School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia.
School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia.
Psychother Psychosom. 2022;91(4):265-276. doi: 10.1159/000522530. Epub 2022 Apr 1.
Psychological adjustment to chronic health conditions is important, as poor adjustment predicts a range of adverse medical and psychosocial outcomes. Psychological treatments demonstrate efficacy for people with chronic health conditions, but existing research takes a disorder-specific approach and they are predominately delivered in face-to-face contexts. The internet and remotely delivered treatments have the potential to overcome barriers to accessing traditional face-to-face treatment.
The current study examined the efficacy and acceptability of an internet-delivered transdiagnostic psychological intervention to promote adjustment to illness, based on cognitive behaviour therapy principles.
In a two-arm randomised controlled trial, participants (n = 676) were randomly allocated to the 8-week intervention or a waitlist control. Treatment included five core lessons, homework tasks, additional resources, and weekly contact with a psychologist. Primary outcomes included depression, anxiety, and disability, assessed at pre-treatment, post-treatment, 3-month follow-up, and 12-month follow-up.
The treatment group reported significantly greater improvements in depression (between-groups d = 0.47), anxiety (d = 0.32), and disability (d = 0.17) at post-treatment (all ps <0.001). Improvements were sustained over the 3-month and 12-month follow-ups. High treatment completion rates (69%) and levels of satisfaction (86%) were reported by participants in treatment. The intervention required a mean clinician time of 56.70 min per participant.
The findings provide preliminary and tentative support for the potential of internet-delivered transdiagnostic interventions to promote adjustment to chronic health conditions. Further research using robust control groups, and exploring the generalisability of findings, is needed before firm conclusions can be drawn.
对慢性健康状况进行心理调整很重要，因为调整不良预示着一系列不良的医疗和心理社会结果。心理治疗对患有慢性健康状况的人有效，但现有研究采用特定障碍的方法，并且主要在面对面的环境中进行。互联网和远程提供的治疗有潜力克服传统面对面治疗的障碍。
本研究基于认知行为治疗原则，考察了一种互联网提供的跨诊断心理干预措施促进疾病适应的疗效和可接受性。
在一项两臂随机对照试验中，参与者（n = 676）被随机分配到 8 周的干预组或等待对照组。治疗包括五个核心课程、家庭作业任务、额外资源和每周与心理学家联系。主要结局包括抑郁、焦虑和残疾，在治疗前、治疗后、3 个月随访和 12 个月随访时进行评估。
治疗组在治疗后报告的抑郁（组间 d = 0.47）、焦虑（d = 0.32）和残疾（d = 0.17）方面有显著更大的改善（均 p <0.001）。改善在 3 个月和 12 个月的随访中得以维持。治疗组的参与者报告了较高的治疗完成率（69%）和满意度（86%）。干预措施平均每个参与者需要临床医生 56.70 分钟的时间。
这些发现初步和暂时支持了互联网提供的跨诊断干预措施促进慢性健康状况适应的潜力。需要使用更强大的对照组进行进一步研究，并探索发现的普遍性，然后才能得出确定的结论。
