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우울증상을 위한 수용전념치료 및 마음챙김기반 모바일 앱 심리치료 관련 체계적 문헌고찰 및 메타분석

Systematic Literature Review and Meta-analysis for Acceptance and Commitment Therapy and Mindfulness-based Mobile Application Psychotherapy for Depression

김은정|정나래
한국임상심리학회 (Korean Clinical Psychology Association)|2023.03|한국심리학회지: 임상심리 연구와 실제 (Clinical Psychology in Korea: Research and Practice)|제9권 제1호|pp. 1-29|DOI http://doi.org/10.15842/CPKJOURNAL.PUB.9.1.1

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키워드

메타분석meta-analysis수용전념치료우울 증상Acceptance and Commitment Therapydepressive symptoms모바일 앱 심리치료마음챙김 기반 심리치료mobile app based psychotherapymindfulness- based therapy

초록

우울 증상을 경험하는 사람들이 점점 증가되고 있지만 비용 및 접근성의 문제가 있기에 저비용의 개입으로 많은 사람들이 혜택을 받을 수 있는 효율적인 방법의 치료가 필요하다. 우울 증상의 감소에 기여한 개입 중에서도 제 3동향의 방법 중의 하나인 수용전념치료 및 마음챙김적 접근법은 모바일 앱으로 구현하여 활용하기에 유용한 근거기반의 방법이다. 이에 본 연구는 우울 증상을 위한 모바일 앱 기반의 치료 중에서도 특히 수용 및 마음챙김 기반의 심리치료가 적용된 논문 중 본 연구의 기준에 맞는 문헌을 선택하였다. 2011년부터 2021년까지의 기간 내에 출간된 14편의 문헌에 대해 체계적 문헌 고찰을 시도하였으며, 우선 문헌들의 주요 특성(대상자, 프로그램 내용, 형태, 대조군 및 기간)에 대해 질적으로 분석하였다. 또한 그 중 10편의 문헌에 대해서는 양적인 분석에 해당하는 메타 분석을 시행하였다. 문헌의 질 평가 결과, 편향의 정도는 낮은 것으로 나타났다. 메타 분석 결과, 수용 및 마음챙김 기반의 모바일 앱은 우울에 대해서 작은 정도의 효과크기를 나타내었으며, 통계적으로 유의하였다. 또한 마음챙김에 대해서는 유의한 수준에서의 효과는 나타나지 않았다. 문헌에서 사용한 도구가 이질적이었던 바, 수용에 대해서는 양적인 분석이 이루어지지 못하였다. 또한 조절효과 분석 결과, 마음챙김 기반의 개입에 비해 수용전념치료 개입을 적용한 모바일 앱이 우울 증상의 감소에 더 효과적일 수 있다는 점이 시사되었다. 마지막으로 연구의 의의와 제한점에 대해 논의하였다.

Abstract

The number of people experiencing depressive symptoms is increasing, and the cost-and access-related problems that arise require effective treatment methods that benefit many people through low-cost interventions. Among the interventions that contributed to a reduction of depressive symptoms, Acceptance and Commitment Therapy and mindfulness-based psychotherapy, two of the methods of the third wave behavioral therapy methods, are useful evidence-based methods that can be implemented and utilized as mobile applications. Therefore, in this study, among the mobile app-based treatments for depressive symptoms, and the data to which ACT and mindfulness-based psychotherapy were applied, the literature that met our criteria was selected. The degree of bias was found to be low after evaluating the quality of the literature. Our meta-analysis showed that mobile apps based on ACT and mindfulness-based psychotherapy showed a small effect size for depression and was statistically significant. However, there was no significant effect on mindfulness. Because the tools used in the literature were heterogeneous, a quantitative analysis of acceptance was not conducted. In addition, the moderating effect analysis, suggested that the mobile apps to which the ACT intervention was applied were more effective in reducing depressive symptoms than mindfulness-based interventions. Finally, the implications and limitations of the study are discussed.

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