背景:与先前的人际关系创伤有关的痛苦在精神保健患者中很常见。诊断标签可能有所不同,但是临床表现通常具有长期和复杂的心理和躯体症状,主观痛苦和健康和生活质量下降。相当比例的患者在普通的专业精神卫生保健机构进行单独治疗后无法康复,尽管个人创伤特异性治疗已被证明是有用的。在群体环境中出现的治疗因素,比如规范化,减少羞耻和纠正关系经验,可能对创伤幸存者特别有用。然而,支持创伤幸存者团体治疗的证据很少.这项研究旨在测试在普通的社区精神卫生医院中将新型团体干预与个体治疗相结合是否优于常规的个体门诊治疗。
方法:在单站点中,非致盲,随机对照试验(RCT),将单独治疗中添加的基于群体的稳定和技能训练(SST)干预措施的效果与常规治疗(照常治疗,TAU)独自一人。将在圣奥拉夫大学医院社区精神卫生中心的普通门诊诊所招募与过去已知的不良生活事件相关的持续和持久反应的参与者(N=160),特隆赫姆,挪威。基线评估和随机化后,参与者将在基线后4,8,13和19个月完成随访措施.主要结果是个人康复(关于康复过程的问卷,QPR)。次要结果包括(1)自我报告的创伤后应激症状,一般精神和躯体健康症状,幸福,功能障碍和客户满意度,(2)在血液样本中测量的免疫和内分泌反应以及(3)有关职业状况的国家注册数据,使用精神卫生服务和药物治疗。此外,通过创伤后认知的变化机制将被检查。
结论:在创伤幸存者的个体治疗中增加基于小组的干预措施可能被证明是一种有效的方法,可以满足大量患者的长期高强度治疗需求。精神保健患者,从而减少他们的痛苦,增加他们的社会心理功能。
背景:ClinicalTrials.gov:NCT03887559。2019年3月25日注册。
BACKGROUND: Suffering linked to previous interpersonal trauma is common among patients in mental health care. Diagnostic labels may vary, but the clinical picture is often characterized by long-lasting and complex psychological and somatic symptoms, subjective distress and reduced quality of health and life. A substantial proportion of patients do not recover after individual treatment in ordinary specialized mental healthcare settings, despite the proven usefulness of individual trauma-specific treatments. The therapeutic factors that arise in group settings, such as normalization, shame reduction and corrective relational experiences, may be particularly useful for trauma survivors. However, evidence in support of group treatment for trauma survivors is scarce. This study aims to test whether combining a novel group intervention to individual treatment is superior to conventional individual out-patient treatment in an ordinary community mental health hospital.
METHODS: In a single-site, non-blinded, randomized controlled trial (RCT), the effect of a combined group-based stabilization and skill-training (SST) intervention added to individual treatment will be compared to conventional treatment (treatment as usual, TAU) alone. Participants (N = 160) with ongoing and long-lasting reactions related to known adverse life events from the past will be recruited among patients at general outpatient clinics in a community mental health centre at St. Olav\'s University Hospital, Trondheim, Norway. Following baseline assessment and randomization, participants will complete follow-up measures at 4, 8, 13 and 19 months post-baseline. The primary outcome is personal recovery (The questionnaire about the process of recovery , QPR). Secondary outcomes include (1) self-reported symptoms of posttraumatic stress, general mental and somatic health symptoms, well-being, functional impairment and client satisfaction, (2) immunological and endocrine response measured in blood samples and (3) national registry data on occupational status, use of mental health services and pharmacological treatment. Additionally, mechanisms of change via posttraumatic cognitions will be examined.
CONCLUSIONS: The addition of a group-based intervention to individual treatment for trauma survivors might prove to be an efficient way to meet the need of long-lasting high-intensity treatment in a large group of patients in mental health care, thereby reducing their suffering and increasing their psychosocial functioning.
BACKGROUND: ClinicalTrials.gov: NCT03887559. Registered on 25 March 2019.