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Portingale J, Butler D, Krug I. Novel online enfacement illusion for investigating self-perception in mental disorders: an experimental study protocol. J Eat Disord 2024; 12:94. [PMID: 38970110 PMCID: PMC11229022 DOI: 10.1186/s40337-024-01026-8] [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: 03/18/2024] [Accepted: 05/17/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Remote research methods and interventions for mental health disorders have become increasingly important, particularly for conditions like eating disorders (EDs). Embodiment illusions, which induce feelings of ownership over another person?s body or body parts, offer valuable insights into the mechanisms underlying self-perception issues in EDs and potential interventions. However, existing research using these illusions has been limited to face-to-face settings. We illustrate a novel online protocol to induce the enfacement illusion (embodiment illusion principles applied to one's face) in an ED-based sample. METHODS Participants complete a 2-hr virtual session with a researcher. First, baseline trait/state ED psychopathology measures and a self-face recognition task occur. Second, participants experience two testing blocks of the enfacement illusion involving synchronously and asynchronously mimicking a pre-recorded actor's facial expressions. After each block, subjective and objective enfacement illusion measures occur alongside state ED psychopathology reassessment. DISCUSSION Successfully inducing enfacement illusions online could provide an affordable, accessible virtual approach to further elucidate the mechanistic role of self-perception disturbances across psychopathologies such as EDs. Moreover, this protocol may represent an innovative, remotely-delivered intervention strategy, as 'enfacement' over another face could update negative self-representations in a cost-effective, scalable manner.
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Affiliation(s)
- Jade Portingale
- School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, 3051, Australia.
| | - David Butler
- Faculty of Psychology and Counselling, The Cairnmillar Institute, Melbourne, VIC, Australia
- Department of Psychology, Counselling and Therapy, LaTrobe University, Melbourne, VIC, Australia
| | - Isabel Krug
- School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, 3051, Australia
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2
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Waller G, Beard J. Recent Advances in Cognitive-Behavioural Therapy for Eating Disorders (CBT-ED). Curr Psychiatry Rep 2024; 26:351-358. [PMID: 38717658 PMCID: PMC11211111 DOI: 10.1007/s11920-024-01509-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE OF REVIEW Eating disorders require more effective therapies than are currently available. While cognitive behavioural therapy for eating disorders (CBT-ED) has the most evidence to support its effectiveness, it requires substantial improvement in order to enhance its reach and outcomes, and to reduce relapse rates. Recent years have seen a number of noteworthy developments in CBT-ED, which are summarised in this paper. RECENT FINDINGS The key advances identified here include: improvements in the efficiency and availability of CBT-ED; expansion of applicability to younger cases across durations of eating disorder; and new methodologies. There have been important recent advances in the field of CBT-ED. However, it is important to stress that there remain gaps in our evidence base and clinical skills, and suggestions are made for future research and clinical directions.
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Affiliation(s)
- Glenn Waller
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield, S1 2LT, UK.
| | - Jessica Beard
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield, S1 2LT, UK
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3
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Parsaei Z, Jangi M, Tahmasebian S, Ehteshami A. Functional and Nonfunctional Requirements of Virtual Clinic Mobile Applications: A Systematic Review. Int J Telemed Appl 2024; 2024:7800321. [PMID: 38899062 PMCID: PMC11186682 DOI: 10.1155/2024/7800321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/24/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
Introduction: The Virtual Clinic Mobile Application (VCMA) is a valuable tool for managing and remotely monitoring patients with various medical conditions. It can alleviate the strain on outpatient services and offer follow-up options for patients who do not require a physical examination. A thorough understanding of recent literature can assist in identifying suitable functionalities for new development and future improvement of current applications (apps). This review study is aimed at identifying functional and nonfunctional requirements for VCMA. Methods: This study conducted a systematic search using databases such as PubMed, Scopus, ISI Web of Science, Science Direct, ProQuest, and IEEE to gather requirements of VCMA articles published in English from the inception of the databases up to April 2022. Out of a total of 1223 articles, 76 met the inclusion criteria. These articles were then analyzed using conventional content analysis to extract and categorize their requirements. Results: Two main themes and 8 subthemes in terms of VCMA requirements were extracted as follows: (1) functional requirements with 3 subthemes (demographic data documentation, health record, general features of the user interface (UI)); (2) nonfunctional requirements with 5 subthemes (usability, accessibility, compatibility, efficiency, and security). Conclusion: The findings highlight the importance of mHealth solutions for virtual care and the need for the development of apps based on the extracted functional and nonfunctional requirements for VCMA; however, controlled trials are necessary. It is recommended that transparent reporting of mHealth interventions be prioritized to enable effective interpretation of the extracted data.
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Affiliation(s)
- Zahra Parsaei
- Health Information Technology Research CenterIsfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Jangi
- Health Information Technology Research CenterIsfahan University of Medical Sciences, Isfahan, Iran
| | - Shahram Tahmasebian
- Department of Medical BiotechnologySchool of Advanced TechnologiesShahrekord University of Medical Science, Shahrekord, Iran
| | - Asghar Ehteshami
- Health Information Technology Research CenterIsfahan University of Medical Sciences, Isfahan, Iran
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4
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Murphy-Morgan C, Brown R, Love C, Branley-Bell D. "Some distance between us": a UK mixed methods study exploring experiences of remote care for eating disorders during COVID-19. Front Psychiatry 2024; 15:1383080. [PMID: 38903648 PMCID: PMC11187335 DOI: 10.3389/fpsyt.2024.1383080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/20/2024] [Indexed: 06/22/2024] Open
Abstract
Introduction COVID-19 necessitated a rapid move from face-to-face services to remote care for eating disorders/eating distress (EDs). This study explores the advantages and challenges of remote care, identifying future implications for service provision. Remote care has been considered in the broadest of terms, including therapeutic care (e.g., Cognitive Behavioural Therapy, peer support, forums, one-to-one and group care options). Methods Using a mixed methods approach, data were collected from 211 people with lived experience of EDs (PWLE), with and without formal diagnosis. 27 participants took part in semi-structured interviews/workshops and a further 184 participants took part via an online survey. Participants reported on their ED status, the impact of the pandemic on symptoms, the benefits, and challenges of remote care (and type of support accessed), and any reasons for not accessing support. Participants were invited to make future care recommendations. Results ED symptoms were reported as worsening during the pandemic with contributing factors including isolation, lack of routine, negative emotions, and feeling like the external situation was outside of one's control. Remote care was positively attributed to increased flexibility and facilitation of social connection. Identified barriers to access included lack of awareness about support availability, digital access/literacy, and competing commitments. Further challenges included approaches being perceived as too clinical (e.g., ED information and support presented using clinical language and/or limited to support within medical care settings, without acknowledging the broader context of disordered eating), uncertainty around remote care quality, and concerns that remote platforms may facilitate masking of symptoms. Participants reported distress caused by online platforms where self-view is the default during video calls. They expressed a need for more holistic approaches to remote care, including: "real stories" of recovery, and hybrid (online and offline) options for greater flexibility and widening of access and choice. Participants also expressed a need for appropriate digital literacy training. Discussion Future recommendations emphasise user-centred holistic and hybrid approaches to ED remote support, with training to address digital literacy barriers and facilitate user control of platform functionalities (e.g., self-view). This study underscores the need for continued remote care with a focus on inclusivity and user empowerment.
