Comparing in-person to videoconference-based cognitive behavioral therapy for mood and anxiety disorders: randomized controlled trial.
Comparing in-person to videoconference-based cognitive behavioral therapy for mood and anxiety disorders: randomized controlled trial.
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DOI：
10.2196/jmir.2564
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发表时间：
2013-11-19
影响因子：
7.4
通讯作者：
Kane RT
中科院分区：
文献类型：
--
作者：
Stubbings DR;Rees CS;Roberts LD;Kane RT
认知行为疗法（CBT）已经证明了治疗情绪和焦虑症的疗效和有效性。通过视频会议传播CBT可能有助于改善获得治疗的机会。本研究旨在比较通过视频会议管理的CBT的有效性，以在混合诊断队列的人的治疗。共有26名主要是白人的客户（平均年龄30岁，SD 11），他们有一个主要的精神疾病诊断和统计手册，第4版文本修订版（DSM-IV-TR）诊断的情绪或焦虑障碍，被随机分配到接受12个会议的CBT无论是在人或通过视频会议。治疗涉及针对当前诊断的个性化CBT制剂;所有会话均由同一治疗师提供。参与者是通过大学诊所招募的。在治疗前、治疗后和治疗后6周，使用问卷调查评估抑郁、焦虑、压力和生活质量的症状。治疗后的次要结果包括工作联盟和客户满意度。治疗条件下的保留情况相似;在治疗后和随访时，还有一名客户处于视频会议状态。采用多水平混合效应线性回归的统计分析表明，随着时间的推移，抑郁（P<.001，d=1.41）、焦虑（P<.001，d=1.14）、压力（P<.001，d=1.81）和生活质量（P<.001，d=1.17）的症状显著减少。治疗条件之间在抑郁症状（P= 0.165，d=0.37）、焦虑（P= 0.41，d=0.22）、压力（P= 0.15，d=0.38）或生活质量（P= 0.62，d=0.13）方面无显著差异。在工作联盟的客户评级（P= 0.53，单尾，d=-0.26），工作联盟的治疗师评级（P= 0.60，单尾，d=0.23）或客户满意度评级（P= 0.77，单尾，d=-0.12）方面没有显著差异。从治疗前到治疗后或从治疗前到随访，抑郁症状（P= 0.41，P= 0.26）、焦虑（P= 0.60，P= 0.99）或生活质量（P= 0.65，P= 0.99）的可靠变化的Fisher精确P值差异不显著，但压力症状的差异显著，有利于视频会议条件（P= 0.03，P= 0.035）。从治疗前到治疗后或从治疗前到随访，抑郁（P= 0.67，P= 0.30）、焦虑（P= 0.99，P= 0.99）、压力（P= 0.19，P= 0.13）或生活质量（P= 0.99，P= 0.62）症状的临床显著变化方面也没有观察到差异。这项对照试验的结果表明，CBT在显着减少抑郁，焦虑和压力的症状，并提高生活质量方面是有效的，无论是在面对面还是视频会议条件下，两者之间没有显着差异。澳大利亚和新西兰临床试验登记处ID：ACTRN 12609000819224; http://www.anzctr.org.au/ACTRN12609000819224.aspx（由WebCite存档，网址为http：//www.webcitation.org/6Kz5iBMiV）。
Cognitive-behavioral therapy (CBT) has demonstrated efficacy and effectiveness for treating mood and anxiety disorders. Dissemination of CBT via videoconference may help improve access to treatment. The present study aimed to compare the effectiveness of CBT administered via videoconference to in-person therapy for a mixed diagnostic cohort. A total of 26 primarily Caucasian clients (mean age 30 years, SD 11) who had a primary Diagnostic and Statistical Manual of Mental Disorders, 4th edition text revision (DSM-IV-TR) diagnosis of a mood or anxiety disorder were randomly assigned to receive 12 sessions of CBT either in-person or via videoconference. Treatment involved individualized CBT formulations specific to the presenting diagnosis; all sessions were provided by the same therapist. Participants were recruited through a university clinic. Symptoms of depression, anxiety, stress, and quality of life were assessed using questionnaires before, after, and 6 weeks following treatment. Secondary outcomes at posttreatment included working alliance and client satisfaction. Retention was similar across treatment conditions; there was one more client in the videoconferencing condition at posttreatment and at follow-up. Statistical analysis using multilevel mixed effects linear regression indicated a significant reduction in client symptoms across time for symptoms of depression (P<.001, d=1.41), anxiety (P<.001, d=1.14), stress (P<.001, d=1.81), and quality of life (P<.001, d=1.17). There were no significant differences between treatment conditions regarding symptoms of depression (P=.165, d=0.37), anxiety (P=.41, d=0.22), stress (P=.15, d=0.38), or quality of life (P=.62, d=0.13). There were no significant differences in client rating of the working alliance (P=.53, one-tailed, d=–0.26), therapist ratings of the working alliance (P=.60, one-tailed, d=0.23), or client ratings of satisfaction (P=.77, one-tailed, d=–0.12). Fisher’s Exact P was not significant regarding differences in reliable change from pre- to posttreatment or from pretreatment to follow-up for symptoms of depression (P=.41, P=.26), anxiety (P=.60, P=.99), or quality of life (P=.65, P=.99) but was significant for symptoms of stress in favor of the videoconferencing condition (P=.03, P=.035). Difference between conditions regarding clinically significant change was also not observed from pre- to posttreatment or from pretreatment to follow-up for symptoms of depression (P=.67, P=.30), anxiety (P=.99, P=.99), stress (P=.19, P=.13), or quality of life (P=.99, P=.62). The findings of this controlled trial indicate that CBT was effective in significantly reducing symptoms of depression, anxiety, and stress and increasing quality of life in both in-person and videoconferencing conditions, with no significant differences being observed between the two. Australian New Zealand Clinical Trials Registry ID: ACTRN12609000819224; http://www.anzctr.org.au/ACTRN12609000819224.aspx (Archived by WebCite at http://www.webcitation.org/6Kz5iBMiV).
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影响因子：
3.6
作者：
Foa, EB;Huppert, JD;Salkovskis, PM
通讯作者：
Salkovskis, PM
DOI：
10.3758/bf03203630
发表时间：
1996-02-01
期刊：
BEHAVIOR RESEARCH METHODS INSTRUMENTS & COMPUTERS
影响因子：
--
作者：
Erdfelder, E;Faul, F;Buchner, A
通讯作者：
Buchner, A
DOI：
10.1089/153056204773644535
发表时间：
2004-03-01
期刊：
TELEMEDICINE JOURNAL AND E-HEALTH
影响因子：
--
作者：
Bouchard, S;Paquin, B;Lapierre, J
通讯作者：
Lapierre, J
影响因子：
4.1
作者：
Diefenbach, Gretchen J.;Abramowitz, Jonathan S.;Tolin, David F.
通讯作者：
Tolin, David F.
影响因子：
3.9
作者：
Day, SX;Schneider, PL
通讯作者：
Schneider, PL