Remote delivery of cognitive behavioral therapy to patients with functional neurological disorders: Promise and challenges.
Remote delivery of cognitive behavioral therapy to patients with functional neurological disorders: Promise and challenges.
复制标题
DOI：
10.1016/j.ebr.2021.100469
复制
发表时间：
2021
影响因子：
--
通讯作者：
Espay AJ
中科院分区：
文献类型：
--
作者：
Lin A;Espay AJ
CBT是FND患者的一种有前途的治疗方法。CBT的远程交付可能会增加FND患者获得护理的机会。远程CBT可以使用逐步的方法整合到临床实践中。远程CBT可以使用患者预测因素整合到实践中。功能性神经系统疾病（FND）是医疗保健利用和发病率的重要来源。虽然没有治疗这些疾病的正式指南，但认知行为疗法（CBT）正在成为一种安全有效的治疗方法。目前，全球缺乏CBT提供者，只有一小部分人接受过FND患者的治疗培训。我们强调了四种类型的远程CBT交付FND患者，以减轻访问障碍：工作簿，互联网引导的CBT，基于应用程序的CBT和远程治疗。CBT练习册和远程治疗已经在FND中进行了研究，初步研究表明有效性;互联网引导的CBT和基于应用程序的CBT没有但已经有效地用于精神疾病患者，特别是抑郁症，焦虑症和创伤后障碍。由于这些疾病通常与FND共病并共享重叠的神经生物学，因此互联网引导的CBT和基于应用程序的CBT代表了FND CBT的有希望的交付选择。虽然远程CBT不太可能取代面对面CBT，并且在广泛部署之前需要克服技术和后勤挑战，但当面对面CBT无法访问时，它有望作为辅助治疗。我们提出了一种合理的方法来未来分配远程CBT治疗方案，并强调了重要的研究差距。
CBT is a promising treatment for patients with FND. Remote delivery of CBT can potentially increase access to care for patients with FND. Remote CBT can be integrated into clinical practice using a stepwise approach. Remote CBT can be integrated into practice using patient predictive factors. Functional neurological disorders (FND) are an important source of healthcare utilization and morbidity. While there are no formal guidelines for treating these disorders, cognitive behavioral therapy (CBT) is emerging as a safe and effective treatment. Currently, there is a global shortage of CBT providers, with only a small subset trained in and comfortable with treating patients with FND. We highlight four types of remote CBT delivery to patients with FND to alleviate the access obstacle: workbooks, internet-guided CBT, app-based CBT, and teletherapy. CBT workbooks and teletherapy have been studied in FND, with preliminary studies suggesting efficacy; internet-guided CBT and app-based CBT have not but have been effectively used in patients with psychiatric disorders, particularly depression, anxiety, and post-traumatic disorders. As these disorders are often comorbid and share overlapping neurobiology with FND, internet-guided CBT and app-based CBT represent promising delivery options of CBT for FND. Although remotely-delivered CBT is unlikely to replace in-person CBT and there are technical and logistical challenges to overcome prior to widespread deployment, it holds promise as an adjunct treatment when in-person CBT is inaccessible. We propose a rational approach to future allocation of remote CBT treatment options and highlight important research gaps to bridge beforehand.
登录
查看更多内容
影响因子：
11
作者：
Carson, AJ;Ringbauer, B;Sharpe, M
通讯作者：
Sharpe, M
影响因子：
64.3
作者：
Egede, Leonard E.;Acierno, Ron;Frueh, B. Christopher
通讯作者：
Frueh, B. Christopher
影响因子：
4.7
作者：
Berger, Thomas;Haemmerli, Katja;Caspar, Franz
通讯作者：
Caspar, Franz
影响因子：
4.1
作者：
Kleiboer, Annet;Donker, Tara;Cuijpers, Pim
通讯作者：
Cuijpers, Pim
DOI：
10.1016/b978-0-12-801772-2.00005-9
发表时间：
2016-01-01
期刊：
FUNCTIONAL NEUROLOGIC DISORDERS
影响因子：
--
作者：
Carson, A.;Lehn, A.
通讯作者：
Lehn, A.