyg.2021.637519. eCollection 2021.
This study examined whether patients who were randomly assigned to their preferred therapy arm had stronger engagement with their treatment than those who were randomly assigned to a non-preferred therapy arm. Data were drawn from a RCT comparing Individual Meaning-Centered Psychotherapy (IMCP), with Individual Supportive Psychotherapy (ISP), in patients with advanced cancer. Treatment engagement was operationalized as patients' perceptions of the therapeutic alliance with their therapist and therapy sessions attended. Two 2 by 2 Analysis of Variance (ANOVA) models were used, with treatment preference (IMCP vs. ISP) and treatment assignment (IMCP vs. ISP) as the independent variables and working alliance and number of sessions attended as outcome variables. Patients who preferred and were assigned to IMCP reported a significantly stronger alliance than those who preferred IMCP but were assigned to ISP. The findings from this study have broader implications for research on psychotherapy beyond the appeal of IMCP in advanced cancer patients. Patients who prefer a novel psychotherapy that they cannot engage in elsewhere, but receive the standard treatment may experience weaker alliance than patients who prefer the standard but receive the novel therapy. Clinicaltrial.gov ID: NCT01323309.
本研究考察了被随机分配到其偏好治疗组的患者，与被随机分配到非偏好治疗组的患者相比，是否对治疗有更强的参与度。数据取自一项随机对照试验，该试验比较了晚期癌症患者的个体意义中心心理治疗（IMCP）和个体支持性心理治疗（ISP）。治疗参与度通过患者对与治疗师的治疗联盟的感知以及参加的治疗疗程来衡量。使用了两个2×2方差分析（ANOVA）模型，将治疗偏好（IMCP与ISP）和治疗分配（IMCP与ISP）作为自变量，将工作联盟和参加的疗程数作为结果变量。偏好并被分配到IMCP的患者报告的联盟明显强于那些偏好IMCP但被分配到ISP的患者。本研究结果对心理治疗研究具有更广泛的意义，而不仅仅局限于IMCP对晚期癌症患者的吸引力。那些偏好一种在其他地方无法接受的新型心理治疗但接受标准治疗的患者，可能比那些偏好标准治疗但接受新型治疗的患者体验到更弱的联盟。临床试验.gov标识符：NCT01323309。
