一项关于改良协作评估与标准评估对心理治疗准备度影响的随机对照优势试验（CO-ASSM-RCT）的结果。

Results of a randomized controlled superiority trial of the effect of modified collaborative assessment vs. standard assessment on patients' readiness for psychotherapy (CO-ASSM-RCT).

机构信息

Psychiatric Research Unit, Region Zealand Mental Health Service, Faelledvej 6, Slagelse, 4200, Denmark.

Department of Clinical Medicine, Faculty of Health, University of Copenhagen, Copenhagen, Denmark.

出版信息

Trials. 2024 Oct 25;25(1):716. doi: 10.1186/s13063-024-08517-8.

DOI:10.1186/s13063-024-08517-8

PMID:39456051

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11515100/

Abstract

BACKGROUND

Avoidant personality disorder (AvPD) and social phobia (SP) are associated with high personal and societal costs. While psychotherapy can be efficient, many patients drop out during treatment. Little is known about what can be done to increase a patient's readiness for psychotherapy. However, research highlights the fields of collaborative and therapeutic assessment as a possible means to enhance readiness for psychotherapy.

METHODS

We conducted a randomized controlled feasibility and superiority trial on patients with SP or AvPD who were to initiate psychotherapeutic treatment in outpatient mental health services. Patients were randomized 1:1 to either assessment as usual or modified collaborative assessment (MCA), provided as a pre-treatment intervention before psychotherapy initiation. MCA included the collaborative administration of a battery of psychological tests designed to assess the patient's psychopathology more systematically. The tests were administered in collaboration with the patient, and detailed oral and written feedback was provided. We investigated the feasibility of the MCA intervention regarding acceptability, patient satisfaction, and adherence. We also investigated MCA's effect on readiness for psychotherapy, as assessed with the University of Rhode Island Change Assessment Scale (URICA), and outcomes relating to symptomatology and dropout rates.

RESULTS

All three prespecified feasibility outcomes were met. At the end of treatment, no significant difference was observed in any other outcome, except client satisfaction, which favored MCA (- 7.42 (95% CI - 11.75; - 3.09; p = 0.002)).

DISCUSSION

We found that MCA was feasible, and patients were highly satisfied with the intervention. It is relevant to investigate another implementation of MCA.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05018312. Registered on August 24, 2021.

摘要

背景

回避型人格障碍（AvPD）和社交恐惧症（SP）会给个人和社会带来高昂的成本。虽然心理治疗可能有效，但许多患者在治疗过程中会中途退出。对于如何提高患者对心理治疗的准备程度，人们知之甚少。然而，研究强调了协作和治疗评估领域，认为这可能是提高对心理治疗准备程度的一种手段。

方法

我们对即将在门诊心理健康服务机构开始心理治疗的 SP 或 AvPD 患者进行了一项随机对照可行性和优越性试验。患者以 1:1 的比例随机分为常规评估组或改良协作评估组（MCA），MCA 作为心理治疗开始前的一种预处理干预。MCA 包括协作式的一系列心理测试，旨在更系统地评估患者的精神病理学。这些测试与患者一起进行，提供详细的口头和书面反馈。我们研究了 MCA 干预的可行性，包括可接受性、患者满意度和依从性。我们还研究了 MCA 对心理治疗准备程度的影响，采用罗得岛大学变化评估量表（URICA）进行评估，并研究了与症状和脱落率相关的结果。