정신증적 장애의 회복 관점에 기초하여 수용전념치료가 적용된 연구의 체계적 문헌고찰 및 메타분석
Systematic Literature Review and Meta-analysis on Acceptance-Commitment Therapy for Psychotic Disorder Based on the Perspective of Recovery
1
조회
0
다운로드
5
인용
0
참고문헌
키워드
초록
수용전념치료(ACT)는 범진단적 접근으로서 정신증의 회복에 대해 효과가 검증되었으며 갈수록 널리 활용되고 있으나 국내에서는 관련 연구가 거의 없다. 본 연구는 정신증적 장애가 있는 참여자들을 대상으로 2002년부터 2021년까지 수용전념치료를 적용하여 그 효과성을 검증한 문헌들을 체계적으로 고찰하고자 하였다. 따라서 수용전념치료가 시행된 문헌들 12편의 질적인 특성들에 대해 우선 검토한 후, 양적 분석을 위해 메타분석을 시행하였고 8편의 문헌들에서 도출한 치료의 효과 크기를 산출하였다. 또한 그 후 문헌들의 결과 측정치에 대해 임상적 회복 및 개인적 회복에 대한 효과성에 대해 각각 세부적으로 검토해 보았다. 연구 결과, 정신증 증상을 경험하는 참여자 집단에서 수용전념치료를 적용한 대다수의 문헌들은 임상적 회복인 양성 증상에 대해서 유의한 효과를 나타내었을 뿐만 아니라, 개인적 회복 중 음성증상 및 주관적 고통감에서 역시 유의한 효과를 나타내었다. 본 연구 결과 정신증적 장애가 있는 당사자의 개인적 회복에 있어 수용전념치료적 접근이 효과적인 방법으로 널리 활용될 수 있으며, 특히 현 연구 결과를 대한민국에서 정신건강 서비스 현장의 적용과 연결해 볼 수 있음을 언급하였다. 마지막으로 그 밖의 연구의 의의와 제한점을 논의하였다.
Abstract
Acceptance and Commitment Therapy (ACT), as a trans-diagnostic approach, has been proven effective in the recovery of psychosis and is being used more and more widely, but there are few related studies in Korea. This study aimed to systematically review the literature from 2002 to 2021 on the application of ACT for participants with psychosis. The data analysis included two folds: (a) the preliminary analysis the literatures (N= 12) to screen the qualitative data for meta-analysis and (b) primary meta-analysis on the relevant literature (n = 8) to determine the effect size in recovery. The results revealed that the effect size of ACT for participants with psychosis was significant. The results suggest that the ACT approach can be a therapeutically effective method for both clinical and personal recovery of a person with psychosis. The significance, limitations, and implications of this study were discussed.
참고문헌 (56)
- 강현, "메타분석에서 통계학적 고려사항들", Hanyang Medical Reviews, 35(1), pp.23~32 (2015), 한양대학교 의과대학[DOI]
- 김나은, "정신건강복지법 개정에 따른 지역사회 정신건강 서비스 개선 방향", 한국심리학회지:일반, 39(1), pp.1~26 (2020), 한국심리학회[DOI]
- "안전하고 편견없는 사회를 위한 중증정신질환 정책제안" (2019), 대한신경정신의학회[URL]
- 문현미, "심리적 수용 촉진 프로그램의 개발과 효과 : 수용-전념 치료 모델을 중심으로", 박사, 상담심리학, pp.2006
- 박서아, "뇌졸중 환자 대상의 가상현실 운동프로그램이 기능회복에 미치는 효과: 체계적 문헌고찰 및 메타분석", 디지털융복합연구, 17(5), pp.235~247 (2019), 한국디지털정책학회[DOI]
- 신우종, "Editorial: Why Perform Meta-Analysis?", Hanyang Medical Reviews, 35(1), pp.1~2 (2015), 한양대학교 의과대학[DOI]
- 이재운, "수용전념치료기반 스트레스 관리 프로그램이 조현병 환자의 입원 스트레스, 자기효능감 및 심리적 안녕감에 미치는 효과", Journal of Korean Academy of Nursing, 48(4), pp.443~444 (2018), 한국간호과학회
- 전진아, "정신건강증진사업의 현황과 최근의 정책적 변화", 보건복지포럼, 246, pp.51~63 (2017)
- 중앙정신건강복지사업지원단 사업보고서, "중앙정신건강복지사업지원단", ~ (2019)
- 황성동, "R을 이용한 메타분석" (2015), 학지사
- Anthony, W. A., "Recovery from mental illness : The guiding vision of the mental health service system in the 1990s", Psychosocial Rehabilitation Journal, 16, pp.11~23 (1993)
- Argentzell, E., "Exploring mediators of the recovery process over time among mental health service users, using a mixed model regression analysis based on cluster RCT data", BMC Research, 20, pp.1~20 (2020)
- Bach, P., "The Use of Acceptance and Commitment Therapy to Prevent the Rehospitalization of Psychotic Patients : A Randomized Controlled Trial", Journal of Counsulting and Clinical Psychology, 70(5), pp.1129~1139 (2002)
- Bach, P, "수용전념치료 실무지침서 중 제 8장" (2004), 학지사
- Bach, P., "Long-term effects of brief acceptance and commitment therapy for psychosis", Behavior Modification, 36, pp.165~181 (2012)
