Reynolds S, Stiles W B, Barkham M, Shapiro D A
Health Policy and Practice Unit, University of East Anglia, Norwich, United Kingdom.
J Consult Clin Psychol. 1996 Jun;64(3):577-86. doi: 10.1037//0022-006x.64.3.577.
Following the suggestion that therapeutic change is accelerated in time-limited psychotherapy, this study investigated the across-session patterns of session impact in the treatments of 117 depressed clients who were randomly allocated to 8 or 16 sessions of cognitive-behavioral (CB) or psychodynamic-interpersonal (PI) therapy. After each session, all clients completed the Session Evaluation Questionnaire and 75 of the clients completed the Session Impacts Scale. Session ratings indicated that sessions were perceived increasingly positively on most impact dimensions (e.g., session depth and smoothness, relationship with the therapist, feelings of understanding and problem solving, postsession positive mood) as treatment progressed. Early in treatment, PI therapy sessions were less smooth (i.e., more tense and uncomfortable) and less focused on problem solving, but PI sessions changed more rapidly than CB sessions on these dimensions, so that later in treatment, sessions of both treatments were equivalently positive. In both treatments, the trend toward more positive sessions was more rapid (i.e., the across-session slope was steeper) in 8-session treatments than in 16-session treatments. Such accelerated changes in session impact may reflect the suggested acceleration of therapeutic change associated with shorter time limits.
遵循限时心理治疗能加速治疗改变这一建议，本研究调查了117名抑郁症患者在治疗过程中各阶段的治疗效果模式，这些患者被随机分配接受8次或16次的认知行为（CB）治疗或心理动力人际（PI）治疗。每次治疗后，所有患者都要完成《治疗阶段评估问卷》，75名患者还要完成《治疗阶段影响量表》。阶段评分表明，随着治疗的推进，在大多数影响维度上（如治疗深度和平顺度、与治疗师的关系、理解和解决问题的感受、治疗后积极情绪），患者对各阶段的评价越来越积极。在治疗早期，PI治疗阶段不太顺畅（即更紧张和不舒服），且较少关注问题解决，但在这些维度上，PI治疗阶段的变化比CB治疗阶段更快，因此在治疗后期，两种治疗的阶段效果相当积极。在两种治疗中，8次治疗的阶段效果向更积极方向发展的趋势更快（即各阶段斜率更陡），比16次治疗的情况更明显。治疗阶段效果的这种加速变化可能反映了与较短时限相关的治疗改变加速的情况。
