Ong Clarissa W, Terry Carina L, Levin Michael E, Twohig Michael P
Department of Psychology.
Psychol Serv. 2023 Feb;20(1):166-177. doi: 10.1037/ser0000596. Epub 2021 Nov 4.
The global burden of mental illness and limited resources make increasing the efficiency of available mental healthcare resources especially crucial. One way this can be done is a stepped care approach to treatment. To test the viability of using internet-based self-help in a stepped care model, we examined the feasibility, acceptability, and effectiveness of an online self-help acceptance and commitment (ACT) program prior to starting in-person therapy at a university community clinic ( = 51). Online program acceptability was at least moderate. There was clinically significant change in 75.9%-79.3% and reliable change in 31.0%-100% of our sample on three of four outcomes of interest (e.g., symptom impairment) after the online program. In addition, 60%-100% reliably improved from the online program as well as from subsequent treatment on three of four outcomes, indicating that most of our sample progressed through the steps of care effectively and benefited from the quasi-stepped care approach. Scores also indicated positive overall effects of the online program and in-person therapy. Our findings tentatively support the use of low-intensity resources like online self-help programs to reduce therapist burden in outpatient clinics by initiating client progress before intake. Limitation to this approach and the study are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
精神疾病的全球负担以及资源有限使得提高现有精神卫生保健资源的效率变得尤为关键。实现这一目标的一种方法是采用阶梯式护理治疗方法。为了测试在阶梯式护理模式中使用基于互联网的自助服务的可行性,我们在一所大学社区诊所(n = 51)开始面对面治疗之前,研究了一个在线自助接纳与承诺疗法(ACT)项目的可行性、可接受性和有效性。在线项目的可接受性至少为中等。在完成在线项目后,我们样本中75.9%-79.3%的人在四个感兴趣的结果(如症状损害)中的三个方面有临床显著变化,31.0%-100%的人有可靠变化。此外,在四个结果中的三个方面,60%-100%的人从在线项目以及后续治疗中得到了可靠改善,这表明我们的大多数样本有效地通过了护理步骤,并从准阶梯式护理方法中受益。分数还表明了在线项目和面对面治疗的积极总体效果。我们的研究结果初步支持使用在线自助项目等低强度资源,通过在患者就诊前启动患者进展来减轻门诊诊所治疗师的负担。本文还讨论了这种方法和该研究的局限性。(PsycInfo数据库记录(c)2023美国心理学会,保留所有权利)