Psychotherapy mediated by remote communication technologies: a meta-analytic review.
Psychotherapy mediated by remote communication technologies: a meta-analytic review.
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DOI：
10.1186/1471-244x-8-60
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发表时间：
2008-07-22
期刊：
影响因子：
4.4
通讯作者：
Roach P
中科院分区：
文献类型：
--
作者：
Bee PE;Bower P;Lovell K;Gilbody S;Richards D;Gask L;Roach P
获得心理治疗的机会受到精神病理学（如广场恐怖症）、身体残疾、职业或社会限制和/或居住在服务不足地区的限制。对于这些人群，通过远程通信技术（如电话、互联网）提供的干预措施可能更合适。然而，存在这样的递送可能影响治疗关系并因此降低治疗有效性的担忧。本综述旨在确定远程沟通，治疗师提供的心理治疗的临床效果。个体远程心理治疗随机试验的系统综述（包括电子数据库检索和与作者的通信）。检索的电子数据库包括MEDLINE（1966-2006）、PsycInfo（1967-2006）、EMBASE（1980-2006）和CINAHL数据库（1982-2006）。科克伦对照试验中心（CENTRAL）和科克伦协作抑郁、焦虑和神经症对照试验登记中心（CCDAN-CTR）。所有检索均包括发表日期至2006年7月的研究。13项研究被确定，其中10项通过电话评估心理治疗，2项通过互联网评估，1项通过视频会议评估。远程治疗与对照条件的合并效应量在抑郁症中为0.44（95%CI 0.29 - 0.59，7次比较，n = 726），在焦虑相关疾病中为1.15（95%CI 0.81 - 1.49，3次比较，n = 168）。很少有人将远程心理治疗与面对面心理治疗进行比较。远程治疗有可能克服传统心理治疗服务的一些障碍。基于电话的干预措施是一个特别受欢迎的研究重点，作为一种治疗沟通的手段，可能会赋予其广泛的可用性和易于操作方面的具体优势。然而，现有的证据在数量和质量上都是有限的。需要更严格的试验来证实这些初步估计的有效性。未来的研究重点应包括通过进行大规模试验，将临床结果和更多的过程导向的措施，克服已发表工作的方法学缺陷。
Access to psychotherapy is limited by psychopathology (e.g. agoraphobia), physical disability, occupational or social constraints and/or residency in under-served areas. For these populations, interventions delivered via remote communication technologies (e.g. telephone, internet) may be more appropriate. However, there are concerns that such delivery may influence the therapeutic relationship and thus reduce therapy effectiveness. This review aimed to determine the clinical effectiveness of remotely communicated, therapist-delivered psychotherapy. Systematic review (including electronic database searching and correspondence with authors) of randomised trials of individual remote psychotherapy. Electronic databases searched included MEDLINE (1966–2006), PsycInfo (1967–2006), EMBASE (1980–2006) and CINAHL databases (1982–2006). The Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDAN-CTR). All searches were conducted to include studies with a publication date to July 2006. Thirteen studies were identified, ten assessing psychotherapy by telephone, two by internet and one by videoconference. Pooled effect sizes for remote therapy versus control conditions were 0.44 for depression (95%CI 0.29 to 0.59, 7 comparisons, n = 726) and 1.15 for anxiety-related disorders (95%CI 0.81 to 1.49, 3 comparisons, n = 168). There were few comparisons of remote versus face-to-face psychotherapy. Remote therapy has the potential to overcome some of the barriers to conventional psychological therapy services. Telephone-based interventions are a particularly popular research focus and as a means of therapeutic communication may confer specific advantages in terms of their widespread availability and ease of operation. However, the available evidence is limited in quantity and quality. More rigorous trials are required to confirm these preliminary estimates of effectiveness. Future research priorities should include overcoming the methodological shortcomings of published work by conducting large-scale trials that incorporate both clinical outcome and more process-orientated measures.