Evaluation of an Open-Access CBT-Based Internet Program for Social Anxiety: Patterns of Use, Retention, and Outcomes
Evaluation of an Open-Access CBT-Based Internet Program for Social Anxiety: Patterns of Use, Retention, and Outcomes
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DOI：
10.1037/ccp0000232
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发表时间：
2017-10-01
影响因子：
5.9
通讯作者：
Heimberg, Richard G.
中科院分区：
文献类型：
--
作者：
Dryman, M. Taylor;McTeague, Lisa M.;Heimberg, Richard G.
目的：互联网提供的认知行为疗法（ICBT）已被确立为有效和有效地减少社交焦虑症状。然而，大多数研究都是在受控环境中进行的，关于开放获取格式的此类程序的实用性知之甚少。本研究探讨了使用，坚持，和有效性的快乐，一个开放的访问，互联网提供的，教练支持的CBT为基础的干预社交焦虑。方法：参与者为3，384名注册用户（M-年龄[SD] = 29.82 [7.89]; 54%为男性），他们在2014年至2016年期间创建了一个帐户。使用的特点，相关因素的磨损和坚持，并在组内的结果进行了检查。主要结果测量是社交恐惧症量表。结果如下：平均而言，参与者在该计划中停留了81.02天（SD = 60.50），在此期间，他们完成了12.14次活动（SD = 11.09）和1.53次暴露（SD = 3.18）。大约一半（57%）的人与教练有联系。16%的参与者完全遵守了该计划，这一比例高于先前发表的ICBT开放获取研究。参与该计划的参与者的社交焦虑症状显着减少，通过认知重建模块（d = 0.63-0.76）从基线到组内效应中等，通过暴露模块（d = 1.40-1.83）从基线到组内效应大。反应率很高（72%）。暴露和教练接触是保留和结果的重要预测因素。结论：这种基于CBT的开放式在线计划可有效减少社交焦虑症状，并有可能将基于互联网的心理健康服务扩展到不愿意或无法寻求面对面循证治疗的社交焦虑个体。
Objective: Internet-delivered cognitive-behavioral therapy (ICBT) has been established as both efficacious and effective in reducing symptoms of social anxiety. However, most research has been conducted in controlled settings, and little is known regarding the utility of such programs in an open-access format. The present study examined the use, adherence, and effectiveness of Joyable, an open-access, Internet-delivered, coach-supported CBT-based intervention for social anxiety. Method: Participants were 3,384 registered users (M-age [SD] = 29.82 [7.89]; 54% male) that created an account between 2014 and 2016. Characteristics of use, factors related to attrition and adherence, and within-group outcomes were examined. The primary outcome measure was the Social Phobia Inventory. Results: On average, participants remained in the program for 81.02 days (SD = 60.50), during which they completed 12.14 activities (SD = 11.09) and 1.53 exposures (SD = 3.18). About half (57%) had contact with a coach. Full adherence to the program was achieved by 16% of participants, a rate higher than previously published open-access studies of ICBT. Social anxiety symptoms were significantly reduced for participants that engaged in the program, with medium within-group effects from baseline through the cognitive restructuring module (d = 0.63-0.76) and large effects from baseline through the exposure module (d = 1.40-1.83). Response rates were high (72%). Exposures and coach contact were significant predictors of retention and outcome. Conclusions: This open-access online CBT-based program is effective in reducing social anxiety symptoms and has the potential to extend Internet-based mental health services to socially anxious individuals unwilling or unable to seek face-to-face evidence-based therapy.