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Van Huysse JL, Prohaska N, Miller C, Jary J, Sturza J, Etsell K, Bravender T. Adolescent eating disorder treatment outcomes of an in-person partial hospital program versus a virtual intensive outpatient program. Int J Eat Disord 2023; 56:192-202. [PMID: 36444727 PMCID: PMC10099740 DOI: 10.1002/eat.23866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/19/2022] [Accepted: 11/20/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Though virtual outpatient psychotherapy for eating disorders is likely effective, less is known about virtual higher levels of care. The current study examined the clinical outcomes of a family-based virtual intensive outpatient program (vIOP) for youth with eating disorders which was developed in response to the COVID-19 pandemic, compared to the same institution's in-person partial hospital program (PHP). METHODS Treatment outcomes were assessed via chart review in 102 patients between the ages of 9-23 (M = 15.2, SD = 2.5) who were predominantly cisgender female (84.3%) and primarily diagnosed with anorexia nervosa (64.7%) or atypical anorexia (23.5%). Participants were either treated in the in-person PHP before the pandemic (n = 49) or the vIOP during the pandemic (n = 53). Percent expected body weight (%EBW) was examined at baseline, end of treatment, 3-months post-treatment, and 6-months post-treatment, as well as the frequency of medical, psychiatric, and residential admissions before, during, and after vIOP or PHP participation. RESULTS Linear mixed models demonstrated no effect of treatment modality (in-person versus virtual) on %EBW over time. The duration of the vIOP was, on average, 12 calendar days longer, though the amount billed for the vIOP was lower. Survival analyses and Cox regression models did not suggest differences in the frequency of hospital and residential treatment admissions during treatment (vIOP: 9.4%, PHP: 10.0%) or post-treatment (vIOP: 15.0%, PHP: 10.2%). DISCUSSION Findings support virtual family-based programs as suitable alternatives to in-person treatment and underscore the potential cost-effectiveness of a family-based IOP versus PHP. PUBLIC SIGNIFICANCE This study demonstrates that a virtual, family-based, intensive outpatient program for youth with eating disorders had similar treatment outcomes to an in-person partial hospitalization program. Specifically, the virtual and in-person programs had similar weight restoration outcomes and rates of medical, psychiatric, or residential treatment admissions during or after treatment initiation. Findings support the use of virtual treatment, even for youth requiring a high level of intervention.
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Affiliation(s)
| | - Natalie Prohaska
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.,Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Catherine Miller
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Jessica Jary
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Julie Sturza
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Terrill Bravender
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.,Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
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Zhou X, Bambling M, Edirippulige S. A mixed-method systematic review of text-based telehealth interventions in eating disorder management. JOURNAL OF HEALTH RESEARCH 2021. [DOI: 10.1108/jhr-03-2021-0179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose
Eating disorders (EDs) is a major health condition affecting 9% of the global population and 10% of those with EDs lost their lives as a result. Text-based telehealth interventions (TTIs) seem to provide a low-cost and convenient treatment option; however, the evidence is scarce. This study aimed to synthesize evidence relating to the use of TTIs for the management of EDs.
Design/methodology/approach
Five databases were searched published between January 2020 and May 2019. The authors used keywords relating to telehealth and EDs. The authors used Joanna Briggs Institute's (JBI's) critical appraisal instrument to assess the methodology quality of included studies.
Findings
Fifteen studies were included in this mix-method systematic review and assessed for methodology quality. Email, web-based texting, text-messaging and online chat room were used as mode for deliver healthcare for patients with EDs. In the treatment phase, all studies (nine studies; n = 860 participants) showed effectiveness (for RCTs) and usefulness (for non-RCT studies). In the aftercare phase (six studies; n = 364 participants), the results regarding the effectiveness of TTIs were mixed. Two studies showed effectiveness whilst four studies did not find statistically significant change of ED outcomes.
Research limitations/implications
The qualities of these studies varied; firstly, 66% (n = 10) of the studies were non-randomized studies (e.g. single-arm trial, case report) with small samples. Moreover, one-fourth (n = 4) of the studies did not use validated instruments or indicate the instrument. Also, half (n = 7) of the studies used TTIs as adjunct to face-to-face treatment or bigger online treatment, it is hard to make conclusion that the changes were due to TTIs' effect. In addition, follow-up rate is not satisfactory, thus results should be interpreted cautiously.
Practical implications
TTIs seem to be promising for management of EDs, particularly in the treatment phase. This provides an important treatment option for health practitioners and people with EDs as an alternative or in adjunct with face-to-face services.
