对与伤害相关的强迫症患者进行反应预防暴露:理论与实践的差距及其与受训者和合格治疗师样本中的经验回避和对暴露的负面信念的关系

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-01-01 DOI:10.1016/j.jocrd.2024.100860
Lena Jelinek , Alicia Balzar , Steffen Moritz , Sarah Liebherz , Amir H. Yassari
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引用次数: 0

摘要

尽管反应预防暴露疗法(ERP)疗效显著,但在强迫症(OCD)患者中却使用不足。由于ERP的使用不足可能尤其适用于与伤害相关的强迫症,因此我们以受训和合格的治疗师为样本,调查了理论与实践之间的差距,以及消极信念和经验回避作为ERP在该群体中使用不足的潜在原因。在所有样本中,74% 的治疗师(n = 251)以 CBT 为导向,61% 的治疗师(n = 209)正在接受培训。我们使用治疗师暴露信念量表(TBES)和接受与行动问卷-II(AAQ-II)评估了治疗师的消极信念和经验回避。虽然74%的治疗师推荐ERP用于案例,但只有43%的治疗师承认在其临床实践中使用ERP治疗伤害相关强迫症。治疗师在理论和实践中对ERP的亲和力与对ERP较少的负面信念有关,其效应大小较大(ηp2 = 0.367 [CI95% 0.285 - 0.433]),而在全部样本中,经验回避较低,其效应大小较小(ηp2 = 0.024 [CI95% 0.001 - 0.059])。为了确保与伤害相关的强迫症患者得到他们所需的循证治疗,对ERP的负面信念可能是一个潜在的目标。
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Exposure therapy in patients with harm-related obsessive-compulsive disorder: The theory-practice gap and its relation to experiential avoidance and negative beliefs about exposure

Despite its efficacy and effectiveness, exposure with response prevention (ERP) is underused in patients with obsessive-compulsive disorder (OCD). As this underuse of ERP may apply particularly to harm-related OCD, we investigated the theory-practice gap as well as negative beliefs and experiential avoidance as potential reasons for the underutilization of ERP with this group in a sample of trainee and qualified therapists.

We assessed 339 therapists’ general knowledge about ERP using a harm-related OCD case example and their utilization of ERP in clinical practice for harm-related OCD. Of the total sample, 74% of the therapists (n = 251) were CBT-oriented and 61% (n = 209) were in training. We assessed negative beliefs and experiential avoidance using the Therapist Beliefs about Exposure Scale (TBES) and the Acceptance and Action Questionnaire-II (AAQ-II).

While 74% of the therapist recommended ERP for the case example, only 43% admitted to using ERP for harm-related OCD in their clinical practice. ERP affinity of therapists in theory and practice was related to fewer negative beliefs about ERP, with large effect size (ηp2 = 0.367 [CI95% 0.285 − 0.433]) and lower experiential avoidance with small effect size (ηp2 = 0.024 [CI95% 0.001 − 0.059]) in the total sample.

We found evidence of a theory-practice gap in the treatment of harm-related OCD in a sample of trainee and qualified therapists. To ensure that patients with harm-related OCD content receive the evidence-based treatment they need, negative beliefs about ERP may represent a potential target.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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