Fletcher Terri L, Boykin Derrecka M, Helm Ashley, Dawson Darius B, Ecker Anthony H, Freshour Jessica, Teng Ellen, Lindsay Jan, Hundt Natalie E
VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas.
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas.
Mil Psychol. 2021 Oct 28;34(1):83-90. doi: 10.1080/08995605.2021.1970983. eCollection 2022.
Exposure and response prevention (ERP) is the gold-standard, evidence-based psychotherapy for obsessive-compulsive disorder (OCD), but few receive it. Video telehealth can increase access to ERP for OCD and may enhance the salience of exposures. This study examined the feasibility, acceptability, and preliminary effectiveness of video telehealth-delivered ERP. We conducted a pilot open trial with 11 Veterans, using mixed quantitative and qualitative methods. Treatment completers (n = 9) had significantly reduced OCD and posttraumatic stress disorder symptoms posttreatment. Patients expressed greater comfort in engaging in ERP at home than in clinics. Therapists reported that seeing patients' home environments helped them understand their symptoms and identify relevant OCD exposures. Results suggest that video telehealth-delivered ERP is feasible and acceptable to patients and therapists and promising for reducing OCD symptoms. Future research should compare its effectiveness to usual care and evaluate patients' preferences for treatment delivery. ERP: exposure and response prevention; GAD-7: Generalized Anxiety Disorder-7 scale; OCD: obsessive-compulsive disorder; OCI-R: Obsessive-Compulsive Inventory, Revised; PCL-5: PTSD Checklist; PHQ-9: Patient Health Questionnaire; PTSD: posttraumatic stress disorder; VA: epartment of Veterans Affairs; Y-BOCS: Yale-Brown Obsessive Compulsive Scale, self report form.
暴露与反应阻止疗法（ERP）是治疗强迫症（OCD）的金标准、循证心理疗法，但很少有人接受该疗法。视频远程医疗可以增加强迫症患者接受ERP治疗的机会，并且可能会提高暴露疗法的显著性。本研究考察了通过视频远程医疗提供ERP治疗的可行性、可接受性和初步疗效。我们对11名退伍军人进行了一项开放式试验，采用了定量和定性相结合的方法。治疗完成者（n = 9）在治疗后强迫症和创伤后应激障碍症状显著减轻。患者表示在家中进行ERP治疗比在诊所更自在。治疗师报告称，了解患者的家庭环境有助于他们理解患者的症状并确定相关的强迫症暴露因素。结果表明，通过视频远程医疗提供ERP治疗对患者和治疗师来说是可行且可接受的，并且有望减轻强迫症症状。未来的研究应将其疗效与常规治疗进行比较，并评估患者对治疗方式的偏好。ERP：暴露与反应阻止疗法；GAD-7：广泛性焦虑障碍7项量表；OCD：强迫症；OCI-R：修订版强迫观念及强迫行为量表；PCL-5：创伤后应激障碍检查表；PHQ-9：患者健康问卷；PTSD：创伤后应激障碍；VA：退伍军人事务部；Y-BOCS：耶鲁-布朗强迫症量表，自评表
