两项基于网络的干预措施（Res-Up!和REMOTION）在常规门诊心理治疗（在线治疗升级版-TOP）中的评估：一项随机对照试验方案

Evaluation of Two Web-Based Interventions (Res-Up! and REMOTION) in Routine Outpatient Psychotherapy (Therapy Online Plus-TOP): Protocol for a Randomized Controlled Trial.

作者信息

Trimpop Leonie Franziska, Bielinski Laura Luisa, Berger Thomas, Willutzki Ulrike

机构信息

Department of Clinical Psychology and Psychotherapy, University of Witten/Herdecke, Witten, Germany.

Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland.

出版信息

JMIR Res Protoc. 2023 Mar 15;12:e41413. doi: 10.2196/41413.

DOI:10.2196/41413

PMID:36920449

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10131645/

Abstract

BACKGROUND

Only 11%-40% of those with a mental disorder in Germany receive treatment. In many cases, face-to-face psychotherapy is not available because of limited resources, such as an insufficient number of therapists in the area. New approaches to improve the German health care system are needed to counter chronification. Web-based interventions have been shown to be effective as stand-alone and add-on treatments to routine practice. Interventions designed for a wide range of mental disorders such as transdiagnostic interventions are needed to make treatment for mental disorders more accessible and thus shorten waiting times and mitigate the chronification of mental health problems. In general, interventions can be differentiated as having either a capitalization (CAP) focus-thus drawing on already existing strengths-or a compensation (COMP) focus-trying to compensate for deficits. Up to now, the effectiveness of transdiagnostic web-based interventions with either a CAP or a COMP focus has not yet been evaluated.

OBJECTIVE

This study is the first to examine the effectiveness of two transdiagnostic web-based interventions: (1) the activation of resilience and drawing on existing strengths (CAP: Res-Up!) and (2) the improvement of emotion regulation (COMP: REMOTION), compared with care as usual (CAU) in routine outpatient psychotherapy.

METHODS

Adults with at least 1 mental health disorder will be recruited at 4 outpatient centers in Germany. Participants will then be randomized equally into 1 of the 2 intervention groups Res-Up! (CAP) and REMOTION (COMP) or into the control group (CAU). Assessments will be made at baseline (T0), at 6 weeks after treatment start (T1), and at 12 weeks after treatment start (T2). A primary outcome will be symptom severity (Brief Symptom Inventory-18). Secondary outcomes will focus on emotion regulation and resilience.

RESULTS

Participant recruitment and data collection started in April 2020 and were ongoing as of July 2022. We expect participants to benefit more from the interventions than from the CAU control on the dimensions of symptom severity, resilience, and emotion regulation. Furthermore, we expect to find possible differences between CAP and COMP. The results of the study are expected in 2023.

CONCLUSIONS

This randomized controlled trial will compare CAU with the transdiagnostic web-based interventions Res-Up! and REMOTION, and will thus inform future studies concerning the effectiveness of transdiagnostic web-based interventions in routine outpatient psychotherapy.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04352010; https://clinicaltrials.gov/ct2/show/NCT04352010.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/41413.

摘要

背景

在德国，只有11%-40%的精神障碍患者接受治疗。在许多情况下，由于资源有限，如该地区治疗师数量不足，面对面心理治疗难以实现。需要新的方法来改善德国的医疗保健系统，以应对疾病慢性化问题。基于网络的干预措施已被证明作为常规治疗的独立治疗方法和辅助治疗方法均有效。需要设计针对广泛精神障碍的干预措施，如跨诊断干预措施，以使精神障碍治疗更容易获得，从而缩短等待时间并减轻心理健康问题的慢性化。一般来说，干预措施可分为以强化（CAP）为重点，即利用已有的优势，或以补偿（COMP）为重点，即试图弥补缺陷。到目前为止，尚未评估以CAP或COMP为重点的基于网络的跨诊断干预措施的有效性。

目的

本研究首次检验两种基于网络的跨诊断干预措施的有效性：（1）激活复原力并利用现有优势（CAP：Res-Up!）和（2）改善情绪调节（COMP：REMOTION），并与常规门诊心理治疗中的常规护理（CAU）进行比较。

方法

将在德国的4个门诊中心招募至少患有一种心理健康障碍的成年人。然后，参与者将被平均随机分为2个干预组中的1组：Res-Up!（CAP）组和REMOTION（COMP）组，或分为对照组（CAU）。将在基线（T0）、治疗开始后6周（T1）和治疗开始后12周（T2）进行评估。主要结局将是症状严重程度（简明症状量表-18）。次要结局将侧重于情绪调节和复原力。