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Affiliation(s)
- Claire Murphy-Morgan
- Department of Psychology, Northumbria University, Newcastle uponTyne, United Kingdom
| | - Richard Brown
- Department of Psychology, Northumbria University, Newcastle uponTyne, United Kingdom
| | - Charlotte Love
- School of Psychology, Newcastle University, Newcastle uponTyne, United Kingdom
| | - Dawn Branley-Bell
- Department of Psychology, Northumbria University, Newcastle uponTyne, United Kingdom
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5
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Cook-Cottone C, Harriger JA, Tylka TL, Wood-Barcalow NL. Virtually possible: strategies for using telehealth in eating disorder treatment learned from the COVID-19 pandemic. Eat Disord 2024; 32:99-119. [PMID: 37772856 DOI: 10.1080/10640266.2023.2261762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
The COVID-19 pandemic resulted in an abrupt shift from in-person to virtual treatment, and clinicians continue to offer telehealth due to its advantages. Telehealth may be a viable, effective, and safe treatment modality for many clients with eating disorders. We consider contemporary issues regarding the use of telehealth in eating disorder treatment and identify strategies to enhance its delivery. First, we emphasize key factors when choosing therapy delivery (telehealth, in-person, or hybrid). Second, we address telehealth-specific planning, preparation, safety, and privacy considerations. Third, we discuss how eating disorder assessment and evidence-based interventions can be adapted for telehealth delivery. Fourth, we raise telehealth-specific challenges related to group-based delivery and the therapeutic alliance offering alternative avenues for connection and engagement. We conclude with a discussion of how additional research is needed to refine the presented strategies, develop new strategies, and assess their efficacy and effectiveness.
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Affiliation(s)
- Catherine Cook-Cottone
- Department of Counseling, School, and Educational Psychology, University at Buffalo, State University of New York
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6
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Penwell TE, Smith M, Ortiz SN, Brooks G, Thompson-Brenner H. Traditional versus virtual partial hospital programme for eating disorders: Feasibility and preliminary comparison of effects. EUROPEAN EATING DISORDERS REVIEW 2024; 32:163-178. [PMID: 37677002 DOI: 10.1002/erv.3031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 08/07/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE Minimal research has examined teletherapy for group or intensive eating disorder (ED) treatment, particularly partial hospital programme (PHP). This study compared treatment outcomes for individuals treated before and after a pandemic-driven implementation of virtual PHP. METHOD Patients received care at ED treatment centres using the Renfrew Unified Treatment for Eating Disorders and Comorbidity. Patients treated with virtual PHP were compared to patients treated with traditional PHP. Measures of ED symptomology and behaviours, depressive symptoms, anxiety severity, anxiety sensitivity, experiential avoidance, mindfulness, and body mass index (BMI; reported for anorexia nervosa [AN] patients only) were collected at intake and discharge. Multiple regression analyses were conducted to examine the effect of treatment group on outcomes, controlling for intake score, comorbidity, discharge status, AN diagnosis, and step-down status. RESULTS Differences in treatment type were only found for binge eating frequency, with those in virtual PHP reporting significantly lower binge eating episodes at discharge than those in traditional PHP. Body mass index showed significantly less improvement in virtual PHP than in traditional PHP. CONCLUSIONS Preliminary results suggest virtual PHP is feasible and effective, potentially increasing access to evidence-based, intensive ED treatment. However, additional research is needed to establish efficacious support for weight gain among individuals with AN in virtual programs.
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Affiliation(s)
| | | | - Shelby N Ortiz
- Department of Psychology, Miami University, Oxford, OH, USA
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7
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Elliott KS, Nabulsi EH, Sims-Rhodes N, Dubre V, Barena E, Yuen N, Morris M, Sass SM, Kennedy B, Singh KP. Modality and terminology changes for behavioral health service delivery during the COVID-19 pandemic: a systematic review. Front Psychiatry 2024; 14:1265087. [PMID: 38375514 PMCID: PMC10876001 DOI: 10.3389/fpsyt.2023.1265087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/27/2023] [Indexed: 02/21/2024] Open
Abstract
Introduction The COVID-19 pandemic prompted healthcare professionals to implement service delivery adaptations to remain in compliance with safety regulations. Though many adaptations in service delivery were reported throughout the literature, a wide variety of terminology and definitions were used. Methods To address this, we conducted a PRISMA review to identify service delivery adaptations across behavioral healthcare services in the United States from March 2020 to May 2022 and to identify variations in terminology used to describe these adaptations. We identified 445 initial articles for our review across eight databases using predetermined keywords. Using a two-round screening process, authors used a team approach to identify the most appropriate articles for this review. Results Our results suggested that a total of 14 different terms were used to describe service modality changes, with the most frequent term being telehealth (63%). Each term found in our review and the frequency of use across identified articles is described in detail. Discussion Implications of this review such as understanding modality changes during the COVID-19 pandemic and beyond are discussed. Our findings illustrate the importance of standardizing terminology to enhance communication and understanding among professionals.
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Affiliation(s)
- Kimberly S. Elliott
- Department of Healthcare Policy, Economics and Management, University of Texas at Tyler Health Science Center, Tyler, TX, United States
| | - Eman H. Nabulsi
- Department of Epidemiology and Biostatistics, University of Texas at Tyler, Tyler, TX, United States
| | - Nicholas Sims-Rhodes
- Department of Epidemiology and Biostatistics, University of Texas at Tyler, Tyler, TX, United States
| | - Vandy Dubre
- Robert R. Muntz Library, The University of Texas at Tyler, Tyler, TX, United States
| | - Emily Barena
- Department of Psychology and Counseling, The University of Texas at Tyler, Tyler, TX, United States
| | - Nelly Yuen
- Department of Psychology and Counseling, The University of Texas at Tyler, Tyler, TX, United States
| | - Michael Morris
- Department of Healthcare Policy, Economics and Management, University of Texas at Tyler Health Science Center, Tyler, TX, United States
| | - Sarah M. Sass
- Department of Psychology and Counseling, The University of Texas at Tyler, Tyler, TX, United States
| | - Bridget Kennedy
- Department of Psychology and Counseling, The University of Texas at Tyler, Tyler, TX, United States
| | - Karan P. Singh
- Department of Epidemiology and Biostatistics, University of Texas at Tyler, Tyler, TX, United States
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8
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Altieri M, Sergi MR, Tommasi M, Santangelo G, Saggino A. The efficacy of telephone-delivered cognitive behavioral therapy in people with chronic illnesses and mental diseases: A meta-analysis. J Clin Psychol 2024; 80:223-254. [PMID: 37428900 DOI: 10.1002/jclp.23563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 03/20/2023] [Accepted: 06/10/2023] [Indexed: 07/12/2023]
Abstract
COVID-19 pandemic led to an increase of remote treatments, such as telephone-delivery cognitive behavioral therapy (T-CBT). To our knowledge, no meta-analyses studied the effect of T-CBT in chronic and/or mental illnesses on multiple psychological outcomes. Therefore, our study aims to evaluating the efficacy of T-CBT compared to other interventions (treatment as usual, TAU, or face-to-face CBT). Each effect size (ES) was calculated in Hedges' g and pooled together to produce a mean ES for each outcome (depression, anxiety, mental and physical QoL, worry, coping, and sleep disturbances). The meta-analysis included 33 studies with a randomized controlled trial design. A large ES was found when comparing the efficacy of T-CBT against TAU on depression (g = 0.84, p < 0.001), whereas a moderate ES was found on anxiety (g = 0.57; p < 0.001), and a small effect on mental quality of life (g = 0.33, p < 0.001), sleep disturbances (g = 0.37, p = 0.042), coping (g = 0.20, p = 0.016) and worry (g = 0.43, p = 0.001). The meta-analysis comparing the efficacy of T-CBT and CBT on depression revealed a not significant pooled ES (g = 0.06, p = 0.466). The results provided evidence that T-CBT could be to be more effective than TAU conditions in multiple psychological outcomes, and as efficient as face-to-face CBT in treating depression.
