How Does Tele-Mental Health Affect Group Therapy Process? Secondary Analysis of a Noninferiority Trial
How Does Tele-Mental Health Affect Group Therapy Process? Secondary Analysis of a Noninferiority Trial
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DOI：
10.1037/a0020158
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发表时间：
2010-10-01
影响因子：
5.9
通讯作者：
Rosen, Craig S.
中科院分区：
文献类型：
--
作者：
Greene, Carolyn J.;Morland, Leslie A.;Rosen, Craig S.
目的：视频电话会议（VTC）用于向地理上偏远、服务不足的人群提供心理健康治疗。然而，很少有研究探讨VTC如何影响个人或团体的心理治疗过程。本研究比较过程变量，如治疗联盟和磨损之间的参与者接受愤怒管理团体治疗，无论是通过传统的面对面交付或VTC。方法：目前的研究代表了随机非劣效性试验（Morland等人，在这些个案中，VTC分娩的临床成效并不逊于亲自接生。参与者是男性退伍军人（N = 112）与创伤后应激障碍（PTSD）和中度至严重的愤怒问题。本研究探讨了潜在的差异过程变量，包括治疗联盟，满意度，治疗的可信度，出勤率，家庭作业完成，和磨损。结果：两种模式在大多数过程变量上无显著差异。然而，在VTC条件下的个人表现出较低的联盟与组长比那些在亲自的条件。平均自我领导者联盟得分分别为4.2（SD = 0.8）和4.5（SD = 0.4），其中5代表强烈同意，4代表同意积极的声明的关系，这表明参与者在这两种情况下感到合理的强大联盟的绝对值。具有更强联盟的个体倾向于具有更好的愤怒结果，但这种影响还不足以导致VTC条件产生较差的总体结果。结论：我们的研究结果表明，即使通过VTC的团体心理治疗与面对面的治疗有细微的不同。职业训练局是提供心理治疗的可行和有效方法。
Objective: Video teleconferencing (VTC) is used for mental health treatment delivery to geographically remote, underserved populations. However, few studies have examined how VTC affects individual or group psychotherapy processes. This study compares process variables such as therapeutic alliance and attrition among participants receiving anger management group therapy either through traditional face-to-face delivery or by VTC. Method: The current study represents secondary analyses of a randomized noninferiority trial (Morland et al., in press) in which clinical effectiveness of VTC delivery proved noninferior to in-person delivery. Participants were male veterans (N = 112) with posttraumatic stress disorder (PTSD) and moderate to severe anger problems. The present study examined potential differences in process variables, including therapeutic alliance, satisfaction, treatment credibility, attendance, homework completion, and attrition. Results: No significant differences were found between the two modalities on most process variables. However, individuals in the VTC condition exhibited lower alliance with the group leader than those in the in-person condition. Mean self-leader alliance scores were 4.2 (SD = 0.8) and 4.5 (SD = 0.4), respectively, where 5 represents strongly agree and 4 represents agree with positive statements about the relationship, suggesting that participants in both conditions felt reasonably strong alliance in absolute terms. Individuals who had stronger alliance tended to have better anger outcomes, yet the effect was not strong enough to result in the VTC condition producing inferior aggregate outcomes. Conclusion: Our findings suggest that even if group psychotherapy via VTC differs in subtle ways from in-person delivery. VTC is a viable and effective means of delivering psychotherapy.