Originality/value
This is the first review to synthesis the use of TTIs for ED management.
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3
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Simpson S, Richardson LK, Pelling N. Introduction to the Special Issue “Telepsychology: Research and Practice”. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Susan Simpson
- School of Psychology, Social Work and Social Policy, University of South Australia,
| | | | - Nadine Pelling
- School of Psychology, Social Work and Social Policy, University of South Australia,
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Hamatani S, Numata N, Matsumoto K, Sutoh C, Ibuki H, Oshiro K, Tanaka M, Setsu R, Kawasaki Y, Hirano Y, Shimizu E. Internet-Based Cognitive Behavioral Therapy via Videoconference for Patients With Bulimia Nervosa and Binge-Eating Disorder: Pilot Prospective Single-Arm Feasibility Trial. JMIR Form Res 2019; 3:e15738. [PMID: 31647472 PMCID: PMC6914274 DOI: 10.2196/15738] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/18/2019] [Accepted: 10/01/2019] [Indexed: 01/18/2023] Open
Abstract
Background A major problem in providing mental health services is the lack of access to treatment, especially in remote areas. Thus far, no clinical studies have demonstrated the feasibility of internet-based cognitive behavioral therapy (ICBT) with real-time therapist support via videoconference for bulimia nervosa and binge-eating disorder in Japan. Objective The goal of the research was to evaluate the feasibility of ICBT via videoconference for patients with bulimia nervosa or binge-eating disorder. Methods Seven Japanese subjects (mean age 31.9 [SD 7.9] years) with bulimia nervosa and binge-eating disorder received 16 weekly sessions of individualized ICBT via videoconference with real-time therapist support. Treatment included CBT tailored specifically to the presenting diagnosis. The primary outcome was a reduction in the Eating Disorder Examination Edition 16.0D (EDE 16D) for bulimia nervosa and binge-eating disorder: the combined objective binge and purging episodes, objective binge episodes, and purging episodes. The secondary outcomes were the Eating Disorders Examination Questionnaire, Bulimic Investigatory Test, Edinburgh, body mass index for eating symptoms, Motivational Ruler for motivation to change, EuroQol-5 Dimension for quality of life, 9-item Patient Health Questionnaire for depression, 7-item Generalized Anxiety Disorder scale for anxiety, and Working Alliance Inventory–Short Form (WAI-SF). All outcomes were assessed at week 1 (baseline) and weeks 8 (midintervention) and 16 (postintervention) during therapy. Patients were asked about adverse events at each session. For the primary analysis, treatment-related changes were assessed by comparing participant scores and 95% confidence intervals using the paired t test. Results Although the mean combined objective binge and purging episodes improved from 47.60 to 13.60 (71% reduction) and showed a medium effect size (Cohen d=–0.76), there was no significant reduction in the combined episodes (EDE 16D –41; 95% CI –2.089 to 0.576; P=.17). There were no significant treatment-related changes in secondary outcomes. The WAI-SF scores remained consistently high (64.8 to 66.0) during treatment. Conclusions ICBT via videoconference is feasible in Japanese patients with bulimia nervosa and binge-eating disorder. Trial Registration UMIN Clinical Trials Registry UMIN000029426; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000033419
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Affiliation(s)
- Sayo Hamatani
- Research Center for Child Mental Development, Chiba University, Chiba, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Noriko Numata
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Kazuki Matsumoto
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Chihiro Sutoh
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hanae Ibuki
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Keiko Oshiro
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Mari Tanaka
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Rikukage Setsu
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan.,Koutokukai Sato Hospital, Yamagata, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan.,Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan.,Cognitive Behavioral Therapy Center, Chiba University Hospital, Chiba, Japan
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5
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Abstract
The delivery of teletherapy is an important advancement in clinical care for the treatment of eating disorders (EDs). Specifically, it seems to improve access to highly specialized ED treatment. Research on the application of videoconferencing-based psychotherapy services for EDs is minimal; however, results suggest that this treatment format leads to significant improvements in clinical symptoms and is well accepted by patients. General telemedicine guidelines and administrative and clinical recommendations specific to the treatment of ED patients have been identified. With careful planning and thoughtful application, Internet-based therapy seems to be a valuable resource for practitioners seeking to disseminate specialized ED treatments.
