Bisby Madelyne A, Scott Amelia J, Fisher Alana, Gandy Milena, Hathway Taylor, Heriseanu Andreea I, Karin Eyal, Cross Shane, Staples Lauren, Titov Nickolai, Dear Blake F
eCentreClinic, School of Psychological Sciences, Faculty of Medicine and Health, Macquarie University.
MindSpot Clinic, MQ Health, Macquarie University.
J Consult Clin Psychol. 2023 Feb;91(2):95-111. doi: 10.1037/ccp0000761. Epub 2022 Oct 6.
In face-to-face treatments, mental health symptoms improve rapidly across the first few treatment sessions, and the pace of improvement slows with additional sessions. Some individuals also report clinically meaningful symptom improvements after only two or three treatment sessions. As the rate of symptom change has been given limited attention within digital treatments, the present study investigated the timing and magnitude of symptom change during an 8-week online treatment for anxiety and depression.
Three adult samples were derived from previous randomized controlled trials: generalized anxiety disorder ( = 165), major depression ( = 149), and mixed anxiety/depression ( = 262). Symptom scores were compared between consecutive weeks of treatment, and we examined the proportion of individuals who achieved a ≥ 25% or ≥ 50% improvement in symptoms each week.
Across all three samples, symptoms improved more rapidly during the first half of treatment compared to the second half of treatment. Within the first 4 weeks, over half of the participants had experienced a ≥ 25% improvement in symptoms, and approximately a third of participants had experienced a ≥ 50% improvement in symptoms. This pattern of change was found irrespective of diagnostic status or outcome measure.
A substantial number of people who receive internet-delivered treatments appear to experience rapid, large, and clinically significant symptom improvement early in treatment. These findings add to our theoretical understanding of symptom improvements during psychotherapy, and further research investigating the mechanisms of such change will inform the development of more effective treatments. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
在面对面治疗中，心理健康症状在最初几次治疗过程中改善迅速，随着治疗次数增加，改善速度会放缓。一些个体在仅接受两三次治疗后也报告有临床上显著的症状改善。由于在数字治疗中症状变化率受到的关注有限，本研究调查了在为期8周的焦虑和抑郁在线治疗期间症状变化的时间和程度。
三个成人样本来自先前的随机对照试验：广泛性焦虑障碍（n = 165）、重度抑郁症（n = 149）和混合性焦虑/抑郁（n = 262）。比较治疗连续几周之间的症状评分，并检查每周症状改善≥25%或≥50%的个体比例。
在所有三个样本中，与治疗后半段相比，治疗前半段症状改善更快。在最初4周内，超过一半的参与者症状改善≥25%，约三分之一的参与者症状改善≥50%。无论诊断状态或结果测量如何，均发现这种变化模式。
大量接受互联网治疗的人似乎在治疗早期就经历了快速、显著且具有临床意义的症状改善。这些发现增加了我们对心理治疗过程中症状改善的理论理解，进一步研究这种变化的机制将为开发更有效的治疗方法提供信息。（PsycInfo数据库记录（c）2023美国心理学会，保留所有权利）
