Developmental Psychology, Department of Psychology, University of Amsterdam, the Netherlands.
Developmental Psychology, Department of Psychology, University of Amsterdam, the Netherlands.
Clin Psychol Rev. 2022 Aug;96:102179. doi: 10.1016/j.cpr.2022.102179. Epub 2022 Jun 9.
Guided internet-based treatment is more efficacious than completely unguided or self-guided internet-based treatment, yet within the spectrum of guidance, little is known about the added value of human support compared to more basic forms of guidance. The primary aims of this meta-analysis were: (1) to examine whether human guidance was more efficacious than technological guidance in text-based internet treatments ("e-therapy") for mental disorders, and (2) whether more intensive human guidance outperformed basic forms of human guidance. PsycINFO, PubMed and Web of Science were systematically searched for randomized controlled trials that directly compared various types and degrees of online guidance. Thirty-one studies, totaling 6215 individuals, met inclusion criteria. Results showed that human guidance was slightly more efficacious than technological guidance, both in terms of symptom reduction (g = 0.11; p < .01) and adherence (0.26 < g < 0.29; p's < 0.01). On the spectrum of human support, results were slightly more favorable for regular guidance compared to optional guidance, but only in terms of adherence (OR = 1.89, g = 0.35; p < .05). Higher qualification of online counselors was not associated with efficacy. These findings extend and refine previous reports on guided and unguided online treatments.
基于互联网的指导治疗比完全无指导或自我指导的基于互联网的治疗更有效，但在指导范围内，与更基本形式的指导相比，人类支持的附加值知之甚少。本次荟萃分析的主要目的是：(1) 检验在基于文本的互联网治疗（“电子治疗”）中，人类指导是否比技术指导更有效，用于治疗精神障碍，以及 (2) 更密集的人类指导是否优于基本形式的人类指导。系统地在 PsycINFO、PubMed 和 Web of Science 中搜索了直接比较各种类型和程度在线指导的随机对照试验。符合纳入标准的研究共有 31 项，总计 6215 人。结果表明，在症状减轻（g=0.11；p<.01）和依从性（0.26<g<0.29；p's<.01）方面，人类指导都比技术指导稍微更有效。在人类支持的范围内，与可选指导相比，常规指导的结果略有利于治疗，但仅在依从性方面（OR=1.89，g=0.35；p<.05）。在线辅导员的更高资格与疗效无关。这些发现扩展和完善了以前关于有指导和无指导的在线治疗的报告。