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Wrape ER, McGinn MM. Clinical and Ethical Considerations for Delivering Couple and Family Therapy via Telehealth. JOURNAL OF MARITAL AND FAMILY THERAPY 2019; 45:296-308. [PMID: 29361194 DOI: 10.1111/jmft.12319] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Studies have generally supported telehealth as a feasible, effective, and safe alternative to in-office visits. Telehealth may also be of particular benefit to couples/families interested in relational treatments, as it addresses some of the barriers that may be more prominent for families, such as childcare and scheduling difficulties. Therapists interested in expanding their practice to include telehealth should understand ethical and practical considerations of this modality. This article discusses areas unique to the delivery of telehealth to couples and families. Each broad domain is then elaborated upon with case examples from actual clinical practice and specific recommendations for addressing potential difficulties. Authors recommend further empirical research examining differences in modality outcome, as well as feasibility of the suggestions proposed here.
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8
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Anderson KE, Byrne C, Goodyear A, Reichel R, Le Grange D. Telemedicine of family-based treatment for adolescent anorexia nervosa: A protocol of a treatment development study. J Eat Disord 2015; 3:25. [PMID: 26167281 PMCID: PMC4499182 DOI: 10.1186/s40337-015-0063-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 07/03/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Family-based treatment is an efficacious treatment available for adolescents with anorexia nervosa. Yet the implementation of this treatment, at least in the United States, is challenging due to a limited number of trained family-based treatment therapists and the concentration of these therapists in a limited number of urban centers. The use of telemedicine in the delivery of family-based treatment can increase access to this therapy for this patient population. METHODS/DESIGN This two-year treatment development study (December 2013-November 2015) follows a two-wave iterative case series design. The study is ongoing and addresses the treatment needs of families in remote, rural, or underrepresented parts of the United States by delivering family-based treatment via telemedicine (video chat). The first six months of the study was dedicated to selecting a cloud-based secure telemedicine portal for use with participants. Recruitment for the first of two consecutive case series (N = 5) began during month seven. After these five patients completed treatment, a systematic review of treatment via feedback from participants and therapists related to the delivery of this model and use of technology was completed. A second wave of recruitment is underway (N = 5). At the end of both waves (N = 10), and after a second review of treatment, we should be able to establish the feasibility and acceptability of family-based treatment delivered via telemedicine for this patient population. DISCUSSION This study is the first attempt to deliver family-based treatment for adolescents with anorexia nervosa via telemedicine. If delivering family-based treatment in this format is feasible, it will provide access to an evidence-based treatment for families heretofore unable to participate in specialist treatment for their child's eating disorder.
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Affiliation(s)
- Kristen E Anderson
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medicine, 5841 S. Maryland Avenue, MC 3077, Room B424, Chicago, IL 60637 USA
| | - Catherine Byrne
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medicine, 5841 S. Maryland Avenue, MC 3077, Room B424, Chicago, IL 60637 USA
| | - Alexandria Goodyear
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medicine, 5841 S. Maryland Avenue, MC 3077, Room B424, Chicago, IL 60637 USA
| | - Ryan Reichel
- Department of Psychiatry, University of California, San Francisco, 3333 California Street, Laurel Heights Suite 245, Box 0503, San Francisco, CA 94143 USA
| | - Daniel Le Grange
- Department of Psychiatry, University of California, San Francisco, 3333 California Street, Laurel Heights Suite 245, Box 0503, San Francisco, CA 94143 USA ; Department of Pediatrics, University of California, San Francisco, 3333 California Street, Laurel Heights Suite 245, Box 0503, San Francisco, CA 94143 USA
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9
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Staton-Tindall M, Havens JR, Webster JM, Leukefeld C. METelemedicine: a pilot study with rural alcohol users on community supervision. J Rural Health 2014; 30:422-32. [PMID: 24800699 DOI: 10.1111/jrh.12076] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE This pilot study examined a telemedicine-based intervention using motivational enhancement therapy (METelemedicine) to reduce alcohol use among a sample of at-risk, rural alcohol users. METHODS A total of 127 rural alcohol users were recruited from community supervision offices and engaged in brief intervention sessions using telemedicine. Analysis examined alcohol outcomes at 3 months postbaseline. FINDINGS Findings indicated that although there were no overall differences between comparison groups on alcohol outcomes, 3+ sessions of METelemedicine significantly reduced the likelihood of any alcohol use by 72% (P < .05). In addition, 3+ sessions of the intervention predicted fewer days of drinking in the follow-up period, fewer drinks per week, and fewer days experiencing alcohol problems. CONCLUSIONS Findings demonstrate that telemedicine may be a promising approach to deliver interventions with alcohol users who may not utilize formal treatment services. This method has potential to decrease some of the barriers to access and use of evidence-based treatment for populations in need of services.
