广泛性焦虑障碍认知行为治疗技术专家共识的德尔菲法研究

Cognitive-behavioral therapy components for generalized anxiety disorder:A Delphi Poll study

目的:使用德尔菲法(Delphi法)研究国内广泛性焦虑障碍(GAD)的认知行为治疗(CBT)技术的使用情况,为进一步规范CBT技术奠定基础。方法:复习国外关于广泛性焦虑障碍的认知行为治疗的随机对照研究文献,筛选出35个认知行为治疗技术并制定专家咨询表,发放给31名认知行为治疗专家,进行两轮咨询,最后对这些技术进行排序。结果:综合秩次排前4位的依次为,建立治疗关系、心理教育、资料收集与评估和放松练习;而国外常用的技术,如苏格拉底提问、担忧暴露排在第26位和第22位;思维阻止在可操作性维度、使用频率维度和对治疗的贡献维度上的变异系数(CV)分别为0.25、0.36和0.31。结论:在广泛性焦虑障碍的治疗中,专家达成共识的技术为建立治疗关系、心理教育、资料收集与评估和放松练习,而思维阻止是否剔除有待进一步研究。

Objective： To explore the status of cognitive-behavioral therapy （CBT） components for generalized anxiety disorder （GAD） by Delphi Poll, in order to lay a foundation to standard domestic CBT techniques. Methods： Totally 35 technique components for GAD were chosen from foreign literatures of randomcontrol study. Questionnaires including these 35 components were filled in by 31 experts of CBT. After two rounds of expert consultation, the CBT components for GAD were sorted. Results： The components of establishing thera- peutic alliance, psychoeducation, assessment and relaxation training were on the first 4 ranks. However the common- ly used components in foreign clinical trials such as socratic questioning and worry exposure, only on the rank of 26 and 22, and the coefficient of variation of thought stopping on the dimensions of operability, frequency of utilization and contribution of treatment were 0. 25, 0. 36, and 0. 31, respectively. Conclusion： It suggests that in the GAD ther- apy, establishing therapeutic alliance, psychoeducation, collection/assessment and relaxation training are reached agreement by CBT experts, and whether the technique of thought stopping should be rejected need to be further studied.