Abstract
Study of change mechanisms is important to advance theory development and to reveal the active components that make a critical difference in treatment. Improved outcomes in a randomized controlled trial that favored Congruence Couple Therapy (CCT) vs individual-based Treatment-as-Usual (TAU) were correlated within each group. Partial correlations were used to test for mediation effects. The aggregate correlation coefficient of improved variables in addiction and mental health, couple adjustment, emotion regulation (ER) and life stress was moderate for CCT and weak for TAU. CCT showed greater number of mediating effects among improved variables than TAU. The prominence of the process mechanism of improved ER with its mediating effects for addiction and psychiatric symptoms evidenced in both groups is noteworthy, but ER improvement was significantly associated with improved couple adjustment only in CCT. Reduction in life stress in CCT was associated with a broader range of improvements in CCT compared to TAU. Correlation patterns were substantiated by CCT participants’ endorsement of treatment targets emphasizing relationship, communication, emotion, problem solving, addiction and intergenerational issues of trauma. TAU participants reported significantly lower endorsements for these treatment targets. The correlation of ER and couple adjustment suggested as a key process mechanism should be further elucidated in future studies to differentiate relationship-based vs individual-based models and their respective outcomes for primary clients and partners. These findings are considered preliminary, requiring larger samples and advanced modelling among variables to provide a more profound mechanism analysis.
摘要
对改变机制的研究对于推进理论和揭示治疗中起关键作用的活性成分具有重要意义。在一项随机对照试验中，一致性伴侣治疗(CCT)与以个体为基础的、有利于CCT的治疗(TAU)的9项改善结果在每组中都是相关的。情绪调节和伴侣关系调整被认为是过程结果，酗酒、赌博和药物使用和精神症状被认为是临床结果，生活压力被认为是社会情境造成的结果。部分相关性用于测试中介效应。CCT改善后的结果的综合相关系数为中等，而TAU改善预后的综合相关系数为微弱。与TAU相比，CCT在改善变量间表现出更多的中介效应。在CCT中，ER改善的过程变量及其对成瘾和精神症状的中介作用的显著性值得注意，ER改善与伴侣适应改善显著相关。ER和伴侣调整改善在TAU中不相关。在以伴侣为基础的CCT干预中，高参与者对强调与成瘾相关的关系和沟通、情感、代际创伤的治疗目标的高度认可证实了相关性模式。TAU参与者报告说，他们对这些治疗目标的认可明显降低。作为上下文变量，压力减少与CCT的其他改善的相关性高于TAU。相关的ER和偶对调整改进表明，它们可能是CCT区别于TAU的关键过程机制。这些发现被认为是初步的，需要更大的样本和先进的模型之间的变量，以提供更深刻的机制分析。