Self-administered psychotherapy for depression using a telephone-accessed computer system plus booklets: An open US-UK study

被引:81
作者
Osgood-Hynes, DJ
Greist, JH
Marks, IM
Baer, L
Heneman, SW
Wenzel, KW
Manzo, PA
Parkin, JR
Spierings, CJ
Dottl, SL
Vitse, HM
机构
[1] Massachusetts Gen Hosp, Boston, MA 02114 USA
[2] Harvard Univ, Sch Med, Boston, MA USA
[3] Healthcare Technol Syst LLC, Madison, WI USA
[4] Dean Fdn Hlth Res & Educ Inc, Middleton, WI USA
[5] Bethlem Royal & Maudsley Hosp, Inst Psychiat, London, England
关键词
D O I
10.4088/JCP.v59n0704
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Objective: To evaluate the efficacy and acceptability of a self-help program for mild-to-moderate depression that combined treatment booklets and telephone calls to a computer-aided Interactive Voice Response (IVR) system. Method: In an open trial, 41 patients from Boston, Massachusetts; Madison, Wisconsin; and London, England, used COPE, a 12-week self-help system for depression. COPE consisted of an introductory videotape and 9 booklets accompanied by 11 telephone calls to an IVR system that made self-help recommendations to patients based on information they entered. Results: All 41 patients successfully completed the self-assessment in the booklets and telephone calls; 28 (68%) also completed the 12-week self-help program. Hamilton Rating Scale for Depression (HAM-D) and Work and Social Adjustment scores improved significantly (41% and 42% mean reduction in the intent-to-treat sample, respectively, p < .001). Eighteen (64%) of the 28 completers were considered responders on the basis of greater than or equal to 50% reduction in their HAM-D scores. There was a higher percentage of completers in the pooled U.S. sites (82% vs. 43%), and U.S, completers improved more than those in the United Kingdom (73% vs. 43% were responders). Most (68%) of the calls were made outside usual office hours, Monday-Friday, 9:00 a.m. to 5:00 p.m. Expectation of effectiveness and time spent making COPE calls (more treatment modules) correlated positively with improvement over 12 weeks. Mean call length for completers was 14 minutes. Conclusion: A self-help system comprised of a computer-aided telephone system and a series of booklets was used successfully by people with mild-to-moderate depression. These preliminary results are encouraging for people who cannot otherwise access ongoing, in-person therapy.
引用
收藏
页码:358 / 365
页数:10
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