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Affiliation(s)
- Manuela Altieri
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Maria R Sergi
- Department of Medicine and Aging Sciences, University of Chieti, Chieti, Italy
| | - Marco Tommasi
- Department of Medicine and Aging Sciences, University of Chieti, Chieti, Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Aristide Saggino
- Department of Medicine and Aging Sciences, University of Chieti, Chieti, Italy
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Zemlak JL, Wilson P, VanGraafeiland B, Rodney T. Telehealth and the Psychiatric Mental Health Nurse Practitioner: Beyond the COVID-19 Pandemic. J Am Psychiatr Nurses Assoc 2024; 30:174-179. [PMID: 34486424 DOI: 10.1177/10783903211045119] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Examine the advantages, disadvantages, and challenges of telehealth for the psychiatric mental health nurse practitioner (PMHNP) in practice and student education. Describe areas for future research and policy development regarding telehealth in PMHNP practice and training during and beyond the COVID-19 pandemic. METHODS Review current evidence, standards of practice, and education for the PMHNP. RESULTS Recent rapid pandemic-related shifts in utilization of telehealth for clinical practice and student education have highlighted the advantages, disadvantages, and areas in need of additional study. CONCLUSIONS Postpandemic telehealth care delivery will likely persist or expand. PMHNPs must advocate for high practice and education standards.
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Affiliation(s)
- Jessica L Zemlak
- Jessica L. Zemlak, PhD, MSN, FNP-BC, PMHNP-BC, Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Patty Wilson
- Patty Wilson, PhD, MSN, PMHNP-BC, Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Brigit VanGraafeiland
- Brigit VanGraafeiland, DNP, CRNP, CNE, Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Tamar Rodney
- Tamar Rodney, PhD, MSN, PMHNP-BC, Johns Hopkins School of Nursing, Baltimore, MD, USA
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10
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Smith KA, Ostinelli EG, Ede R, Allard L, Thomson M, Hewitt K, Brown P, Zangani C, Jenkins M, Hinze V, Ma G, Pothulu P, Henshall C, Malhi GS, Every-Palmer S, Cipriani A. Assessing the Impact of Evidence-Based Mental Health Guidance During the COVID-19 Pandemic: Systematic Review and Qualitative Evaluation. JMIR Ment Health 2023; 10:e52901. [PMID: 38133912 PMCID: PMC10760515 DOI: 10.2196/52901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/30/2023] [Accepted: 11/03/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the Oxford Precision Psychiatry Lab (OxPPL) developed open-access web-based summaries of mental health care guidelines (OxPPL guidance) in key areas such as digital approaches and telepsychiatry, suicide and self-harm, domestic violence and abuse, perinatal care, and vaccine hesitancy and prioritization in the context of mental illness, to inform timely clinical decision-making. OBJECTIVE This study aimed to evaluate the practice of creating evidence-based health guidelines during health emergencies using the OxPPL guidance as an example. An international network of clinical sites and colleagues (in Australia, New Zealand, and the United Kingdom) including clinicians, researchers, and experts by experience aimed to (1) evaluate the clinical impact of the OxPPL guidance, as an example of an evidence-based summary of guidelines; (2) review the literature for other evidence-based summaries of COVID-19 guidelines regarding mental health care; and (3) produce a framework for response to future global health emergencies. METHODS The impact and clinical utility of the OxPPL guidance were assessed using clinicians' feedback via an international survey and focus groups. A systematic review (protocol registered on Open Science Framework) identified summaries or syntheses of guidelines for mental health care during and after the COVID-19 pandemic and assessed the accuracy of the methods used in the OxPPL guidance by identifying any resources that the guidance had not included. RESULTS Overall, 80.2% (146/182) of the clinicians agreed or strongly agreed that the OxPPL guidance answered important clinical questions, 73.1% (133/182) stated that the guidance was relevant to their service, 59.3% (108/182) said that the guidelines had or would have a positive impact on their clinical practice, 42.9% (78/182) that they had shared or would share the guidance, and 80.2% (146/182) stated that the methodology could be used during future health crises. The focus groups found that the combination of evidence-based knowledge, clinical viewpoint, and visibility was crucial for clinical implementation. The systematic review identified 2543 records, of which 2 syntheses of guidelines met all the inclusion criteria, but only 1 (the OxPPL guidance) used evidence-based methodology. The review showed that the OxPPL guidance had included the majority of eligible guidelines, but 6 were identified that had not been included. CONCLUSIONS The study identified an unmet need for web-based, evidence-based mental health care guidance during the COVID-19 pandemic. The OxPPL guidance was evaluated by clinicians as having a real-world clinical impact. Robust evidence-based methodology and expertise in mental health are necessary, but easy accessibility is also needed, and digital technology can materially help. Further health emergencies are inevitable and now is the ideal time to prepare, including addressing the training needs of clinicians, patients, and carers, especially in areas such as telepsychiatry and digital mental health. For future planning, guidance should be widely disseminated on an international platform, with allocated resources to support adaptive updates.