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Affiliation(s)
- Michele Staton-Tindall
- College of Social Work, University of Kentucky, Lexington, Kentucky; Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky
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Gros DF, Morland LA, Greene CJ, Acierno R, Strachan M, Egede LE, Tuerk PW, Myrick H, Frueh BC. Delivery of Evidence-Based Psychotherapy via Video Telehealth. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2013. [DOI: 10.1007/s10862-013-9363-4] [Citation(s) in RCA: 141] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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11
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Staton-Tindall M, Wahler E, Webster JM, Godlaski T, Freeman R, Leukefeld C. Telemedicine-based alcohol services for rural offenders. Psychol Serv 2013; 9:298-309. [PMID: 22867122 DOI: 10.1037/a0026772] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Research has consistently shown that alcohol use is a problem in rural communities and access to substance abuse treatment, particularly evidence-based treatment is limited. Because telemedicine has been shown to be effective in delivering services, this article presents a novel and innovative way of using telemedicine technology in the form of videoconferencing to deliver an evidence-based alcohol intervention (motivational enhancement therapy) with at-risk alcohol users in real-world settings (rural probation and parole offices). This article focuses on: (a) creating a profile of an at-risk group of rural alcohol users; (b) describing the evidence-based intervention; and (c) describing the innovative telemedicine-based service delivery approach.
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Affiliation(s)
| | | | | | | | | | - Carl Leukefeld
- University of Kentucky, Center on Drug and Alcohol Research
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12
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Bulik CM, Marcus MD, Zerwas S, Levine MD, Hofmeier S, Trace SE, Hamer RM, Zimmer B, Moessner M, Kordy H. CBT4BN versus CBTF2F: comparison of online versus face-to-face treatment for bulimia nervosa. Contemp Clin Trials 2012; 33:1056-64. [PMID: 22659072 DOI: 10.1016/j.cct.2012.05.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 05/22/2012] [Accepted: 05/24/2012] [Indexed: 01/28/2023]
Abstract
Cognitive-behavioral therapy (CBT) is currently the "gold standard" for treatment of bulimia nervosa (BN), and is effective for approximately 40-60% of individuals receiving treatment; however, the majority of individuals in need of care do not have access to CBT. New strategies for service delivery of CBT and for maximizing maintenance of treatment benefits are critical for improving our ability to treat BN. This clinical trial is comparing an Internet-based version of CBT (CBT4BN) in which group intervention is conducted via therapeutic chat group with traditional group CBT (CBTF2F) for BN conducted via face-to-face therapy group. The purpose of the trial is to determine whether manualized CBT delivered via the Internet is not inferior to the gold standard of manualized group CBT. In this two-site randomized controlled trial, powered for non-inferiority analyses, 180 individuals with BN are being randomized to either CBT4BN or CBTF2F. We hypothesize that CBT4BN will not be inferior to CBTF2F and that participants will value the convenience of an online intervention. If not inferior, CBT4BN may be a cost-effective approach to service delivery for individuals requiring treatment for BN.
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Affiliation(s)
- Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB 7160, Chapel Hill, NC 27599, USA.
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13
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Ertelt TW, Crosby RD, Marino JM, Mitchell JE, Lancaster K, Crow SJ. Therapeutic factors affecting the cognitive behavioral treatment of bulimia nervosa via telemedicine versus face-to-face delivery. Int J Eat Disord 2011; 44:687-91. [PMID: 22072405 PMCID: PMC4496947 DOI: 10.1002/eat.20874] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2010] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Recently, Mitchell et al. (Behav Res Ther, 46, 581-592, 2008) conducted a randomized controlled trial of an empirically supported treatment for bulimia nervosa (BN) delivered face-to-face (FTF-CBT) or via telemedicine (TV-CBT). Results suggested that the TV-CBT and FTF-CBT were generally equivalent in effectiveness. The objective of the current study was to examine ratings of therapeutic alliance factors in TV-CBT and FTF-CBT. METHOD Data obtained from 116 adults who met criteria for BN or eating disorder-not otherwise specified with binge eating or purging weekly and six doctoral-level psychologists who delivered the therapy were used in the analyses. RESULTS Therapists generally endorsed greater differences between the treatment delivery methods than patients. Patients tended to make significantly higher ratings of therapeutic factors than therapists. DISCUSSION TV-CBT is an acceptable method for the delivery of BN treatment compared to FTF-CBT, and TV-CBT is more easily accepted as a treatment delivery method by patients than therapists.