- Breier, A., "National institue of mental health longitudinal study of chronic schizophrenia : Prognosis and predictors of outcome", Archives of General Psychiatry, 48, pp.239~246 (1991)
- Corrigan, P. W., "The effects of atypical antipsychotic medications on psychosocial outcomes", Schizophrenia Research, 63, pp.97~101 (2002)
- Freeman, D., "Effects of cognitive behaviour therapy for worry on persecutory delusions in patients with psychosis(WIT) : a parallel, single-blind, randomised controlled trial with a mediation analysis", Lancet Psychiatry, 2, pp.305~313 (2015)
- Gaudiano, B. A., "Acute tretment of inpatients with psychotic symptoms using Acceptance and Commitment Therapy : Pilot results", Behaviour Research and Therapy, 44, pp.415~437 (2006)
- Gaudiano, B, "Cognitive-Behavioral Therapies : achievements and challenges", Evidence-based Mental Health, 11(1), pp.5~7 (2008)
- Gaudiano, B. A., "Is it the symptom or the relation to it? Investigating potential mediators of change in acceptance and commitment therapy for psychosis", Behavior Therapy, 41, pp.543~554 (2010)
- Gaudiano, B. A., "Feasibility and preliminary effects of implementing acceptance and commitment therapy for inpatients with psychotic-spectrum disorders in a clinical psychiatric intensive care setting", Journal of Cognitive Psychotherapy, 34(1), pp.80~96 (2020)
- Gumley, A., "A parallel group randomised open blinded evaluation of acceptance and commitment therapy for depression after psychosis : A pilot trial ouctomes(ADAPT)", Schizophrenia Research, 183, pp.143~150 (2017)
- Hayes, S. C., "Acceptance and commitment therapy: An experiential approach to behavior change" (1999), Guilford
- Hayes, S. C., "Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies", Behavior Therapy, 35, pp.639~665 (2004)
- "Revised Cochrane risk-of-bias tool for randomized trials" (2019)[URL]
- Jansen, J. E., "Acceptance-and mindfulness-based interventions for persons with psychosis : A systematic review and meta-analysis", Schizophrenia Research, 215, pp.25~37 (2020)
- Johns, L. C., "The feasibility and acceptability of a brief Acceptance and Commitment Therapy(ACT)group intervention for people with psychosis : The ‘Act for life’ study", Journal of Behavior Therapy & Experimental Psychiatry, 50, pp.257~263 (2016)
- Jolly, S., "Group acceptance and commitment therapy for patients and caregivers in psychosis services : Feasibility of training and a prelimeinary randomized controlled evaluation", The British Psychological Society, 59, pp.523~551 (2020)
- Leonhardt, N. L., "Expert Review of Neurotherapeutics", 17(11), pp.1117~1130 (2017)
- Louise, S., "Mindfulness-and acceptance-based interventions for psychosis : Our current understanding and a meta-analysis", Schizophrenia Research, 192, pp.57~63 (2018)
- Longden, E., "Voice hearing in a biographical context: A model for formulating the relationship between voices and life history", Psychosis: Psychological, Social and Integrative Approaches, 4(3), pp.224~234 (2012)
- Kohn, M. L., "The transmission of schizophrenia" (1968), Pergamon
- Macpherson, R., "The relationship between clinical and recovery dimensions of outcome in mental health", Schizophrenia Research, 175(3), pp.142~147 (2016)
- Miner, C. R., "Prediction of compliance with outpatient referral in patients with schizophrenia and psychoactive substance use disorders", Archives of General Psychiatry, 54, pp.706~712 (1997)
- Morris, S. B., "Combining effect size estimates in meta-analysis with repeated measures and independent groups designs", Psychological Methods, 7(1), pp.105~125 (2002)
