Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.
J Clin Psychol. 2022 Dec;78(12):2381-2395. doi: 10.1002/jclp.23360. Epub 2022 Apr 11.
Generalized anxiety disorder (GAD) is a chronic mental health condition that results in significant individual, societal, and economic burden. While cognitive behavioral therapy (CBT) is well established as an efficacious treatment for GAD, individuals have identified several logistical barriers to accessing face-to-face CBT. Remotely delivered treatments address many of these treatment barriers.
The aim of the current study was to synthesize the current literature on the efficacy of remote CBT for GAD using a meta-analytic approach. Relevant articles were identified through an electronic database search and 10 studies (with 11 remote conditions and 1071 participants) were included in the meta-analysis.
Within-group findings indicate that remote CBT for GAD results in large effect sizes from pretreatment to posttreatment (g = 1.30; 95% confidence interval [CI]: 1.03-1.58). Both low intensity and high intensity remote CBT interventions were found to result in large effect sizes (g = 1.36; 95% CI: 1.11-1.61 and g = 0.83; 95% CI: 0.20-1.47, respectively), with no significant differences between the treatment formats (Q = 2.28, p = 0.13). Between-group effect sizes were medium in size at posttreatment (g = 0.76; 95% CI: 0.47-1.06).
These findings have potential implications for the delivery of evidence-based treatment for GAD and the inclusion of remote methods in stepped care treatment approaches.
广泛性焦虑障碍（GAD）是一种慢性精神健康状况，会给个人、社会和经济带来重大负担。认知行为疗法（CBT）已被证实是治疗 GAD 的有效方法，但患者在接受面对面 CBT 治疗时会遇到一些实际困难。远程提供的治疗方法可以解决其中的许多治疗障碍。
本研究旨在通过元分析方法综合当前关于远程 CBT 治疗 GAD 的疗效的文献。通过电子数据库搜索确定相关文章，共有 10 项研究（涉及 11 种远程治疗方案和 1071 名参与者）纳入元分析。
组内发现表明，远程 CBT 治疗 GAD 可在治疗前后产生较大的效果（g=1.30；95%置信区间：1.03-1.58）。低强度和高强度远程 CBT 干预均能产生较大的效果（g=1.36；95%置信区间：1.11-1.61 和 g=0.83；95%置信区间：0.20-1.47），两种治疗方案之间无显著差异（Q=2.28，p=0.13）。治疗后组间效应大小为中等（g=0.76；95%置信区间：0.47-1.06）。
这些发现可能对 GAD 的循证治疗方法的实施以及将远程方法纳入阶梯式治疗方法产生影响。
