ABSTRACT

Objective

Cognitive-behaviour therapy (CBT) is a research-supported treatment for anxiety disorders. Transdiagnostic CBT protocols have been recently developed to manage multiple anxiety disorders. The efficacy of transdiagnostic CBT is directly dependent on acceptability as perceived by patients and health care providers. In this study, we sought to examine the acceptability of transdiagnostic CBT from the patient perspective within the context of a community-based group delivery for mixed anxiety disorders.

Method

An embedded qualitative study was conducted as part of a pragmatic randomized clinical trial of group transdiagnostic CBT for anxiety disorders. Semi-structured interviews were conducted based on a meta-framework of the concept of acceptability. Acceptability of the therapy was examined with a thematic analysis of interview verbatims.

Results

Seventeen patients were interviewed. Patients’ perception of acceptability of tCBT was classified into eight themes: 1) therapy features; 2) intervention components; 3) group format; 4) group cohesiveness; 5) co-therapists with different expertise; 6) quality of therapeutic alliance; 7) perceived effectiveness; and 8) access to the therapy.

Conclusion

The acceptability of transdiagnostic group CBT for patients was generally perceived as adequate in community-based therapy. Recommendations to enhance acceptability of the group therapy were related to group size, group dynamics and exposure.

KEY POINTS

What is already known about this topic

(1) Transdiagnostic group CBT is an effective treatment for anxiety disorders.

(2) Studies generally report good acceptability for CBT, but dropout rates suggest a potential area for improvement.

(3) To date, few studies have examined the comprehensive concept of acceptability of CBT from the patients’ perspective.

What this paper adds

(1) A qualitative study was conducted with a meta-framework of the concept of acceptability in the context of a community-based therapy.

(2) The acceptability of transdiagnostic group CBT for patients was generally perceived as adequate.

(3) Recommendations to enhance acceptability emerged from participants’ experiences concerning the topics of group size, group dynamics and exposure.

中文翻译：

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患者对团体跨诊断认知行为疗法在社区护理中治疗焦虑症的可接受性：一项定性研究

摘要

客观的

认知行为疗法 (CBT) 是一种研究支持的焦虑症治疗方法。最近开发了跨诊断 CBT 协议来管理多种焦虑症。跨诊断 CBT 的功效直接取决于患者和医疗保健提供者认为的可接受性。在这项研究中，我们试图在基于社区的混合焦虑症小组交付的背景下，从患者的角度检查跨诊断 CBT 的可接受性。

方法

一项嵌入式定性研究是作为焦虑症组跨诊断 CBT 实用随机临床试验的一部分进行的。半结构化访谈是基于可接受性概念的元框架进行的。通过逐字逐句的主题分析来检查治疗的可接受性。

结果

十七名患者接受了采访。患者对 tCBT 可接受性的感知分为八个主题：1）治疗特征；2）干预组件；3) 小组形式；4) 群体凝聚力；5) 具有不同专长的联合治疗师；6) 治疗联盟的质量；7) 感知有效性；8) 获得治疗。

结论

对患者进行跨诊断组 CBT 的可接受性通常被认为在基于社区的治疗中是足够的。提高团体治疗可接受性的建议与团体规模、团体动力和暴露程度有关。

关键点

关于这个主题的已知信息

(1)跨诊断组CBT是治疗焦虑症的有效方法。

(2) 研究普遍报告了 CBT 的良好可接受性，但辍学率表明存在潜在的改进领域。

(3) 迄今为止，很少有研究从患者的角度审视 CBT 可接受性的综合概念。

本文补充了什么

(1) 在基于社区的治疗的背景下，使用可接受性概念的元框架进行了定性研究。

(2) 跨诊断组 CBT 对患者的可接受性通常被认为是足够的。

(3) 提高可接受性的建议来自参与者关于小组规模、小组动态和曝光度等主题的经验。