Riello Marianna, Purgato Marianna, Bove Chiara, Tedeschi Federico, MacTaggart David, Barbui Corrado, Rusconi Elena
Department of Psychology and Cognitive Science, University of Trento, Corso Bettini, 31, 3868 Rovereto, Trentino, Italy.
Gruppo SPES, Trento, Italy.
R Soc Open Sci. 2021 Nov 24;8(11):210219. doi: 10.1098/rsos.210219. eCollection 2021 Nov.
This article describes a randomized controlled trial to evaluate the effectiveness of a supervised online delivery of self-help plus (SH+), during the second wave of COVID-19 contagions in Northern Italy. The SH+ is a psychological intervention developed by the World Health Organization to increase a person's ability to deal with stress. In this trial, it was tested primarily as a tool to reduce anxiety and post-traumatic symptomatology in workers of residential nursing and care homes. In order to partial out non-specific effects of the intervention, the SH+ was compared to an equally supervised and structured alternative activity. Secondarily, in view of future emergencies, the potential of SH+ as a tool to reduce perceived stress, increase subjective well-being and foster individual resilience was explored. At post-intervention, the preregistered analysis revealed no difference in self-reported anxiety and/or post-traumatic symptomatology between the group receiving the SH+ and the group engaged in an alternative activity. Some specific and positive effects of the SH+ intervention were only found on self-reported intervention effectiveness and engagement in exploratory analyses. These findings raise the question whether the previously documented effectiveness of the SH+ on self-reported symptomatology and on the prevention of psychiatric conditions could be attributed mostly to non-specific rather than specific factors connected with participant enrolment in a psychological intervention. Indeed, the effects of the SH+ had been previously compared only to the effects of not being engaged in any alternative activity (often described in the literature as 'treatment as usual'-or 'enhanced treatment as usual', when some relevant information is given to the control group as a one-off). Given the negative findings of this study, before the SH+ is implemented in clinical practice, further studies should be conducted to examine its short- and long-term beneficial effects, by means of randomized studies that employ alternative but similarly structured interventions as control conditions, aiming to minimize the confounding effect of non-specific factors.
本文介绍了一项随机对照试验，以评估在意大利北部第二波新冠疫情期间，在线监督下提供自助增强疗法（SH+）的有效性。SH+是世界卫生组织开发的一种心理干预措施，旨在提高个人应对压力的能力。在这项试验中，它主要作为一种工具，用于减轻住宿护理院工作人员的焦虑和创伤后症状。为了排除干预措施的非特异性影响，将SH+与一项同样受到监督且结构相同的替代活动进行了比较。其次，鉴于未来可能出现的紧急情况，还探讨了SH+作为一种工具，在减轻感知压力、提高主观幸福感和培养个人复原力方面的潜力。干预后，预先注册的分析显示，接受SH+的组与参与替代活动的组在自我报告的焦虑和/或创伤后症状方面没有差异。仅在探索性分析中，发现SH+干预措施对自我报告的干预效果和参与度有一些特定的积极影响。这些发现提出了一个问题，即先前记录的SH+对自我报告症状和预防精神疾病的有效性，是否主要可归因于与参与者参与心理干预相关的非特异性而非特异性因素。事实上，之前SH+的效果仅与不参与任何替代活动的效果进行了比较（在文献中通常称为“常规治疗”，或者当向对照组一次性提供一些相关信息时称为“强化常规治疗”）。鉴于这项研究的负面结果，在将SH+应用于临床实践之前，应通过随机研究进一步开展研究，以检验其短期和长期的有益效果，随机研究采用替代但结构相似的干预措施作为对照条件，旨在尽量减少非特异性因素的混杂效应。