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Affiliation(s)
- Katharine A Smith
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Edoardo G Ostinelli
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Roger Ede
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Lisa Allard
- Pharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | | | - Kiran Hewitt
- Lincolnshire Partnership NHS Foundation Trust, Lincoln, United Kingdom
| | - Petra Brown
- Pennine Care NHS Foundation Trust, Manchester, United Kingdom
- Department of Pharmacy and Optometry, University of Manchester, Manchester, United Kingdom
| | - Caroline Zangani
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Matthew Jenkins
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Verena Hinze
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - George Ma
- Pharmacy Department, The Prince Charles Hospital, Metro North Health, Brisbane, Australia
| | - Prajnesh Pothulu
- Pharmacy Department, Princess Alexandra Hospital, Brisbane, Australia
| | - Catherine Henshall
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom
- Nursing and Midwifery Office, National Institute for Health and Care Research, London, United Kingdom
| | - Gin S Malhi
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Academic Department of Psychiatry, Faculty of Medicine and Health, Kolling Institute, Northern Clinical School, The University of Sydney, Sydney, Australia
- CADE Clinic and Mood-T, Royal North Shore Hospital, Northern Sydney Local Health District, St. Leonards, New South Wales, Australia
| | - Susanna Every-Palmer
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
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11
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Rodríguez Guarin M, Gempeler Rueda J, Castro SM, Ospina MM, Villanueva Betancourth C, Amórtegui JP, Vázquez L. Feasibility and acceptability of comprehensive virtual treatment in eating disorders: perspectives from patients, parents and therapists during the COVID-19 pandemic. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2023; 52:337-344. [PMID: 38008675 DOI: 10.1016/j.rcpeng.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 07/13/2021] [Indexed: 11/28/2023]
Abstract
BACKGROUND Lockdowns and social distancing as a result of the COVID-19 pandemic have brought about the need to continue treatment virtually in patients with Eating Disorders (ED). OBJECTIVE To evaluate feasibility, acceptability and adherence to virtual treatment in patients, families and therapists. METHODS Fourteen patients, 10 family members and eight therapists from an intensive outpatient program for ED answered online surveys and a SWOT analysis was performed with the responses. RESULTS Virtual treatment during lockdown was considered feasible and useful by all respondents. Fear of contagion and the presence of parents in the home were identified as strengths. Parents reported problems with nutritional plan compliance, especially in anorexia patients. Therapists highlighted the importance of methodological adaptations in sessions to improve participation. Adherence to sessions was 100% for family members and 90% for patients. CONCLUSIONS Adaptation to a virtual program is a valid and useful option during lockdowns. It improves family participation, but does not replace face-to-face treatment.
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Affiliation(s)
| | - Juanita Gempeler Rueda
- Programa Equilibrio Para Trastornos Alimentarios, Afectivos y de Ansiedad, Bogotá, Colombia
| | - Sergio Mario Castro
- Programa Equilibrio Para Trastornos Alimentarios, Afectivos y de Ansiedad, Bogotá, Colombia
| | - María Mercedes Ospina
- Programa Equilibrio Para Trastornos Alimentarios, Afectivos y de Ansiedad, Bogotá, Colombia
| | | | - Juan Pablo Amórtegui
- Programa Equilibrio Para Trastornos Alimentarios, Afectivos y de Ansiedad, Bogotá, Colombia
| | - Laura Vázquez
- Programa Equilibrio Para Trastornos Alimentarios, Afectivos y de Ansiedad, Bogotá, Colombia
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Baudinet J, Konstantellou A, Hambleton A, Bialluch K, Hurford G, Stewart CS. Do People Want the 'New Normal'? A Mixed Method Investigation of Young Person, Parent, and Clinician Experience and Preferences for Eating Disorder Treatment Delivery in the Post-COVID-19 World. Nutrients 2023; 15:3732. [PMID: 37686764 PMCID: PMC10490168 DOI: 10.3390/nu15173732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
Eating disorder treatment was predominantly provided online during the COVID-19 pandemic, which has continued into the post-pandemic world. This mixed method study explored young person, parent/caregiver, and clinician experiences of child and adolescent eating disorder treatment. In total, 90 participants (25 young people, 49 parents/caregivers, and 16 clinicians) completed online surveys about the experience of online working. Data were compared to similar data collected by the same service earlier in the pandemic. The results show that preferences are largely unchanged since 2020; online treatment is considered helpful and acceptable by all groups. Nevertheless, face-to-face assessment sessions (young people: 52.2%; and parents/caregivers: 68.9%) and final sessions (young people: 82.6%; and parents/caregivers: 82.2%) were preferred compared to online. There was also a preference for early treatment sessions to either be always or mostly face-to-face (young people: 65.2%; and parents/caregivers: 73.3%). The middle and latter parts of treatment were a time when preferences shifted slightly to a more hybrid mode of delivery. Participants reported finding engagement with the therapist (young people: 70.6%; and parents/caregivers: 52.5%) easier during face-to-face treatment. Stepping away from the binary of online or face-to-face, the current data suggest that a hybrid and flexible model is a way forward with current findings providing insights into how to structure this.
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Affiliation(s)
- Julian Baudinet
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), 16 De Crespigny Park, London SE5 8AD, UK
- Maudsley Centre for Child and Adolescent Eating Disorders (MCCAED), Maudsley Hospital, De Crespigny Park, London SE5 8AZ, UK
| | - Anna Konstantellou
- Maudsley Centre for Child and Adolescent Eating Disorders (MCCAED), Maudsley Hospital, De Crespigny Park, London SE5 8AZ, UK
| | - Ashlea Hambleton
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre (D17), University of Sydney, Camperdown, NSW 2006, Australia
| | - Katrin Bialluch
- Maudsley Centre for Child and Adolescent Eating Disorders (MCCAED), Maudsley Hospital, De Crespigny Park, London SE5 8AZ, UK
| | - Georgina Hurford
- Maudsley Centre for Child and Adolescent Eating Disorders (MCCAED), Maudsley Hospital, De Crespigny Park, London SE5 8AZ, UK
| | - Catherine S. Stewart
- Maudsley Centre for Child and Adolescent Eating Disorders (MCCAED), Maudsley Hospital, De Crespigny Park, London SE5 8AZ, UK
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13
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Schlissel AC, Richmond TK, Eliasziw M, Leonberg K, Skeer MR. Anorexia nervosa and the COVID-19 pandemic among young people: a scoping review. J Eat Disord 2023; 11:122. [PMID: 37474976 PMCID: PMC10360262 DOI: 10.1186/s40337-023-00843-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 07/07/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The extent to which the recent global COVID-19 Pandemic has impacted young people with restrictive eating disorders [i.e., anorexia nervosa (AN) and atypical anorexia nervosa (AAN)] is unclear. We conducted a scoping review of the literature to identify how the pandemic has impacted this population and to identify gaps in the current literature to inform future research efforts. MAIN BODY We searched PubMed, EMBASE, the Web of Science, The Cochrane Library, PsycInfo, ProQuest Dissertations and Theses Global, LitCovid, Google Scholar, and relevant agency websites from 2019 to 2022. We included studies that focused on young people with AN/AAN globally. Of the 916 unduplicated articles screened, 17 articles met the inclusion criteria, reporting on 17 unique studies including 4,379 individuals. Three key findings were identified. First, an increase in hospitalizations related to eating disorders was found during COVID-19 among young people with AN and AAN. Multiple studies cited increased medical instability, even though the overall duration of disease was shorter compared to pre-pandemic levels. Second, changes in eating disorder-related symptomology during the pandemic were reported in this population, as well as poorer overall behavioral and mental health. Suggested reasons behind changes included boredom or minimal distraction from pathological thoughts, increased social isolation, increased social media and online use (e.g., reading blogs or watching YouTube), gym and school closures, changes in routines due to lockdowns and quarantines, and worries over gaining the "Quarantine 15". Third, there was an increase in the use of telemedicine as a treatment modality for the treatment of AN. Challenges were reported by both clinicians and patients regardless of past experience using telemedicine. When compared to no treatment, telemedicine was recognized as the best option during COVID-19 lockdowns; however some individuals expressed the preference for in-person treatment and planned to return to it once it became available. CONCLUSION The pandemic significantly impacted young people with restrictive eating disorders as seen by increased hospitalizations and requests for outpatient care. A primary driver of the changes in eating disorder symptomatology may be lockdowns and quarantines. Further research investigating how the series of lockdowns and re-openings impacted individuals with AN/AAN is warranted.
