Winter Halaina R, Norton Alice R, Burley Jade L, Wootton Bethany M
Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia.
Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia; Clinical Psychology Unit, School of Psychology, The University of Sydney, Camperdown, NSW 2006, Australia.
J Anxiety Disord. 2023 Dec;100:102787. doi: 10.1016/j.janxdis.2023.102787. Epub 2023 Oct 16.
Remote cognitive behaviour therapy (CBT) for social anxiety disorder (SAD) has the potential to improve access to treatment by reducing economic, geographic, and psychological barriers. The aim of this study was to use a meta-analytic approach to examine the efficacy of the different remote CBT methods for treating SAD. A systematic electronic database search was used to identify 31 studies (n = 2905; mean age range: 24.73-41.65 years; mean female representation = 60.2 %). Pooled within-group analyses indicated large effect sizes from pre-treatment to post-treatment (Hedges' g = 1.06; 95 % CI: 0.96-1.16) and pre-treatment to follow up (g = 1.18; 95 % CI: 1.03-1.33) for remote CBT. Internet-delivered CBT (g = 1.08; 95 % CI: 0.98-1.19) and application-delivered CBT (g = 1.19; 95 % CI: 0.75-1.64) produced large within-group effect sizes. Bibliotherapy-delivered CBT (g = 0.79; 95 % CI: 0.45-1.13) produced medium within-group effect sizes. Pooled between-group findings indicate that remote CBT treatments were more effective than passive control (g = 0.87; 95 % CI: 0.70-1.03) and non-CBT remote treatments (g = 0.41; 95 % CI: 0.17-0.66), and were at least as effective, or slightly more effective, than face-to-face CBT treatments (g = 0.34; 95 % CI: 0.14-0.54). These findings have important implications for the dissemination of remote and stepped-care treatments for SAD.
针对社交焦虑障碍（SAD）的远程认知行为疗法（CBT）有潜力通过减少经济、地理和心理障碍来改善治疗的可及性。本研究的目的是采用荟萃分析方法来检验不同远程CBT方法治疗SAD的疗效。通过系统的电子数据库检索，共识别出31项研究（n = 2905；平均年龄范围：24.73 - 41.65岁；女性平均占比 = 60.2%）。汇总的组内分析表明，远程CBT从治疗前到治疗后（Hedges' g = 1.06；95%置信区间：0.96 - 1.16）以及从治疗前到随访（g = 1.18；95%置信区间：1.03 - 1.33）均产生了较大的效应量。互联网提供的CBT（g = 1.08；95%置信区间：0.98 - 1.19）和应用程序提供的CBT（g = 1.19；95%置信区间：0.75 - 1.64）产生了较大的组内效应量。文献疗法提供的CBT（g = 0.79；95%置信区间：0.45 - 1.13）产生了中等的组内效应量。汇总的组间结果表明，远程CBT治疗比被动对照（g = 0.87；95%置信区间：0.70 - 1.03）和非CBT远程治疗（g = 0.41；95%置信区间：0.17 - 0.66）更有效，并且至少与面对面CBT治疗效果相同或略更有效（g = 0.34；95%置信区间：0.14 - 0.54）。这些发现对于SAD的远程和阶梯式护理治疗的传播具有重要意义。
