Vernmark Kristofer, Buhrman Moncia, Carlbring Per, Hedman-Lagerlöf Erik, Kaldo Viktor, Andersson Gerhard
Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
Department of Psychology, Uppsala University, Uppsala, Sweden.
Digit Health. 2024 Oct 7;10:20552076241287059. doi: 10.1177/20552076241287059. eCollection 2024 Jan-Dec.
This narrative historical review examines the development of internet-based cognitive behavioral therapy (ICBT) in Sweden, describing its progression within both academic and routine care settings. The review encompasses key publications, significant scientific findings, and contextual factors in real-world settings. Over 25 years ago, Sweden emerged as a pioneering force in internet-delivered treatment research for mental health. Since then, Swedish universities, in collaboration with research partners, have produced substantial research demonstrating the efficacy of ICBT across various psychological problems, including social anxiety disorder, panic disorder, generalized anxiety disorder, and depression. Although research conducted in clinical settings has been less frequent than in academic contexts, it has confirmed the effectiveness of therapist-supported ICBT programs for mild-to-moderate mental health problems in routine care. Early on, ICBT was provided as an option for patients at both the primary care level and in specialized clinics, using treatment programs developed by both public and private providers. The development of a national platform for delivering internet-based treatment and the use of procurement in selecting ICBT programs and providers are factors that have shaped the current routine care landscape. However, gaps persist in understanding how to optimize the integration of digital treatment in routine care, warranting further research and the use of specific implementation frameworks and outcomes. This historical perspective on the research and delivery of ICBT in Sweden over two decades offers insights for the international community into the development and broad dissemination of a specific digital mental health intervention within a national context.
这篇叙述性历史综述考察了瑞典基于互联网的认知行为疗法(ICBT)的发展,描述了其在学术和常规护理环境中的进展。该综述涵盖了关键出版物、重要科学发现以及现实世界环境中的背景因素。25 多年前,瑞典在互联网心理健康治疗研究方面成为先驱力量。从那时起,瑞典的大学与研究伙伴合作,开展了大量研究,证明了 ICBT 对包括社交焦虑症、恐慌症、广泛性焦虑症和抑郁症在内的各种心理问题的疗效。尽管在临床环境中进行的研究不如在学术环境中频繁,但它证实了治疗师支持的 ICBT 项目对常规护理中轻度至中度心理健康问题的有效性。早期,ICBT 作为一种选择提供给初级保健层面和专科诊所的患者,使用的是公共和私人提供者开发的治疗项目。一个提供基于互联网治疗的国家平台的发展以及在选择 ICBT 项目和提供者时采用采购方式,这些因素塑造了当前的常规护理格局。然而,在如何优化数字治疗在常规护理中的整合方面仍存在差距,这需要进一步研究以及使用特定的实施框架和成果。这种对瑞典二十多年来 ICBT 研究与实施的历史视角,为国际社会提供了关于在国家背景下特定数字心理健康干预措施的发展和广泛传播的见解。