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Affiliation(s)
- Troy W. Ertelt
- Department of Psychology, University of North Dakota, Grand Forks, ND
| | - Ross D. Crosby
- Neuropsychiatric Research Institute, Fargo, ND,Department of Clinical Neuroscience, University of North Dakota, Grand Forks, ND
| | - Joanna M. Marino
- Department of Psychology, University of North Dakota, Grand Forks, ND,College of Public Health & Health Professions, University of Florida, Gainesville, FL
| | - James E. Mitchell
- Neuropsychiatric Research Institute, Fargo, ND,Department of Clinical Neuroscience, University of North Dakota, Grand Forks, ND
| | | | - Scott J. Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
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Germain V, Marchand A, Bouchard S, Drouin MS, Guay S. Effectiveness of cognitive behavioural therapy administered by videoconference for posttraumatic stress disorder. Cogn Behav Ther 2009; 38:42-53. [PMID: 19235601 DOI: 10.1080/16506070802473494] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Telehealth, or health care via videoconferencing, constitutes a clinical option that makes it possible to treat patients remotely. A growing number of studies have demonstrated that telehealth is a feasible and effective method for diagnostic interviews and psychiatric consultations. However, few studies have assessed the effectiveness of psychotherapy given by videoconference. This study examines the effectiveness of cognitive behavioural therapy (CBT) administered by videoconference for posttraumatic stress disorder (PTSD). Forty-eight participants with PTSD were recruited for the study: 16 in the videoconferencing condition and 32 in a control face-to-face condition. Each participant received CBT for 16 to 25 weeks and completed various questionnaires before and after treatment. The results show a significant decline in the frequency and severity of posttraumatic symptoms after treatment in both conditions. A clinical improvement in overall functioning was also observed. No significant difference was observed in the effectiveness of the two therapeutic conditions. The examination of effect sizes supports these results. A number of clinical implications and certain avenues for future research are discussed.
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Fernández-Aranda F, Núñez A, Martínez C, Krug I, Cappozzo M, Carrard I, Rouget P, Jiménez-Murcia S, Granero R, Penelo E, Santamaría J, Lam T. Internet-Based Cognitive-Behavioral Therapy for Bulimia Nervosa: A Controlled Study. ACTA ACUST UNITED AC 2009; 12:37-41. [DOI: 10.1089/cpb.2008.0123] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Spain
| | - Araceli Núñez
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain
| | - Cristina Martínez
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain
| | - Isabel Krug
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Spain
| | - Mikael Cappozzo
- Psychiatric Liaison Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - Isabelle Carrard
- Psychiatric Liaison Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - Patrick Rouget
- Psychiatric Liaison Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Spain
| | - Roser Granero
- Laboratori d'Estadistica Aplicada, Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Spain
| | - Eva Penelo
- Laboratori d'Estadistica Aplicada, Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Spain
| | - Juanjo Santamaría
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain
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Mitchell JE, Crosby RD, Wonderlich SA, Crow S, Lancaster K, Simonich H, Swan-Kremeier L, Lysne C, Myers TC. A randomized trial comparing the efficacy of cognitive-behavioral therapy for bulimia nervosa delivered via telemedicine versus face-to-face. Behav Res Ther 2008; 46:581-92. [PMID: 18374304 PMCID: PMC2633728 DOI: 10.1016/j.brat.2008.02.004] [Citation(s) in RCA: 159] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Revised: 12/26/2007] [Accepted: 02/04/2008] [Indexed: 12/11/2022]
Abstract
OBJECTIVE A major problem in the delivery of mental health services is the lack of availability of empirically supported treatment, particularly in rural areas. To date no studies have evaluated the administration of an empirically supported manual-based psychotherapy for a psychiatric condition via telemedicine. The aim of this study was to compare the relative efficacy and acceptability of a manual-based cognitive-behavioral therapy (CBT) for bulimia nervosa (BN) delivered in person to a comparable therapy delivered via telemedicine. METHOD One hundred twenty-eight adults meeting DSM-IV criteria for BN or eating disorder-not otherwise specified with binge eating or purging at least once per week were recruited through referrals from clinicians and media advertisements in the targeted geographical areas. Participants were randomly assigned to receive 20 sessions of manual-based, CBT for BN over 16 weeks delivered either face-to-face (FTF-CBT) or via telemedicine (TV-CBT) by trained therapists. The primary outcome measures were binge eating and purging frequency as assessed by interview at the end of treatment, and again at 3- and 12-month follow-ups. Secondary outcome measures included other bulimic symptoms and changes in mood. RESULTS Retention in treatment was comparable for TV-CBT and FTF-CBT. Abstinence rates at end-of-treatment were generally slightly higher for FTF-CBT compared with TV-CBT, but differences were not statistically significant. FTF-CBT patients also experienced significantly greater reductions in eating disordered cognitions and interview-assessed depression. However, the differences overall were few in number and of marginal clinical significance. CONCLUSIONS CBT for BN delivered via telemedicine was both acceptable to participants and roughly equivalent in outcome to therapy delivered in person.
