Hadjistavropoulos H D, Peynenburg V, Sapkota R P, Titov N, Dear B F
Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada.
MindSpot Clinic, School of Psychological Sciences, Macquarie University, Sydney, NSW 2109, Australia.
Internet Interv. 2024 Jul 10;37:100758. doi: 10.1016/j.invent.2024.100758. eCollection 2024 Sep.
In internet-delivered cognitive behavioural therapy (ICBT) programs, beyond standardized core ICBT lessons, brief additional resources are sometimes available to clients to address comorbid concerns or offer additional information/strategies. These resources remain understudied in terms of how they are selected and perceived by clients, as well as their relationship to satisfaction and outcomes.
Among clients ( = 793) enrolled in a 5-lesson transdiagnostic ICBT course, we examined client use and perceptions of 18 additional resources at 8 weeks in terms of whether clients found resources informative (yes/no) and or helpful (yes/no). Resources elaborated on cognitive strategies (managing beliefs, risk calculation) or on managing specific problems (agricultural stress, alcohol misuse, anger, assertiveness, chronic conditions, communication, grief, health anxiety, motivation, pain, panic, postpartum depression/anxiety, PTSD, sleep, workplace accomodations, worry). Clients also completed symptom measures and ICBT satisfaction questions at 8 weeks.
Approximately 50 % ( = 398) of clients rated the resources and, on average, clients reported that 3.35 (SD = 3.34) resources were informative and 2.35 (SD = 2.52) resources were helpful as measured by direct questions developed for this study. Higher pre-treatment PTSD and GAD scores were related to a greater number of resources perceived as informative and or helpful. Rating more resources as informative and or helpful had a weak but positive association with ICBT satisfaction and depression, anxiety, PTSD and insomnia change scores. Limitations of the study include that 31 % ( = 245) did not respond to questions about use of resources and 18.9 % ( = 150) said they did not review resources.
There is considerable use of diverse additional resources in ICBT in routine care. Associations suggest that clients are using resources to personalize treatment to their needs and these resources are associated with treatment satisfaction and outcomes. The correlational associations between symptoms and perceived helpfulness of resources can help inform personalization algorithms to optimize ICBT delivery for clients. Further research on how to match clients with, encourage use of, and maximize benefits of resources would be beneficial.
在互联网提供的认知行为疗法（ICBT）项目中，除了标准化的核心ICBT课程外，有时还会向客户提供简短的额外资源，以解决共病问题或提供更多信息/策略。这些资源在如何被客户选择和认知，以及它们与满意度和治疗效果的关系方面仍未得到充分研究。
在参加了一个为期5节的跨诊断ICBT课程的客户（n = 793）中，我们在8周时检查了客户对18种额外资源的使用情况和认知，具体涉及客户是否认为这些资源提供了有用信息（是/否）和/或有帮助（是/否）。这些资源详细阐述了认知策略（管理信念、风险计算）或管理特定问题（农业压力、酒精滥用、愤怒、自信、慢性病、沟通、悲伤、健康焦虑、动机、疼痛、恐慌、产后抑郁/焦虑、创伤后应激障碍、睡眠、工作场所适应、担忧）。客户在8周时还完成了症状测量和ICBT满意度问题。
约50%（n = 398）的客户对这些资源进行了评分，平均而言，根据本研究设计 的直接问题测量，客户报告称有3.35（标准差 = 3.34）种资源提供了有用信息，2.35（标准差 = 2.52）种资源有帮助。治疗前较高的创伤后应激障碍和广泛性焦虑症得分与更多被认为提供了有用信息和/或有帮助的资源相关。将更多资源评为提供了有用信息和/或有帮助与ICBT满意度以及抑郁、焦虑、创伤后应激障碍和失眠变化得分呈微弱但正相关。该研究的局限性包括31%（n = 245）的客户未回复关于资源使用的问题，18.9%（n = 150）的客户表示他们没有查看资源。
在常规护理的ICBT中，客户大量使用了各种额外资源。相关性表明客户正在利用资源根据自身需求对治疗进行个性化调整，并且这些资源与治疗满意度和效果相关。症状与资源感知帮助性之间的相关联系有助于为个性化算法提供信息，以优化为客户提供的ICBT服务。关于如何为客户匹配资源、鼓励使用资源并最大化资源效益的进一步研究将很有裨益。
