Atik Ece, Hornstein Silvan, Reinking Elisabeth, Schückes Magnus
Translational Psychotherapy, Georg-Elias-Mueller-Institute of Psychology, University of Goettingen.
Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.
Internet Interv. 2025 Feb 18;39:100815. doi: 10.1016/j.invent.2025.100815. eCollection 2025 Mar.
Blended cognitive behavioral therapy (bCBT), which involves the use of a digital application to support face-to-face psychotherapy, is increasingly offered to patients with depression amid a growing body of research on its efficacy. However, there is still limited understanding of the factors that influence the efficacy of this novel treatment method. To investigate the effects of potential factors such as patient satisfaction with the received treatment, patients' self-rated working alliance with their therapist, and patients' rating of system usability of the digital application, this secondary analysis study focused on a sample of 66 university students who completed an effective 6-week bCBT program that included weekly sessions with a therapist and access to a digital mental health application. We examined whether those three potential factors predict patients' improvement in depressive symptoms in a bCBT treatment. Patient satisfaction and working alliance are known predictors of treatment success in standard psychotherapy, yet their importance in blended treatment is largely unstudied. System usability is a factor that is frequently addressed while describing digital treatment programs, yet its contribution to the success of treatments has been mostly omitted. All the variables analyzed displayed a significant positive correlation with improvement in depressive symptoms. When taken together, all the factors account for 16.6 % of the variance in the outcome. However, when three variables were added in the backward multiple linear regression with stepwise elimination, only patient satisfaction emerged as a predictor of the outcome. Although there are significant correlations between working alliance and system usability and the improvement of depression in the bCBT program, their lack of predictive power in comparison to patient satisfaction renders the results inconclusive. Future studies could explore the potential contribution of additional variables to the improvement of depressive symptoms.
混合认知行为疗法（bCBT）涉及使用数字应用程序来支持面对面心理治疗，随着对其疗效的研究越来越多，越来越多的抑郁症患者开始接受这种疗法。然而，对于影响这种新型治疗方法疗效的因素，人们的了解仍然有限。为了研究诸如患者对所接受治疗的满意度、患者对与治疗师的工作联盟的自评以及患者对数字应用程序系统可用性的评分等潜在因素的影响，这项二次分析研究聚焦于66名大学生样本，他们完成了一个为期6周有效的bCBT项目，该项目包括每周与治疗师会面以及使用数字心理健康应用程序。我们研究了这三个潜在因素是否能预测bCBT治疗中患者抑郁症状的改善情况。患者满意度和工作联盟是标准心理治疗中已知的治疗成功预测因素，但它们在混合治疗中的重要性在很大程度上尚未得到研究。系统可用性是在描述数字治疗项目时经常提到的一个因素，但其对治疗成功的贡献大多被忽略了。所有分析的变量与抑郁症状的改善都显示出显著的正相关。综合来看，所有因素占结果方差的16.6%。然而，当在逐步消除的向后多元线性回归中加入这三个变量时，只有患者满意度成为结果的预测因素。尽管在bCBT项目中工作联盟和系统可用性与抑郁症的改善之间存在显著相关性，但与患者满意度相比，它们缺乏预测能力，导致结果尚无定论。未来的研究可以探索其他变量对抑郁症状改善的潜在贡献。
