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利用单病例实验设计促进个性化心理治疗:涉及个性化心理治疗门诊利益相关者的一步一步实施协议。

Leveraging Single-Case Experimental Designs to Promote Personalized Psychological Treatment: Step-by-Step Implementation Protocol with Stakeholder Involvement of an Outpatient Clinic for Personalized Psychotherapy.

机构信息

Department of Psychology, Pain and Psychotherapy Research Lab, RPTU Kaiserslautern-Landau, Ostbahnstr. 10, 76829, Landau, Germany.

Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02138, USA.

出版信息

Adm Policy Ment Health. 2024 Sep;51(5):702-724. doi: 10.1007/s10488-024-01363-5. Epub 2024 Mar 11.

Abstract

Our objective is to implement a single-case experimental design (SCED) infrastructure in combination with experience-sampling methods (ESM) into the standard diagnostic procedure of a German outpatient research and training clinic. Building on the idea of routine outcome monitoring, the SCED infrastructure introduces intensive longitudinal data collection, individual effectiveness measures, and the opportunity for systematic manipulation to push personalization efforts further. It aims to empower psychotherapists and patients to evaluate their own treatment (idiographic perspective) and to enable researchers to analyze open questions of personalized psychotherapy (nomothetic perspective). Organized around the principles of agile research, we plan to develop, implement, and evaluate the SCED infrastructure in six successive studies with continuous stakeholder involvement: In the project development phase, the business model for the SCED infrastructure is developed that describes its vision in consideration of the context (Study 1). Also, the infrastructure's prototype is specified, encompassing the SCED procedure, ESM protocol, and ESM survey (Study 2 and 3). During the optimization phase, feasibility and acceptability are tested and the infrastructure is adapted accordingly (Study 4). The evaluation phase includes a pilot implementation study to assess implementation outcomes (Study 5), followed by actual implementation using a within-institution A-B design (Study 6). The sustainability phase involves continuous monitoring and improvement. We discuss to what extent the generated data could be used to address current questions of personalized psychotherapy research. Anticipated barriers and limitations during the implementation processes are outlined.

摘要

我们的目标是将单一案例实验设计(SCED)基础设施与经验采样方法(ESM)结合起来,纳入德国门诊研究和培训诊所的标准诊断程序。基于常规结果监测的理念,SCED 基础设施引入了密集的纵向数据收集、个体效果衡量指标以及系统操作的机会,以进一步推动个性化努力。它旨在赋予治疗师和患者评估自己治疗的能力(个体视角),并使研究人员能够分析个性化心理治疗的开放性问题(共同理论视角)。我们计划围绕敏捷研究的原则,通过六个连续的研究来开发、实施和评估 SCED 基础设施,并持续让利益相关者参与:在项目开发阶段,将制定 SCED 基础设施的商业模式,在考虑到背景的情况下描述其愿景(研究 1)。此外,还将指定基础设施的原型,包括 SCED 程序、ESM 协议和 ESM 调查(研究 2 和 3)。在优化阶段,将测试可行性和可接受性,并相应地调整基础设施(研究 4)。评估阶段包括一项试点实施研究,以评估实施结果(研究 5),然后使用机构内 A-B 设计进行实际实施(研究 6)。可持续性阶段涉及持续监测和改进。我们将讨论所生成的数据在多大程度上可以用于解决个性化心理治疗研究的当前问题。概述了在实施过程中预期的障碍和限制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a0d/11379774/a90dd18568fc/10488_2024_1363_Fig1_HTML.jpg

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