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Affiliation(s)
- Anna C. Schlissel
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111 USA
| | - Tracy K. Richmond
- Division of Adolescent Medicine, Boston Children’s Hospital, 6th Floor, 333 Longwood Avenue, Boston, MA 02115 USA
- Harvard Medical School, Pediatrics, 25 Shattuck Street, Boston, MA 02115 USA
| | - Misha Eliasziw
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111 USA
| | - Kristin Leonberg
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Jaharis Family Center for Biomedical and Nutrition Sciences, Tufts University, 150 Harrison Avenue, Boston, MA 02111 USA
| | - Margie R. Skeer
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111 USA
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14
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Pagano N, Glasofer DR, Attia E, Ruggiero J, Eziri K, Goldstein CM, Steinglass JE. Perspectives on relapse prevention following intensive treatment of anorexia nervosa: A focus group study. Int J Eat Disord 2023; 56:1417-1431. [PMID: 37051854 PMCID: PMC10524497 DOI: 10.1002/eat.23952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/24/2023] [Accepted: 03/24/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE Including the perspectives of individuals with lived experience of mental health issues is a critical step in research and treatment development. Focus groups with patients with a history of treatment for anorexia nervosa (AN) were conducted in anticipation of a clinical trial of Relapse Prevention and Changing Habits (REACH+). METHODS Seven female adults (23-51 years) who had previously received inpatient treatment for AN, now in remission, participated in one of two semistructured focus groups. Rapid qualitative analysis was used to examine participants' contributions and identify common topics. RESULTS Transcript analysis yielded three topics related to relapse prevention: (1) recovery aids, including a sense of agency in treatment decisions and finding new interests/passions, (2) recovery hindrances, such as lack of access to care, and (3) identification of members of support system. Aspects of REACH+ received positive feedback, such as continuity of care from the inpatient setting and the use of telehealth. Viewpoints differed with respect to the helpfulness of obtaining patient weights in treatment. The REACH+ online platform received positive comments regarding content and usability, as well as suggestions for additional content. DISCUSSION Qualitative feedback from patients with a history of AN highlighted the value of engaging patients in their own treatment decisions, as well as in treatment design and innovation. Within this small group, there were differences of opinion about treatment components, specifically weight assessment, that suggest the need for further data. User-centered design provides opportunities to improve the acceptability and, therefore, dissemination of novel treatments. PUBLIC SIGNIFICANCE Relapse prevention is a critical treatment need for patients with anorexia nervosa, as this illness too often follows a protracted course. There are challenges in both obtaining specialized care and in retaining patients in treatment. Here, patient perspectives on these challenges offer input to allow for optimization of relapse prevention treatment. Shared decision-making may be particularly valuable to support an individual's sense of agency and engagement in care.
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Affiliation(s)
- Nikki Pagano
- New York State Psychiatric Institute, Columbia University
Irving Medical Center, New York, New York, USA
| | - Deborah R. Glasofer
- New York State Psychiatric Institute, Columbia University
Irving Medical Center, New York, New York, USA
| | - Evelyn Attia
- New York State Psychiatric Institute, Columbia University
Irving Medical Center, New York, New York, USA
- Weill Cornell Medical College, New York, New York,
USA
| | - Julia Ruggiero
- New York State Psychiatric Institute, Columbia University
Irving Medical Center, New York, New York, USA
| | - Kelechi Eziri
- New York State Psychiatric Institute, Columbia University
Irving Medical Center, New York, New York, USA
| | - Carly M. Goldstein
- Weight Control and Diabetes Research Center, The Miriam
Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode
Island, USA
| | - Joanna E. Steinglass
- New York State Psychiatric Institute, Columbia University
Irving Medical Center, New York, New York, USA
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15
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Cavallo M, Pedroli E, Cantoia M, McGrath B, Cecchetti S. Attitudes of Mental Health Professionals towards Telepsychology during the Pandemic: A Pilot Study. Healthcare (Basel) 2023; 11:healthcare11111542. [PMID: 37297682 DOI: 10.3390/healthcare11111542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/21/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVE This pilot study investigated mental health professionals' attitudes towards remote psychological consultations and internet-based interventions. METHODS An online survey in Italian and English was administered to a sample of 191 psychologists and psychotherapists to collect detailed information about their professional experience providing online psychological interventions a year and a half after the beginning of the SARS-CoV-2 pandemic. RESULTS The results did not reveal a statistically significant association between the participants' theoretical approaches and the number of patients treated via the online modality. Overall, most of the participants found advantages to the online setting but also noted critical issues regarding privacy and the ease of integrating new technology into their clinical practice. CONCLUSIONS According to the participants, despite the challenges that must be addressed, telehealth is a viable psychological therapeutic option that is destined to grow in importance in the near future.
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Affiliation(s)
- Marco Cavallo
- Faculty of Psychology, eCampus University, 22060 Novedrate, CO, Italy
- Clinical Psychology Service, Saint George Foundation, 12030 Cavallermaggiore, CN, Italy
| | - Elisa Pedroli
- Faculty of Psychology, eCampus University, 22060 Novedrate, CO, Italy
- Applied Technology for Neuropsychology Lab, IRCCS Istituto Auxologico Italiano, 20135 Milan, MI, Italy
| | - Manuela Cantoia
- Faculty of Psychology, eCampus University, 22060 Novedrate, CO, Italy
| | - Breeda McGrath
- The Chicago School of Professional Psychology, Chicago, IL 60601, USA
| | - Sonja Cecchetti
- Faculty of Psychology, eCampus University, 22060 Novedrate, CO, Italy
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16
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Walton CJ, Gonzalez S, Cooney EB, Leigh L, Szwec S. Engagement over telehealth: comparing attendance between dialectical behaviour therapy delivered face-to-face and via telehealth for programs in Australia and New Zealand during the Covid-19 pandemic. Borderline Personal Disord Emot Dysregul 2023; 10:16. [PMID: 37208784 DOI: 10.1186/s40479-023-00221-4] [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: 01/26/2023] [Accepted: 04/24/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND While the COVID-19 crisis has had numerous global negative impacts, it has also presented an imperative for mental health care systems to make digital mental health interventions a part of routine care. Accordingly, through necessity, many Dialectical Behaviour Therapy (DBT) programs transitioned to telehealth, despite little information on clinical outcomes compared with face-to-face treatment delivery. This study examined differences in client engagement (i.e. attendance) of DBT: delivered face-to-face prior to the first COVID-19 lockdown in Australia and New Zealand; delivered via telehealth during the lockdown; and delivered post-lockdown. Our primary outcomes were to compare: [1] client attendance rates of DBT individual therapy delivered face-to-face with delivery via telehealth, and [2] client attendance rates of DBT skills training delivered face-to-face compared with delivery via telehealth. METHODS DBT programs across Australia and New Zealand provided de-identified data for a total of 143 individuals who received DBT treatment provided via telehealth or face-to-face over a six-month period in 2020. Data included attendance rates of DBT individual therapy sessions; attendance rates of DBT skills training sessions as well as drop-out rates and First Nations status of clients. RESULTS A mixed effects logistic regression model revealed no significant differences between attendance rates for clients attending face-to-face sessions or telehealth sessions for either group therapy or individual therapy. This result was found for clients who identified as First Nations persons and those who didn't identify as First Nations persons. CONCLUSIONS Clients were as likely to attend their DBT sessions over telehealth as they were face-to-face during the first year of the Covid-19 pandemic. These findings provide preliminary evidence that providing DBT over telehealth may be a viable option to increase access for clients, particularly in areas where face-to-face treatment is not available. Further, based on the data collected in this study, we can be less concerned that offering telehealth treatment will compromise attendance rates compared to face-to-face treatment. Further research is needed comparing clinical outcomes between treatments delivered face-to-face compared delivery via telehealth.
