Internet-delivered psychological treatments: from innovation to implementation
Internet-delivered psychological treatments: from innovation to implementation
复制标题
DOI：
10.1002/wps.20610
复制
发表时间：
2019-02-01
期刊：
影响因子：
73.3
通讯作者：
Carlbring, Per
中科院分区：
文献类型：
--
作者：
Andersson, Gerhard;Titov, Nickolai;Carlbring, Per
互联网干预，特别是互联网提供的认知行为疗法，已经存在了至少20年。在这里，我们审查的治疗方法和证据基础，认为ICBT可以被视为创新的工具。ICBT已经开发并测试了几种精神和身体状况，直接比较研究表明，治疗师指导的ICBT比焦虑症和抑郁症的等待名单更有效，并且往往与面对面的CBT一样有效。还审查了关于信通技术可能产生的有害影响的研究：有相当一部分人确实受到负面影响，尽管恶化率似乎与面对面治疗报告的情况相似，但低于对照条件。我们进一步审查研究的变化机制，并得出结论，很少，如果有的话，一致的主持人和调解人的变化已被确定。最近的趋势，重点放在知识的获取被认为是，并讨论实施ICBT的可能性和障碍。后者包括的调查结果表明，对ICBT的态度可能不如使用现代信息技术作为面对面治疗的辅助手段时那么积极（即，混合处理）。最后，我们讨论了未来的发展方向，包括技术和机器学习所发挥的作用，混合治疗，少数民族和非西方环境的适应治疗，ICBT以外的其他治疗方法（包括互联网提供的心理动力学和人际心理治疗以及接受和承诺治疗），新兴法规，以及报告失败试验的重要性。
Internet interventions, and in particular Internet-delivered cognitive behaviour therapy (ICBT), have existed for at least 20 years. Here we review the treatment approach and the evidence base, arguing that ICBT can be viewed as a vehicle for innovation. ICBT has been developed and tested for several psychiatric and somatic conditions, and direct comparative studies suggest that therapist-guided ICBT is more effective than a waiting list for anxiety disorders and depression, and tends to be as effective as face-to-face CBT. Studies on the possible harmful effects of ICBT are also reviewed: a significant minority of people do experience negative effects, although rates of deterioration appear similar to those reported for face-to-face treatments and lower than for control conditions. We further review studies on change mechanisms and conclude that few, if any, consistent moderators and mediators of change have been identified. A recent trend to focus on knowledge acquisition is considered, and a discussion on the possibilities and hurdles of implementing ICBT is presented. The latter includes findings suggesting that attitudes toward ICBT may not be as positive as when using modern information technology as an adjunct to face-to-face therapy (i.e., blended treatment). Finally, we discuss future directions, including the role played by technology and machine learning, blended treatment, adaptation of treatment for minorities and non-Western settings, other therapeutic approaches than ICBT (including Internet-delivered psychodynamic and interpersonal psychotherapy as well as acceptance and commitment therapy), emerging regulations, and the importance of reporting failed trials.