Bielinski Laura Luisa, Krieger Tobias, Kley Marijke Amanda, Moggi Franz, Berger Thomas
Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland.
University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
Internet Interv. 2023 Jul 20;33:100650. doi: 10.1016/j.invent.2023.100650. eCollection 2023 Sep.
Transdiagnostic interventions targeting shared mechanisms may improve treatment of mental health disorders. One way of providing such interventions is through blended treatment. This study examined the addition of an internet-based emotion regulation intervention to face-to-face psychotherapy in an outpatient setting.
In a pilot randomized controlled trial, 70 patients with a range of diagnoses were assigned to an internet-based program targeting emotion regulation + treatment as usual (face-to-face psychotherapy; TAU) ( = 35) or TAU ( = 35). Assessments occurred at baseline, after six, and after 12 weeks and included measures of symptom severity, emotion regulation, and various intervention feasibility parameters.
ITT-analyses revealed no significant group-by-time interaction for the primary and almost all secondary outcomes. Descriptively, between-group effect sizes were in favor of the intervention group for almost all outcomes. Sensitivity analysis with patients who completed a minimum of three modules of the internet-based program showed a significant group-by-time interaction for the Difficulties in Emotion Regulation Scale in favor of the intervention group. The internet-based intervention showed good satisfaction ratings, user experience and usability. Findings from therapist measures complemented patient measures.
Preliminary results show that an internet-based emotion regulation intervention added to psychotherapy may not reduce symptom severity compared to psychotherapy alone. The intervention was rated positively by patients and therapists regarding several parameters, but certain features still need to be improved. An RCT powered to detect small between-group effect-sizes is necessary to consolidate findings.
针对共同机制的跨诊断干预可能会改善心理健康障碍的治疗。提供此类干预的一种方式是通过混合治疗。本研究在门诊环境中,考察了在面对面心理治疗基础上增加基于互联网的情绪调节干预的效果。
在一项试点随机对照试验中,70名患有多种诊断的患者被分配到针对情绪调节的基于互联网的项目+常规治疗(面对面心理治疗;TAU)(n = 35)或TAU组(n = 35)。在基线、6周后和12周后进行评估,包括症状严重程度、情绪调节和各种干预可行性参数的测量。
意向性分析显示,主要结局和几乎所有次要结局均未发现显著的组×时间交互作用。从描述性角度来看,几乎所有结局的组间效应量都有利于干预组。对至少完成了基于互联网项目三个模块的患者进行的敏感性分析显示,情绪调节困难量表存在显著的组×时间交互作用,有利于干预组。基于互联网的干预显示出良好的满意度评分、用户体验和可用性。治疗师测量结果补充了患者测量结果。
初步结果表明,与单独的心理治疗相比,在心理治疗基础上增加基于互联网的情绪调节干预可能不会降低症状严重程度。患者和治疗师对该干预在几个参数方面给予了积极评价,但某些特征仍需改进。有必要进行一项有足够效力检测组间小效应量的随机对照试验来巩固研究结果。