TY - JOUR AU - Peynenburg, Vanessa AU - Hadjistavropoulos, Heather AU - Thiessen, David AU - Titov, Nickolai AU - Dear, Blake PY - 2022 DA - 2022/9/7 TI -互联网提供的高等教育学生认知行为治疗:研究动机访谈和辅助课程的随机析因试验JO - J Med Internet Res SP - e40637 VL - 24 IS - 9 KW -大专学生KW -跨诊断KW -助推器KW -动机访谈KW -互联网提供的认知行为治疗AB -背景:互联网提供的认知行为疗法(ICBT)可以改善学生获得心理健康护理的机会，尽管高流失率令人担忧，而且对长期结果知之甚少。动机访谈(MI)练习和辅助课程可以提高面对面认知行为治疗的参与度和效果。目的:本研究旨在探讨预处理MI练习和辅助课程在大专学生ICBT中的应用。方法:本析因试验(因子1:治疗前基于网络的心肌梗死;因子2:治疗后1个月的自我指导强化课)，308例患者随机分为4个治疗条件中的1个，其中277例(89.9%)患者开始治疗。所有患者均接受了为期5周的ICBT跨诊断课程(uniwellness课程)。主要结局包括治疗前、治疗后以及随访1个月和3个月时抑郁、焦虑和感知学术功能的变化。结果:总体而言，54%(150/277)的学生完成了治疗，并报告治疗后抑郁和焦虑症状有很大改善，学习功能有很小的改善，这种改善在1个月和3个月的随访中保持不变。 Pretreatment MI did not contribute to better treatment completion or engagement, although small between-group effects favored MI for reductions in depression (Cohen d=0.23) and anxiety (Cohen d=0.25) after treatment. Only 30.9% (43/139) of students randomized to one of the booster conditions accessed the booster. Overall, no main effects were found for the booster. Subanalyses revealed that clients who accessed the booster had larger decreases in depressive symptoms (Cohen d=0.31) at the 3-month follow-up. No interactions were found between MI and the booster. Conclusions: Rather than offering MI before treatment, clients may experience more benefits from MI exercises later in ICBT when motivation wanes. The low uptake of the self-guided booster limited our conclusions regarding its effectiveness. Future research should examine offering a booster for a longer duration after treatment, with therapist support and a longer follow-up period. Trial Registration: ClinicalTrials.gov NCT04264585; https://clinicaltrials.gov/ct2/show/NCT04264585 SN - 1438-8871 UR - //www.mybigtv.com/2022/9/e40637 UR - https://doi.org/10.2196/40637 UR - http://www.ncbi.nlm.nih.gov/pubmed/36069785 DO - 10.2196/40637 ID - info:doi/10.2196/40637 ER -