通訊心理服務在成人對象之實徵研究回顧

目的：通訊心理治療（telepsychotherapy）的需求在新型冠狀病毒肺炎（coronavirus disease 2019, COVID-19）大流行後急遽提升，目前已有許多研究探討通訊心理服務於成人族群之效果。鑑於臨床心理師應提供循證實務，本研究整理通訊心理衡鑑與通訊心理治療的研究結果，作為參考。方法：本研究回顧以成人為個案的整合性文獻回顧與後設分析研究，整理不同類型衡鑑方式以通訊方式實施時的心理計量特性，以及回顧通訊心理治療與不同對照情境（包含治療前、無治療／常規治療、面對面心理治療）的療效之比較，以及影響療效的其他調節因素。結果：在通訊心理衡鑑方面，以心理師觀察與病人口頭報告為主的客觀性衡鑑工具，具有良好信度。自陳式問卷的網路施測與紙筆施測則略有差異，操作型測驗則不宜使用。在通訊心理治療方面，和治療前以及控制組相比下，通訊心理治療有顯著較高的治療成效，和面對面心理治療之間則無顯著差異。此成效在認知行為治療取向上尤為明顯，在創傷後壓力症、焦慮及憂鬱等上的實徵支持最為豐富。某些個案相關與機構相關變項，亦對療效具有調節效果。結論：在通訊心理實務上，不同衡鑑工具的心理計量特性以及不同臨床問題與治療取向的療效上存在異質性，且相關研究亦尚未完善。臨床上應審慎根據現有之實徵證據設計介入方案，並持續進行研究，以作為提供通訊心理服務的實證基礎。

關鍵字

通訊心理服務；通訊心理衡鑑；通訊心理治療；循證實務

並列摘要

Objectives: As a result of the coronavirus disease 2019 (COVID-19) pandemic, the need for telepsychotherapy is rapidly increasing. In previous studies, the effects of telepsychology have been examined in adults. As clinical psychologists are expected to utilize evidence-based practices in their practice, the present study reviewed empirical evidence related to telepsychological assessments and telepsychotherapy. Methods: This review included integrative reviews and meta-analyses of the literature on telepsychology. The psychometric properties of various types of assessment tools administered remotely were examined. We evaluated the effects of telepsychotherapy compared to various control conditions (including the pre-therapy baseline, no treatment or treatment as usual, and face-to-face psychotherapy), and also the effects of moderating variables. Results: When telepsychological assessment tools are based on psychological observations and patients' verbal reports, their reliability is good. However, self-report questionnaires administered online may result in different results than those administered in a paper-and-pencil format. Due to the difficulty of administering performance-based assessments, performance-based assessments were not feasible. The evidence of the therapeutic effects of telepsychotherapy is generally in favor of telepsychotherapy in comparison with pre-psychotherapy baseline and no-treatment/treatment as usual and is not significant as compared to face-to-face psychotherapy. In particular, these effects are evident with the cognitive-behavioral treatment approach, with abundant evidence that this approach is effective for posttraumatic stress disorder, anxiety, and depression. Variables specific to patients or institutions may moderate telepsychotherapy's effectiveness. Conclusions: As a result of the various methods of assessment, psychological disorders treated, and therapeutic approaches used remotely, the psychometric properties and therapeutic effects are heterogeneous. Insufficient research has been conducted on this topic. Clinical intervention plans should be designed based on empirical evidence that is currently available. Furthermore, studies should be accumulated to provide empirical-based telepsychology.

並列關鍵字

telepsychology ； psychological tele-assessment ； telepsychotherapy ； evidenced-based practice

參考文獻

陳怡群、台灣臨床心理學會通訊心理工作小組（2022）。COVID-19 之前通訊科技在兒童和青少年心理健康衡鑑與治療之使用。臨床心理學刊，16(1-2)，47-75。https://doi.org/10.6550/ACP.202212_16(1_2).0004

黃芸新、陳怡群、游勝翔、蘇逸人、劉彥君、台灣臨床心理學會通訊心理工作小組（2022）。台灣臨床心理學會通訊心理治療實務指引：台灣通訊心理治療實務指引。臨床心理學刊，16(1-2)，1-15。https://doi.org/10.6550/ACP.202212_16(1_2).0001

劉同雪、黃天豪、台灣臨床心理學會通訊心理工作小組（2022）。通訊心理治療之實務面探討。臨床心理學刊，16(1-2)，16-32。https://doi.org/10.6550/ACP.202212_16(1_2).0002

Ales, F., Meyer, G. J., Mihura, J. L., Loia, A. C., Pasqualini, S., Zennaro, A., & Giromini, L. (2022). Can the Rorschach be administered remotely? A review of options and a pilot study using a newly developed R-PAS App. Psychological Injury and Law. Advance online publication. https://doi.org/10.1007/s12207-022-09447-z

Barak, A., & English, N. (2002). Prospects and limitations of psychological testing on the internet. Journal of Technology in Human Services, 19(2-3), 65-89. https://doi.org/10.1300/J017v19n02_06

被引用紀錄

黃芸新、陳怡群、游勝翔、蘇逸人、劉彥君、台灣臨床心理學會通訊心理工作小組（2022）。台灣臨床心理學會通訊心理治療實務指引：台灣通訊心理治療實務指引。臨床心理學刊，16(1/2)，1-15。https://doi.org/10.6550/ACP.202212_16(1_2).0001

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