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인터넷 기반 사회불안장애 인지행동 자가 치료 프로그램 개발 및 효과검증

Effectiveness of the Internet-Based Self-Help Program for Social Anxiety Disorder

윤혜영|권정혜|안정광
한국임상심리학회 (Korean Clinical Psychology Association)|2014.11|Korean Journal of Clinical Psychology|제33권 제4호|pp. 695-718|DOI 10.15842/kjcp.2014.33.4.003

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인지행동치료사회불안장애인터넷 기반 자가 치료Social anxiety disorderInternet-based Self-help ProgramCognitive behavior Therapy
주제분류심리과학

초록

본 연구에서는 사회불안장애가 있는 사람들을 대상으로 인터넷 기반 자가 치료 프로그램을 개발하고 치료 효과를 살펴보고자 하였다. 인터넷 기반 자가 치료 프로그램은 총 8회기로 구성되어 있으며 면대면 집단 치료의 치료 요소인 인지 재구조화와 노출 훈련을 모두 담고 있다. 인터넷 사이트에 접속하여 자기가 원하는 시간과 장소에서 프로그램을 진행할 수 있도록 하였으며, 자신의 작업 내용은 이메일을 통해 피드백 받았다. 연구대상은 모두 26명으로 사회불안에 대한 자기보고식 설문지와 반구조화된 초기면접을 통해 사회불안장애로 진단된 사람들로 선발하였다. 이중 인터넷 기반 자가 치료에 참가한 집단이 14명(남자 6명, 여자 8명)이었다. 그리고 대기자 조건에 있었던 통제집단이 12명(남자 5명, 여자 7명)이었다. 본 연구에서는 사회불안 수준을 알아보기 위해 사회적 회피 및 불편감 척도, 부정적 평가에 대한 두려움 척도-단축형, 사회적 상호작용 불안 척도, 사회불안장애 척도, Beck 우울 척도 값을 치료 전, 4회기 후, 8회기에 걸쳐서 측정하였다. 각 척도들에 대한 반복측정 변량분석 결과 인터넷 기반 자가 치료 프로그램이 사회불안장애의 다양한 증상들을 완화시키는 것으로 나타났다. 인터넷 기반 자가 치료 프로그램은 사회적 회피와 불편감, 사회적 수행 상황에서 측정 시기와 집단 사이의 상호작용이 나타났다. 이에 더해, 인터넷 기반 자가 치료의 효과 크기는 0.70~1.21로 인터넷 기반 자가 치료가 중간 크기에서 큰 효과 크기를 갖는 것으로 나타났다. 연구 결과, 인터넷 기반 자가 치료 프로그램은 사회불안장애 증상 완화에 효과가 있는 것으로 나타났으며, 추후 최적의 치료 요소 구성과 전달 방식의 다변화를 통해 프로그램의 효과를 더욱 향상시켜야 할 것이다.

Abstract

This study examined the effectiveness of the Internet-based self-help program for social anxiety disorder. Twenty six individuals with social anxiety disorder were assigned to eight sessions of the internet-based self-help program or to a waiting list control group. Korean version of Social Avoidance and Distress Scale (SADS), Brief Fear of negative Evaluation Scale (BFNE), Social Interaction Anxiety Scale (SIAS), Social Phobia Scale (SPS), and Beck Depression Inventory (BDI) were administered before, after four sessions, and after treatment to all participants. The effectiveness of the Internet-based self-help program was analyzed using repeated-measure ANOVAs. Participants in the self-help program showed significant improvement on SADS, SPS, but changes were not significant on BFNE and SIAS. In addition, there were moderate to large effect sizes (0.70 to 1.21). These findings demonstrated that the Internet-based self-help program could provide a cost effective intervention method for individuals with social anxiety disorder.

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