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Affiliation(s)
- Carla J Walton
- Centre for Psychotherapy, Hunter New England Mental Health Service, 2300, PO Box 833, Newcastle, NSW, Australia
| | - Sharleen Gonzalez
- Centre for Psychotherapy, Hunter New England Mental Health Service, 2300, PO Box 833, Newcastle, NSW, Australia
| | - Emily B Cooney
- Department of Psychological Medicine, Wellington Medical School, University of Otago (Te Whare, Wānanga o Otāgo ki Te Whanga-Nui-a-Tara), Newtown, Wellington, New Zealand
- Yale University, New Haven, Connecticut, United States of America
| | - Lucy Leigh
- Data Sciences Unit, Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, 2305, New Lambton Heights, NSW, Australia
| | - Stuart Szwec
- Data Sciences Unit, Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, 2305, New Lambton Heights, NSW, Australia
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17
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Haas A, Laboe AA, McGinnis CG, Firebaugh ML, Shah J, Bardone-Cone AM, Pike KM, Taylor CB, Wilfley DE, Fitzsimmons-Craft EE. Adapting a mobile app to support patients with anorexia nervosa following post-acute care: perspectives from eating disorder treatment center stakeholders. Front Digit Health 2023; 5:1099718. [PMID: 37274762 PMCID: PMC10235779 DOI: 10.3389/fdgth.2023.1099718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/05/2023] [Indexed: 06/06/2023] Open
Abstract
Introduction Anorexia nervosa (AN) is a harmful, life-threatening illness. Patients with severe AN often receive acute treatment but, upon discharge, experience high relapse rates. Evidence-based, outpatient treatment following acute care is critical to preventing relapse; however, numerous barriers (e.g., location, financial limitations, low availability of providers) preclude individuals from accessing treatment. mHealth technologies may help to address these barriers, but research on such digital approaches for those with AN is limited. Further, such technologies should be developed with all relevant stakeholder input considered from the outset. As such, the present study aimed to garner feedback from eating disorder (ED) treatment center providers on (1) the process of discharging patients to outpatient services, (2) their experiences with technology as a treatment tool, and (3) how future mHealth technologies may be harnessed to offer the most benefit to patients in the post-acute period. Methods Participants (N = 11, from 7 ED treatment centers across the United States) were interviewed. To analyze the data for this study, each interview was manually transcribed and analyzed using components of Braun and Clarke's six-phase thematic analysis framework (Braun & Clarke, 2006). Results Participants indicated proactively securing outpatient care for their patients, but mentioned several barriers their patients face in accessing evidence-based ED treatment. All participants had some experience using various technologies for treatment (e.g., teletherapy, self-monitoring apps), and mentioned a high level of interest in the development of a new app to be used by patients recently discharged from acute treatment for AN. Participants also offered suggestions of effective and relevant content for a potential app and adjunctive social networking component for post-acute care of AN. Discussion Overall, participants expressed positive attitudes toward the integration of an app into the care flow, suggesting the high potential benefit of harnessing technology to support individuals recovering from AN.
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Affiliation(s)
- Anneliese Haas
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Agatha A. Laboe
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Claire G. McGinnis
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Marie-Laure Firebaugh
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Jillian Shah
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Anna M. Bardone-Cone
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kathleen M. Pike
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - C. Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
- Center for m2Health, Palo Alto University, Palo Alto, CA, United States
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
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18
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Moore E, Waller G. Brief group cognitive-behavioral therapy for bulimia nervosa and binge-eating disorder: A pilot study of feasibility and acceptability. Int J Eat Disord 2023. [PMID: 36938973 DOI: 10.1002/eat.23935] [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: 07/25/2022] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/21/2023]
Abstract
OBJECTIVE Brief cognitive-behavioral therapy for non-underweight eating disorders (CBT-T) has been shown to be clinically useful in non-underweight samples, when delivered one-to-one. This pilot study assessed the acceptance, compliance and feasibility levels of a group version of CBT-T, which has the potential to enhance patient access. METHOD A group CBT-T protocol was developed and piloted in two therapy groups (N = 8). Eating disorder attitudes and behaviors, depression and anxiety were assessed at the beginning and end of treatment. RESULTS A third of all patients approached accepted the offer of group CBT-T, and entered treatment. Among that group of treatment starters, none were lost to treatment. The therapy was feasible in practical terms, including online delivery. Finally, mean scores on measures suggested improvement in clinical profiles. DISCUSSION This pilot study demonstrated that a group CBT-T is a feasible intervention for non-underweight eating disorders in adults, with low acceptance but high compliance. Group CBT-T has the potential to reduce demand on services and in turn increase availability of treatment to those with eating disorders. PUBLIC SIGNIFICANCE The present research contributes to the treatment of non-underweight adults with eating disorders. Group CBT-T was shown to be feasible in this pilot study. It was associated with low acceptance but strong compliance. If supported by further research, group CBT-T has the potential to reduce waitlists, ensure throughput in services, and ultimately improve the lives of many who are affected by eating disorders.
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Affiliation(s)
- Elana Moore
- South Yorkshire Eating Disorders Association, Sheffield, UK
| | - Glenn Waller
- Department of Psychology, University of Sheffield, Sheffield, S1 2LT, UK
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19
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Cieślik B, Kuligowski T, Cacciante L, Kiper P. The Impact of Personality Traits on Patient Satisfaction after Telerehabilitation: A Comparative Study of Remote and Face-to-Face Musculoskeletal Rehabilitation during COVID-19 Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5019. [PMID: 36981927 PMCID: PMC10049300 DOI: 10.3390/ijerph20065019] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to evaluate the differences in patient satisfaction between telerehabilitation and traditional face-to-face rehabilitation and to identify the impact of personality traits on patient satisfaction with the remote form of rehabilitation. Eighty participants with musculoskeletal pain were recruited for the study. The telerehabilitation group (n = 40) completed a single remote session of rehabilitation, whereas the traditional rehabilitation group (n = 40) completed a single face-to-face session. After therapy, each participant was asked to complete a tailored satisfaction survey using Google Forms. The Health Care Satisfaction Questionnaire (HCSQ) and the International Personality Item Pool-Big Five Markers-20 (IPIP-BFM-20) were used as outcome measures. Considering the results of patient satisfaction with healthcare service, there were no statistically significant differences between telerehabilitation and traditional rehabilitation groups in the total HCSQ score and its subscales. For the complete HCSQ, agreeableness, conscientiousness, and extraversion were essential predictor variables, accounting for 51% of the variance in patient satisfaction. In conclusion, there were no differences in patient satisfaction between telerehabilitation and traditional rehabilitation groups. In the telerehabilitation group, higher agreeableness levels and lower conscientiousness and extraversion level could predict patients' satisfaction with telerehabilitation.
