Therapist use of Socratic questioning predicts session-to-session symptom change in cognitive therapy for depression
Therapist use of Socratic questioning predicts session-to-session symptom change in cognitive therapy for depression
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DOI：
10.1016/j.brat.2015.05.004
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发表时间：
2015-07-01
影响因子：
4.1
通讯作者：
Cooper, Andrew A.
中科院分区：
文献类型：
--
作者：
Braun, Justin D.;Strunk, Daniel R.;Cooper, Andrew A.
苏格拉底提问是抑郁症认知治疗(CT)中的关键治疗策略。然而，人们对它与结果的关系知之甚少。在这项研究中，我们考察了治疗师使用苏格拉底提问作为会话到会话症状变化的预测因素。参与者是55名抑郁症成年人，他们参加了为期16周的CT疗程(见Adler，Strunk，&Fazio，2015)。苏格拉底的提问通过前三次会议的观察员评分进行评估。苏格拉底评分被分解为反映患者内部和患者之间变异性的分数，以便于检查患者内部苏格拉底提问和会话间症状变化的关系。因为我们在苏格拉底提问中考察了患者内部的可变性，这种关系的识别不能归因于任何稳定的患者特征，否则可能会引入虚假的关系。患者内部的苏格拉底问题显著预测了早期会议期间的症状变化，苏格拉底的标准差增加了一个标准差-在预测下一次会议的BDI-II分数下降1.51分内。在控制了治疗联盟的患者内部评分(即关系和协议)后，患者内部的苏格拉底问题继续预测症状变化，这表明苏格拉底问题与症状变化的关系不仅独立于治疗联盟中的稳定特征，而且还与患者内部的变化无关。我们的结果首次为治疗师使用苏格拉底问题与抑郁症的CT症状变化之间的关系提供了经验支持。(C)2015爱思唯尔有限公司。保留所有权利。
Socratic questioning is a key therapeutic strategy in cognitive therapy (CT) for depression. However, little is known regarding its relation to outcome. In this study, we examine therapist use of Socratic questioning as a predictor of session-to-session symptom change. Participants were 55 depressed adults who participated in a 16-week course of CT (see Adler, Strunk, & Fazio, 2015). Socratic questioning was assessed through observer ratings of the first three sessions. Socratic ratings were disaggregated into scores reflecting within-patient and between-patient variability to facilitate an examination of the relation of within-patient Socratic questioning and session-to-session symptom change. Because we examined within-patient variability in Socratic questioning, the identification of such a relation cannot be attributed to any stable patient characteristics that might otherwise introduce a spurious relation. Within-patient Socratic questioning significantly predicted session-to-session symptom change across the early sessions, with a one standard deviation increase in Socratic-Within predicting a 1.51-point decrease in BDI-II scores in the following session. Within-patient Socratic questioning continued to predict symptom change after controlling for within-patient ratings of the therapeutic alliance (i.e., Relationship and Agreement), suggesting that the relation of Socratic questioning and symptom change was not only independent of stable characteristics, but also within-patient variation in the alliance. Our results provide the first empirical support for a relation of therapist use of Socratic questioning and symptom change in CT for depression. (C) 2015 Elsevier Ltd. All rights reserved.