Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel.
Department of Pediatric Rehabilitation, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel.
Dev Med Child Neurol. 2023 Aug;65(8):1012-1028. doi: 10.1111/dmcn.15507. Epub 2023 Feb 1.
To synthesize the evidence about the main intervention characteristics of cognitive behavioral therapies (CBTs) for individuals with cerebral palsy and identify barriers and facilitators to their success, focusing on aspects of feasibility and markers of success.
A scoping review methodology informed a literature search for papers published between 1991 and 2021. Articles were screened, reviewed, and categorized using the DistillerSR systematic review software, and critically appraised for quantitative and/or qualitative criteria.
Out of 1265 publications identified, 14 met the inclusion criteria. Elements associated with the specific study participant characteristics (46% female; aged 6-65 years), type of CBT techniques used (third-wave [n = 6], cognitive [n = 3], cognitive and behavioral [n = 2], biofeedback training [n = 2]), and features of the study context and methodological quality (two randomized clinical trials and small sample sizes [n ≤ 12]), were identified. Most studies had psychological targets of intervention (n = 10) and secondary physiological (n = 3) or social (n = 2) objectives. Feasibility indicators were described in nearly one-third of the papers.
This study highlights the high flexibility within CBT interventions, enabling their adaptation for individuals with cerebral palsy. However, relatively little, and only low-certainty evidence was identified. More high-quality research in terms of specific CBT techniques, optimal treatment doses, and detailed population characteristics are needed.
综合有关针对脑瘫患者的认知行为疗法(CBT)的主要干预特征的证据,并确定其成功的障碍和促进因素,重点关注可行性方面和成功指标。
采用范围综述方法对 1991 年至 2021 年间发表的论文进行文献检索。使用 DistillerSR 系统评价软件对文章进行筛选、审查和分类,并根据定量和/或定性标准进行批判性评价。
在确定的 1265 篇论文中,有 14 篇符合纳入标准。与特定研究参与者特征(46%为女性;年龄 6-65 岁)、使用的 CBT 技术类型(第三波 [n=6]、认知 [n=3]、认知和行为 [n=2]、生物反馈训练 [n=2])以及研究背景和方法学质量特征(两项随机临床试验和小样本量 [n≤12])相关的元素被确定。大多数研究都有心理干预目标(n=10)和次要的生理(n=3)或社会(n=2)目标。近三分之一的论文描述了可行性指标。
本研究强调了 CBT 干预措施的高度灵活性,使其能够适应脑瘫患者的需要。然而,仅确定了相对较少且仅具有低确定性的证据。需要更多关于特定 CBT 技术、最佳治疗剂量和详细人群特征的高质量研究。