Norder Susanne J, Visvalingam Shanara, Norton Peter J, Norberg Melissa M
Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia.
School of Psychology, Counselling, and Psychotherapy, The Cairnmillar Institute, Hawthorn East, VIC, Australia.
Psychother Res. 2023 Feb;33(2):131-145. doi: 10.1080/10503307.2022.2082340. Epub 2022 Jun 15.
Internalised shame has been linked to psychopathology and consistently identified as a predictor of poor treatment outcomes and premature therapy termination. We conducted a scoping review of therapist-delivered psychosocial interventions to reduce internalised shame to learn how to improve outcomes for individuals experiencing shame. Six bibliographical databases were searched for studies measuring internalised shame pre- and post-treatment. We screened 6846 abstracts; 42 full-text manuscripts were retrieved, with 16 studies meeting the inclusion criteria. Of these, 10 studies examined between- and within-subject effects, and 6 studies exclusively examined within-subject effects. Twelve of the sixteen included studies reported small to moderate within-group reductions in internalised shame. Between group analyses showed that shame interventions may be more effective than no treatment or treatment as usual, but not more effective than an active comparator. Successful treatments often involved psychoeducation, experiential exercises, and techniques to increase social support and emotional expression; however, study quality was weak to moderate and the importance of each of these techniques for reducing internalised shame was not determined.
内化羞耻感与精神病理学有关，并一直被认为是治疗效果不佳和过早终止治疗的预测因素。我们对治疗师提供的减少内化羞耻感的心理社会干预措施进行了一项范围综述，以了解如何改善有羞耻感个体的治疗效果。我们在六个书目数据库中搜索了测量治疗前后内化羞耻感的研究。我们筛选了6846篇摘要；检索到42篇全文手稿，其中16项研究符合纳入标准。其中，10项研究考察了组间和组内效应，6项研究专门考察了组内效应。16项纳入研究中的12项报告了组内内化羞耻感有小到中度的降低。组间分析表明，羞耻感干预可能比不治疗或常规治疗更有效，但不比积极对照更有效。成功的治疗通常包括心理教育、体验式练习以及增加社会支持和情感表达的技巧；然而，研究质量较弱至中等，且这些技巧中每一项对减少内化羞耻感的重要性尚未确定。
