Can the Patient Decide Which Modules to Endorse? An Open Trial of Tailored Internet Treatment of Anxiety Disorders
Can the Patient Decide Which Modules to Endorse? An Open Trial of Tailored Internet Treatment of Anxiety Disorders
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DOI：
10.1080/16506073.2010.529457
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发表时间：
2011-01-01
影响因子：
4.7
通讯作者：
Carlbring, Per
中科院分区：
文献类型：
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作者：
Andersson, Gerhard;Estling, Fanny;Carlbring, Per
互联网提供的认知行为疗法通常包括基于面对面手册的特定障碍模块。该领域的最新发展是根据患者情况定制治疗，这有可能涵盖与焦虑和情绪障碍相关的共病状况。但是，患者可以自己决定使用哪些模块。作者在一项开放的试点试验中对27名混合性焦虑症患者进行了测试。模块介绍了一个简短的描述，患者可以选择使用哪些模块。前两个单元和最后一个单元是例外，它们涉及心理教育和预防复发。疗程为10周。结果显示，组内效应量较大，平均科恩d为0.88。在结构化临床访谈中，大多数（54%）在开始治疗后10周有显著改善。只有一个人退出了。根据这项初步研究的结果，作者建议在对照试验中进一步探讨选择和定制的作用，并将患者的选择纳入互联网提供的治疗方案中。
Internet-delivered cognitive behaviour therapy commonly consists of disorder-specific modules that are based on face-to-face manuals. A recent development in the field is to tailor the treatment according to patient profile, which has the potential to cover comorbid conditions in association with anxiety and mood disorders. However, it could be that the patients themselves are able to decide what modules to use. The authors tested this in an open pilot trial with 27 patients with mixed anxiety disorders. Modules were introduced with a brief description, and patients could choose which modules to use. The exception was the two first modules and the last, which involved psychoeducation and relapse prevention. The treatment period lasted for 10 weeks. Results showed large within-group effect sizes, with an average Cohen's d of 0.88. In a structured clinical interview, a majority (54%) had significantly improved 10 weeks after commencing treatment. Only one person dropped out. On the basis of results of this preliminary study, the authors suggest that the role of choice and tailoring should be further explored in controlled trials and that patient choice could be incorporated into Internet-delivered treatment packages.