Manualized Therapy for PTSD: Flexing the Structure of Cognitive Processing Therapy
Manualized Therapy for PTSD: Flexing the Structure of Cognitive Processing Therapy
复制标题
DOI：
10.1037/a0030600
复制
发表时间：
2012-12-01
影响因子：
5.9
通讯作者：
Houle, Timothy
中科院分区：
文献类型：
--
作者：
Galovski, Tara E.;Blain, Leah M.;Houle, Timothy
目的：本研究测试了一种改良的认知加工疗法（MCPT）干预，该干预设计为更灵活的方案管理。会议的数量是由客户端的进展，对一个先验定义的最终状态标准，“应激会话”插入时，必要的，和治疗进行了新手CPT临床医生。方法：采用随机、对照、重复测量、半交叉设计，（a）测试MCPT干预与监测延迟治疗（SMDT）条件相比的相对有效性，（B）评估100名患有创伤后应激障碍（PTSD）的男性和女性人际创伤幸存者样本的组内变化。结果如下：分层线性模型分析显示，MCFT证明了所有主要（PTSD和抑郁症）和次要（内疚，生活质量，一般心理健康，社会功能和健康观念）的结果相比，SMDT更大的改善。SMDT结束后，参与者交叉到MCPT，产生合并的MCPT样本（n = 69）。在完成MCFT的50名参与者中，58%在第12次会议之前达到最终状态标准，8%在第12次会议期间，34%在第12次会议和第18次会议之间。在3个月的随访中，发现治疗收益维持不变，只有2个治疗样本符合PTSD标准。使用压力源会话并没有导致较差的治疗结果。结论：研究结果表明，个体对CPT的反应率各不相同，当有指征时，额外治疗会带来显著的益处，并保持良好的收益。插入应激会话并没有改变治疗的疗效。
Objective: This study tested a modified cognitive processing therapy (MCPT) intervention designed as a more flexible administration of the protocol. Number of sessions was determined by client progress toward a priori defined end-state criteria, "stressor sessions" were inserted when necessary, and therapy was conducted by novice CPT clinicians. Method: A randomized, controlled, repeated measures, semicrossover design was utilized (a) to test the relative efficacy of the MCPT intervention compared with a symptom-monitoring delayed treatment (SMDT) condition and (b) to assess within-group variation in change with a sample of 100 male and female interpersonal trauma survivors with posttraumatic stress disorder (PTSD). Results: Hierarchical linear modeling analyses revealed that MCFT evidenced greater improvement on all primary (PTSD and depression) and secondary (guilt, quality of life, general mental health, social functioning, and health perceptions) outcomes compared with SMDT. After the conclusion of SMDT, participants crossed over to MCPT, resulting in a combined MCPT sample (n = 69). Of the 50 participants who completed MCFT, 58% reached end-state criteria prior to the 12th session, 8% at Session 12, and 34% between Sessions 12 and 18. Maintenance of treatment gains was found at the 3-month follow-up, with only 2 of the treated sample meeting criteria for PTSD. Use of stressor sessions did not result in poorer treatment outcomes. Conclusions: Findings suggest that individuals respond at a variable rate to CPT, with significant benefit from additional therapy when indicated and excellent maintenance of gains. Insertion of stressor sessions did not alter the efficacy of the therapy.