Computerized cognitive behavioural therapy and the therapeutic alliance: A qualitative enquiry
Computerized cognitive behavioural therapy and the therapeutic alliance: A qualitative enquiry
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DOI：
10.1111/j.2044-8260.2012.02035.x
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发表时间：
2012-11-01
影响因子：
3.1
通讯作者：
Richards, David A.
中科院分区：
文献类型：
--
作者：
Barazzone, Natalie;Cavanagh, Kate;Richards, David A.
目标.抑郁症的计算机认知行为疗法（cCBT）有越来越多的证据基础，并在最近的国家健康与临床卓越研究所（NICE，2009）指南中推荐为英格兰和威尔士健康服务的抑郁症治疗选择。cCBT项目旨在将CBT的循证任务和技术转化为可访问的多媒体格式，但尚不清楚它们是否也转化了治疗的关键共同因素，这些因素可能是参与所必需的，并与治疗结果相关。本研究调查了三种广泛使用的抑郁症cCBT项目是否以及在多大程度上纳入并传达了有助于建立，发展和维持与项目用户的治疗联盟的关键特征。设计本研究采用质性研究方法，建立了一个针对cCBT的联盟特征的主题框架。法三个在线cCBT计划，旨在治疗轻度至中度抑郁症进行了调查联盟相关的主题和子主题。结果分析显示，在cCBT项目的样本中，有大量证据表明治疗联盟的特征，其患病率和质量在关系阶段各不相同。结论. cCBT计划建立在传统的自助工具之上，提供独特的关系功能。研究结果提出了理论意义，除了未来的cCBT计划的发展和服务提供的指导。
Objectives. Computerized cognitive behavioural therapy (cCBT) for depression has a growing evidence base, and is recommended as a treatment choice for depression in recent National Institute for Health and Clinical Excellence (NICE, 2009) guidelines to health services in England and Wales. cCBT programs are designed to translate the evidence-based tasks and techniques of CBT into an accessible, multimedia format, but it is less clear whether they also translate critical common factors of therapy, which may be necessary for engagement and associated with therapeutic outcomes. This study investigates whether and to what extent three widely used cCBT programs for depression incorporate and convey key features that serve to establish, develop, and maintain a therapeutic alliance with program users. Design. This study adopted a qualitative approach to develop a thematic framework of alliance features specific to cCBT. Method. Three online cCBT programs designed to treat mild-to-moderate depression were investigated for alliance-related themes and sub-themes. Results. The analysis revealed substantial evidence of therapeutic alliance features across the sample of cCBT programs, the prevalence and quality of which varied across relational stages. Conclusions. cCBT programs build on traditional self-help tools, offering unique relational features. Findings raise theoretical implications, in addition to guidance for future cCBT program development and service provision.