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Affiliation(s)
- Błażej Cieślik
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venezia, Italy
| | - Tomasz Kuligowski
- Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Luisa Cacciante
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venezia, Italy
| | - Pawel Kiper
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venezia, Italy
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20
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Allen KL, Mountford VA, Elwyn R, Flynn M, Fursland A, Obeid N, Partida G, Richards K, Schmidt U, Serpell L, Silverstein S, Wade T. A framework for conceptualising early intervention for eating disorders. EUROPEAN EATING DISORDERS REVIEW 2023; 31:320-334. [PMID: 36426567 PMCID: PMC10100476 DOI: 10.1002/erv.2959] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/27/2022] [Accepted: 11/10/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This paper outlines the evidence base for early intervention for eating disorders; provides a global overview of how early intervention for eating disorders is provided in different regions and settings; and proposes policy, service, clinician and research recommendations to progress early intervention for eating disorders. METHOD AND RESULTS Currently, access to eating disorder treatment often takes many years or does not occur at all. This is despite neurobiological, clinical and socioeconomic evidence showing that early intervention may improve outcomes and facilitate full sustained recovery from an eating disorder. There is also considerable variation worldwide in how eating disorder care is provided, with marked inequalities in treatment provision. Despite these barriers, there are existing evidence-based approaches to early intervention for eating disorders and progress is being made in scaling these. CONCLUSIONS We propose action steps for the field that will transform eating disorder service provision and facilitate early detection, treatment and recovery for everyone affected by eating disorders, regardless of age, socioeconomic status and personal characteristics.
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Affiliation(s)
- Karina L Allen
- Eating Disorders Outpatients Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Victoria A Mountford
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,LightHouse Arabia, Dubai, United Arab Emirates
| | - Rosiel Elwyn
- Thompson Institute, University of the Sunshine Coast, Gubbi Gubbi Country, Queensland, Australia
| | - Michaela Flynn
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Nicole Obeid
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Georgina Partida
- Eating Disorders Outpatients Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK
| | - Katie Richards
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ulrike Schmidt
- Eating Disorders Outpatients Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lucy Serpell
- Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Eating Disorder Service, North East London NHS Foundation Trust, Essex, UK
| | | | - Tracey Wade
- Flinders Institute for Mental Health and Wellbeing, Flinders University, Adelaide, South Australia, Australia
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21
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Wade TD, Byrne S, Touyz S. A clinician’s quick guide to evidence-based approaches: eating disorders (Version 2). CLIN PSYCHOL-UK 2023. [DOI: 10.1080/13284207.2022.2163885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Tracey D. Wade
- Blackbird Initiative, Flinders Institute for Mental Health and Wellbeing, Flinders University, Adelaide, SA, Australia
| | - Susan Byrne
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Stephen Touyz
- Inside Out Institute, University of Sydney, Sydney Local Health District, NSW, Australia
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22
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Gori A, Topino E, Brugnera A, Compare A. Assessment of professional self-efficacy in psychological interventions and psychotherapy sessions: Development of the Therapist Self-Efficacy Scale (T-SES) and its application for eTherapy. J Clin Psychol 2022; 78:2122-2144. [PMID: 35615900 PMCID: PMC9796675 DOI: 10.1002/jclp.23391] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 02/20/2022] [Accepted: 05/13/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study aimed to develop the Therapist Self-Efficacy Scale (T-SES), and test its validity in a sample of Italian mental health therapists, to assess their professional self-efficacy concerning their practice of eTherapy in a synchronous video-based setting. METHODS A sample of 322 Italian mental health professionals (37.6% psychologists, 62.4% psychotherapists; Mage = 38.48, SD = 8.509) completed an online survey. RESULTS The T-SES showed a clear, one-factor structure with good psychometric properties. Significant associations were found with insight orientation, general self-efficacy, self-esteem, and personality traits of openness, conscientiousness, and agreeableness. The results showed no differences between psychologists and psychotherapists, or differences based on years of experience. CONCLUSION The T-SES is an agile and versatile self-report measure for mental health professionals to assess their self-efficacy concerning their therapeutic activity, which can provide information for tailoring training for eTherapy.
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Affiliation(s)
- Alessio Gori
- Department of Health SciencesUniversity of FlorenceFlorenceItaly,Integrated Psychodynamic Psychotherapy Institute (IPPI)FlorenceItaly
| | - Eleonora Topino
- Department of Human SciencesLUMSA University of RomeRomeItaly
| | - Agostino Brugnera
- Department of Human and Social SciencesUniversity of BergamoBergamoItaly
| | - Angelo Compare
- Department of Human and Social SciencesUniversity of BergamoBergamoItaly
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23
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Krom H, van Mameren J, Remijn L, de Nennie K, Dumont E, van der Gaag E, van Leeuwen MCC, Mulkens S, Schakelaar C, Kindermann A. Impact of COVID-19 Pandemic on Young Children With Feeding and Eating Problems and Disorders and Their Families. J Pediatr Gastroenterol Nutr 2022; 75:529-534. [PMID: 35836323 PMCID: PMC9470045 DOI: 10.1097/mpg.0000000000003563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES The incidence of feeding and eating problems and disorders (FEPD) in children increased during the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to assess the impact of the COVID-19 pandemic on young children with FEPD and their parents. METHODS Cross-sectional survey: parents of children with FEPD (0-11 years) in the Netherlands completed an online questionnaire (January-April 2021). This questionnaire included 4 demographic questions (including criteria of pediatric feeding disorder [PFD] and/or avoidant/restrictive food intake disorder [ARFID]) and 11 questions related to experienced impact of the COVID-19 pandemic. Parental responses regarding children with FEPD (including PFD and ARFID) were compared with those of healthy controls (HCs). RESULTS In total, 240 children (median age, 5.5 years; interquartile range [IQR], 3.5-7.9 years; 53.3% female) were included; 129 children with FEPD and 111 HC. Most children with FEPD fulfilled criteria for PFD (n = 119; 92.2%) and/or ARFID (n = 117; 90.7%). Parents of children with FEPD reported more stress (of their child [ P = 0.014] and parental stress [ P = 0.014]), worse eating by the child ( P < 0.001), more negative relations within the family ( P = 0.006), and less support from the environment ( P = 0.001) compared with parents of HC during the COVID-19 pandemic than before. CONCLUSIONS It seems that the COVID-19 pandemic had great impact on young children with FEPD and their parents because parents of children with FEPD reported significantly more perceived stress within both the child and parents, more difficult eating behavior of the child, more negative behavior between family members, and less support from the environment as compared with HC.
