Indiana University, Bloomington, USA.
Behav Res Ther. 2023 Sep;168:104365. doi: 10.1016/j.brat.2023.104365. Epub 2023 Jul 3.
Identifying active ingredients of psychological interventions is a major goal of psychotherapy researchers that is often justified by the promise that it will lead to improved patient outcomes. Much of this "active ingredients" research is conducted within randomized controlled trials (RCTs) with patient populations, putting it in Phase T2 of the clinical-translational spectrum. I argue that RCTs in patient populations are very "messy laboratories" in which to conduct active ingredient work and that T0 and T1 research provide more controlled contexts. However, I call attention to the long road from identifying active ingredients of CBTs, whether in T0, T1, or T2 research, to improving outcomes. Dissemination and implementation research (T3 and T4 approaches) may be conceptually closer to improving outcomes. Given how common and disabling mental health symptoms are, I argue that if researchers want to improve patient outcomes, these research programs must receive more attention including work on the uptake of psychological interventions as well as work on optimal ordering of existing interventions.
确定心理干预的有效成分是心理治疗研究人员的主要目标，他们常常认为这将导致改善患者的预后。这方面的大量“有效成分”研究是在患者人群中进行的随机对照试验（RCT）中进行的，将其置于临床转化谱的 T2 期。我认为，在患者人群中进行 RCT 是进行有效成分工作的非常“混乱的实验室”，而 T0 和 T1 研究提供了更受控制的环境。然而，我提请注意从确定认知行为疗法（CBT）的有效成分（无论是在 T0、T1 还是 T2 研究中）到改善结果的漫长道路。传播和实施研究（T3 和 T4 方法）在概念上可能更接近改善结果。鉴于常见且致残的心理健康症状的普遍性，我认为，如果研究人员想要改善患者的预后，这些研究计划必须得到更多的关注，包括对心理干预的采用以及对现有干预措施的最佳排序的研究。
