Drüge Marie, Staeck Robert, Haller Elisa, Seiler Cara, Rohner Valentin, Watzke Birgit
Department of Psychology, Clinical Psychology with Focus on Psychotherapy Research, University of Zurich, Zurich, Switzerland.
Faculty of Medicine, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Front Psychol. 2023 Jul 25;14:1165899. doi: 10.3389/fpsyg.2023.1165899. eCollection 2023.
Innovative moments (IMs), defined as moments in psychotherapy when patients' problematic patterns change toward more elaborated and adaptive patterns, have been shown to be associated with a clinical change in patients with depression. Thus, far IMs have been studied in face-to-face settings but not in telephone-based cognitive-behavioral therapy (t-CBT). This study investigates whether IMs occur in t-CBT and examines the association between IMs and symptom improvement, and reconceptualization and symptom improvement.
The therapy transcripts of = 10 patients with mild to moderate depression (range: 7-11 sessions, in total 94 sessions) undergoing t-CBT were qualitatively and quantitatively analyzed. Symptom severity (Patient Health Questionnaire-9) and IMs (levels and proportions) were assessed for each therapy session. Hierarchical linear models were used to test the prediction models.
The rating of IMs was shown to be feasible and reliable using the Innovative Moments Coding System (IMCS) (84.04% agreement in words coded), which is indicative of the applicability of the concept of IMs in t-CBT. Only reconceptualization IMs were shown to have a predictive value for treatment success ( = 0.05, = 0.01).
The results should be interpreted with caution due to the exploratory nature of this study. Due to the telephone setting, it was necessary to adapt the IMCS. Nonetheless, the extent of IMs identified in the low-intensity t-CBT investigated was comparable to IMs in face-to-face therapy. Further studies are needed to clarify the association between IMs and treatment success as a change process, especially for low-intensity treatments.
创新时刻（IMs）被定义为心理治疗中患者的问题模式朝着更精细和适应性更强的模式转变的时刻，已被证明与抑郁症患者的临床变化相关。迄今为止，创新时刻已在面对面治疗环境中得到研究，但尚未在电话认知行为疗法（t-CBT）中进行研究。本研究调查创新时刻是否出现在电话认知行为疗法中，并检验创新时刻与症状改善、重新概念化和症状改善之间的关联。
对10例接受电话认知行为疗法的轻度至中度抑郁症患者（范围：7 - 11次治疗，共94次治疗）的治疗记录进行定性和定量分析。对每次治疗 session 评估症状严重程度（患者健康问卷-9）和创新时刻（水平和比例）。使用分层线性模型检验预测模型。
使用创新时刻编码系统（IMCS）显示创新时刻的评级是可行且可靠的（编码单词的一致性为84.04%），这表明创新时刻的概念在电话认知行为疗法中的适用性。仅重新概念化创新时刻显示对治疗成功具有预测价值（ = 0.05， = 0.01）。
由于本研究的探索性质，结果应谨慎解释。由于电话治疗环境，有必要对创新时刻编码系统进行调整。尽管如此，在所研究的低强度电话认知行为疗法中识别出的创新时刻程度与面对面治疗中的创新时刻相当。需要进一步研究来阐明创新时刻与作为一个变化过程的治疗成功之间的关联，特别是对于低强度治疗。