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Affiliation(s)
- James E Mitchell
- Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, ND, USA.
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17
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Mitchell JE, Crosby RD, Wonderlich SA, Crow S, Lancaster K, Simonich H, Swan-Kremeier L, Lysne C, Myers TC. A randomized trial comparing the efficacy of cognitive-behavioral therapy for bulimia nervosa delivered via telemedicine versus face-to-face. Behav Res Ther 2008. [PMID: 18374304 DOI: 10.3410/f.1104678.560745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE A major problem in the delivery of mental health services is the lack of availability of empirically supported treatment, particularly in rural areas. To date no studies have evaluated the administration of an empirically supported manual-based psychotherapy for a psychiatric condition via telemedicine. The aim of this study was to compare the relative efficacy and acceptability of a manual-based cognitive-behavioral therapy (CBT) for bulimia nervosa (BN) delivered in person to a comparable therapy delivered via telemedicine. METHOD One hundred twenty-eight adults meeting DSM-IV criteria for BN or eating disorder-not otherwise specified with binge eating or purging at least once per week were recruited through referrals from clinicians and media advertisements in the targeted geographical areas. Participants were randomly assigned to receive 20 sessions of manual-based, CBT for BN over 16 weeks delivered either face-to-face (FTF-CBT) or via telemedicine (TV-CBT) by trained therapists. The primary outcome measures were binge eating and purging frequency as assessed by interview at the end of treatment, and again at 3- and 12-month follow-ups. Secondary outcome measures included other bulimic symptoms and changes in mood. RESULTS Retention in treatment was comparable for TV-CBT and FTF-CBT. Abstinence rates at end-of-treatment were generally slightly higher for FTF-CBT compared with TV-CBT, but differences were not statistically significant. FTF-CBT patients also experienced significantly greater reductions in eating disordered cognitions and interview-assessed depression. However, the differences overall were few in number and of marginal clinical significance. CONCLUSIONS CBT for BN delivered via telemedicine was both acceptable to participants and roughly equivalent in outcome to therapy delivered in person.
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Affiliation(s)
- James E Mitchell
- Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, ND, USA.
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Simpson S, Bell L, Britton P, Mitchell D, Morrow E, Johnston AL, Brebner J. Does video therapy work? A single case series of bulimic disorders. EUROPEAN EATING DISORDERS REVIEW 2006. [DOI: 10.1002/erv.686] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Abstract
Effective cognitive-behavioral treatments for childhood depression have developed over the last decade, but many families face barriers to such care. Telemedicine increases access to psychological interventions by linking the child and the clinician using videoconferencing (VC). The current study evaluated an 8-week, cognitive-behavioral therapy (CBT) intervention for childhood depression either face-to-face (F2F) or over VC. The telemedicine setup included two PC-based PictureTel systems at 128 kilibits per second (kbps). Success was defined by (1) decreasing depressive symptoms at similar rates in both the VC group and the F2F group and (2) demonstrating the feasibility of a randomized controlled trial in telemental health. Children were assessed for childhood depression using the mood section of the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present Episode (K-SADS-P). Twenty-eight children were randomized to either F2F or VC treatment. The participants completed the K-SADS-P and the Children's Depression Inventory (CDI) at pre- and post-treatment. The CBT treatment across the two conditions was effective. The overall response rate based on post-evaluation with the K-SADS-P was 82%. For the CDI total score, both the Time and the Group by Time effects were significant (p < 0.05). The interaction effect reflected a faster rate of decline in the CDI total score for the VC group. The study serves as a model for building on past research to implement a randomized controlled trial. This information provides persuasive research data concerning treatment effectiveness for clinicians, families, and funders.
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Affiliation(s)
- Eve-Lynn Nelson
- Center for Telemedicine and Telehealth, Kansas University Medical Center, Kansas City, Kansas 66160-7171, USA.
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