- Efficacy of Acceptance and Commitment Therapy in Daily Life (ACT-DL) in Early Psychosis: Results from the Multi-Centre Interact Randomized Controlled Trial, "Myin-Germeys, I.", ~ (2021)
- O’Donogue, E., "A Practical manual for group-based interventions using Acceptance & Commitment Therapy" (2018), Contextpress
- "The matrix life manual" (2009)[URL]
- Rector, N. A., "The negative symptoms of schizophrenia : A cognitive perspective", Canadian Journal of Psychiatry, 50(5), pp.247~257 (2005)
- Reininghaus, U., "Efficacy of Acceptance and Commitment Therapy in Daily Life(ACT-DL)in early psychosis : study protocol for a multi-centre randomized controlled trial", Trials, 20(769), pp.1~12 (2019)
- Resnick, S., "An exploratory analysis of correlates of recovery", Psychiatric Service, 55(5), pp.540~547 (2004)
- Romme, M., "Accepting voices" (1993), Mind Publications
- Shawyer, F., "A randomised controlled trial of acceptance-based cognitive behavioural therapy for command hallucinations in psychotic disorders", Behaviour Research and Therapy, 50, pp.110~121 (2012)
- Shawyer, F., "Acceptance and commitment therapy for psychosis : Randomised controlled trial", British Journal of Psychiatry, 210, pp.140~148 (2017)
- Soundy, A., "Identifying the facilitators and processes which influence recovery individuals with schizophrenia : a systematic review and thematic synthesis", Journal of Mental Health, 24, pp.103~110 (2014)
- Slade, M, Leamy, M., "International differences in understanding recovery : systematic review", Epidemiology and Psychiatric Sceinces, 21(4), pp.353~364 (2012)
- Spidel, A., "Acceptance and Commitment Therapy for Psychosis and Trauma : Improvement in psychiatric symptoms, emotion regulation, and treatment compliance following a brief group intervention", Psychology and Psychotherapy: Theory, Research and Practice, 91(2), pp.248~261 (2017)
- Trauer, T., "A randomised controlled trial of acceptance-based cognitive behavioral therapy for command hallucinations in psychotic disorders", Behaviour Research and Therapy, 50, pp.110~121 (2012)
- Tyrberg, M. J., "Brief acceptance and commitment therapy for psychotic inpatients : A randomized controlled feasibility trail in Sweden", Nordic Psycholog, 69(2), pp.110~125 (2017)
- van der Graag, M., "The effects of individually tailored formulation-based cognitive behavioural therapy in auditory hallucinations and delusions : A meta-analysis", Schizophrenia Research, 156, pp.30~37 (2014)
- Waller, H., "Targeting reasoning biases in delusions : A pilot study of the Maudsley Review Training Programme for individuals with persistent, high conviction delusions", Journal of Behavior Therapy and Experimental Psychiatry, 42, pp.414~421 (2011)
- White, R., "A feasibility study of Acceptance and Commitment Therapy for emotional dysfuntion following psychosis", Behaviour Research and Therapy, 4, pp.901~907 (2011)
- Wood, L., "A systematic review and meta-analysis of cognitive behavioural informed psychological interventions for psychiatric inpatients with psychosis", Schizophrenia Research, 222, pp.133~144 (2020)
- Wykes, T, "Cognitive behavior therapy for schizophrenia : Effect sizes, clinical models, and methodological rigor", Schizophrenia Bulletin, 34(3), pp.523~537 (2008)
- Yildiz, E., "The effects of acceptance and commitment therpay in psychosis treatment : A systematic review of randomized controlled trials", Perspectives in Psychiatric Care, 56, pp.149~167 (2019)
