A National Survey of Patient Completion of Cognitive Behavioral Therapy for Chronic Pain: The Role of Therapist Characteristics, Attempt Rates, and Modification.
A National Survey of Patient Completion of Cognitive Behavioral Therapy for Chronic Pain: The Role of Therapist Characteristics, Attempt Rates, and Modification.
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慢性疼痛认知行为治疗患者完成情况的全国调查：治疗师特征、尝试率和修改的作用。
DOI：
10.1037/pro0000399
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Murphy,JenniferL
中科院分区：
文献类型：
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作者：
McGuire,Alan;Matthias,MarianneS;Kukla,Marina;Henry,Nancy;Carter,Jessica;Flanagan,Mindy;Bair,MatthewJ;Murphy,JenniferL
循证心理治疗的实施，包括患者层面的措施，如渗透率和成功完成疗程的比率，越来越受到关注。虽然很多人都注意到病人层面的因素对实施的影响，相对较少的关注已经支付给治疗师的因素（如，专业培训，经验）。本研究探讨治疗师的决定，提供一个特定的循证心理治疗（认知行为治疗慢性疼痛[CBT-CP]），他们是否以及如何修改CBT-CP，以及这些决定和患者完成率之间的关系。该研究利用了141名退伍军人事务部治疗师在CBT-CP认证的调查答复。治疗师报告称，他们对不到一半的慢性疼痛患者尝试了CBT-CP（M= 48.8%，SD= 35.7）。治疗师通常分为极少数或大多数患者报告修改CBT-CP。在控制治疗师特征和修改后，治疗师报告的尝试CBT-CP患者的百分比与完成率呈正相关，t（111）= 4.57，p<0.05。001.更频繁地尝试CBT-CP的治疗师可能会有更好的完成率，这可能是由于实践效果或支持尝试和完成的背景因素。未来的研究应该使用尝试率和完成率的客观测量来检查这种关系。
The implementation of evidence-based psychotherapies, including patient-level measures such as penetration and rates of successfully completing a course of therapy, has received increasing attention. While much attention has been paid to the effect of patient-level factors on implementation, relatively little attention has been paid to therapist factors (eg, professional training, experience). The present study explores therapists’ decisions to offer a particular evidence-based psychotherapy (Cognitive-behavioral therapy for chronic pain [CBT-CP]), whether and how they modify CBT-CP, and the relationship between these decisions and patient completion rates. The study utilized survey responses from 141 Veterans Affairs therapists certified in CBT-CP. Therapists reported attempting CBT-CP with a little less than one half of their patients with chronic pain (M= 48.8%, SD= 35.7). Therapist were generally split between reporting modifying CBT-CP for either very few or most of their patients. After controlling for therapist characteristics and modification, therapist-reported percentage of patients with attempted CBT-CP was positively associated with completion rates, t (111)= 4.57, p<. 001. Therapists who attempt CBT-CP more frequently may experience better completion rates, perhaps due to practice effects or contextual factors that support both attempts and completion. Future research should examine this relationship using objective measures of attempt rates and completion.