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Affiliation(s)
- Hilde Krom
- From the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- the SeysCentra, Malden, The Netherlands
| | - Joost van Mameren
- the Multidisciplinary Advisory Board, Patient organization "Nee-eten," Haarlem, The Netherlands
- the Institute of Physics, University of Amsterdam, Amsterdam, The Netherlands
| | - Lianne Remijn
- the Multidisciplinary Advisory Board, Patient organization "Nee-eten," Haarlem, The Netherlands
- the HAN University of Applied Sciences, Academy of Health Studies, Nijmegen, The Netherlands
| | - Katinka de Nennie
- the Multidisciplinary Advisory Board, Patient organization "Nee-eten," Haarlem, The Netherlands
- the Pediatric Dietetic Practice Katinka de Nennie, Gouda/Zoetermeer, The Netherlands
| | - Eric Dumont
- the SeysCentra, Malden, The Netherlands
- the Multidisciplinary Advisory Board, Patient organization "Nee-eten," Haarlem, The Netherlands
- the Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
- the Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Ellen van der Gaag
- the Multidisciplinary Advisory Board, Patient organization "Nee-eten," Haarlem, The Netherlands
- the Pediatric Department Hospital Group Twente, Almelo-Hengelo, The Netherlands
| | | | - Sandra Mulkens
- the SeysCentra, Malden, The Netherlands
- the Multidisciplinary Advisory Board, Patient organization "Nee-eten," Haarlem, The Netherlands
- the Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
- the Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Chantal Schakelaar
- the Multidisciplinary Advisory Board, Patient organization "Nee-eten," Haarlem, The Netherlands
- the Isa Power, Udenhout, The Netherlands
| | - Angelika Kindermann
- From the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- the Multidisciplinary Advisory Board, Patient organization "Nee-eten," Haarlem, The Netherlands
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Psychotherapy under lockdown: The use and experience of teleconsultation by psychotherapists during the first wave of the COVID-19 pandemic. CLINICAL PSYCHOLOGY IN EUROPE 2022; 4:e6821. [PMID: 36398003 PMCID: PMC9667335 DOI: 10.32872/cpe.6821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 05/31/2022] [Indexed: 11/25/2022] Open
Abstract
Background Facing the COVID-19 pandemic, some psychotherapists had to propose remote consultations, i.e., teleconsultation. While some evidence suggests positive outcomes from teleconsultation, professionals still hold negative beliefs towards it. Additionally, no rigorous and integrative practice framework for teleconsultation has yet been developed. This article aims to explore the use and experience of teleconsultation by 1) investigating differences between psychotherapists proposing and not proposing it; 2) evaluating the impact of negative attitudes towards teleconsultation on various variables; 3) determining the perceived detrimental effect of teleconsultation, as opposed to in-person, on the therapeutic relationship and personal experience; and 4) providing insights for the development of a teleconsultation practice framework. Method An online survey was distributed via different professional organisations across several countries to 246 (195 women) French-speaking psychotherapists. Results Psychotherapists who did not propose teleconsultation believed it to be more technically challenging than psychotherapists who proposed it, but felt less constrained to propose it, and had less colleagues offering it. Attitudes towards teleconsultation showed no significant associations with therapeutic relationship, personal experience, and percentage of teleconsultation. As compared to in-person, empathy, congruence, and therapeutic alliance were perceived to significantly deteriorate online, whereas work organisation was perceived to be significantly better. While most psychotherapists proposed remote consultations, they did not provide adaptations to such setting (e.g., ascertaining a neutral video background); nor used videoconferencing platforms meeting privacy and confidentiality criteria. Conclusion Training and evidenced-based information should be urgently provided to practitioners to develop rigorous guidelines and an ethically and legally safe practice framework. Psychotherapists differ in their perceptions of teleconsultation as whether they propose it or not. Attitudes towards teleconsultation are not related to its use nor to the therapeutic relationship. Teleconsultation worsens perceived therapeutic relationship, but improves work organisation. Training is needed to improve an ethically and legally safe practice of teleconsultation.
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Zangani C, Ostinelli EG, Smith KA, Hong JSW, Macdonald O, Reen G, Reid K, Vincent C, Syed Sheriff R, Harrison PJ, Hawton K, Pitman A, Bale R, Fazel S, Geddes JR, Cipriani A. Impact of the COVID-19 Pandemic on the Global Delivery of Mental Health Services and Telemental Health: Systematic Review. JMIR Ment Health 2022; 9:e38600. [PMID: 35994310 PMCID: PMC9400843 DOI: 10.2196/38600] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/05/2022] [Accepted: 07/21/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic required mental health services around the world to adapt quickly to the new restrictions and regulations put in place to reduce the risk of transmission. As face-to-face contact became difficult, virtual methods were implemented to continue to safely provide mental health care. However, it is unclear to what extent service provision transitioned to telemental health worldwide. OBJECTIVE We aimed to systematically review the global research literature on how mental health service provision adapted during the first year of the pandemic. METHODS We searched systematically for quantitative papers focusing on the impact of the COVID-19 pandemic on mental health services published until April 13, 2021, in the PubMed, Embase, medRxiv, and bioXriv electronic bibliographic databases, using the COVID-19 Open Access Project online platform. The screening process and data extraction were independently completed by at least two authors, and any disagreement was resolved by discussion with a senior member of the team. The findings were summarized narratively in the context of each country's COVID-19 Stringency Index, which reflects the stringency of a government's response to COVID-19 restrictions at a specific time. RESULTS Of the identified 24,339 records, 101 papers were included after the screening process. Reports on general services (n=72) showed that several countries' face-to-face services reduced their activities at the start of the pandemic, with reductions in the total number of delivered visits and with some services forced to close. In contrast, telemental health use rapidly increased in many countries across the world at the beginning of the pandemic (n=55), with almost complete virtualization of general and specialistic care services by the end of the first year. Considering the reported COVID-19 Stringency Index values, the increased use of virtual means seems to correspond to periods when the Stringency Index values were at their highest in several countries. However, due to specific care requirements, telemental health could not be used in certain subgroups of patients, such as those on clozapine or depot treatments and those who continued to need face-to-face visits. CONCLUSIONS During the pandemic, mental health services had to adapt quickly in the short term, implementing or increasing the use of telemental health services across the globe. Limited access to digital means, poor digital skills, and patients' preferences and individual needs may have contributed to differences in implementing and accessing telemental health services during the pandemic. In the long term, a blended approach, combining in-person and virtual modalities, that takes into consideration the needs, preferences, and digital skills of patients may better support the future development of mental health services. It will be required to improve confidence with digital device use, training, and experience in all modalities for both clinicians and service users.
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Affiliation(s)
- Caroline Zangani
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | | | - Katharine A Smith
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - James S W Hong
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Orla Macdonald
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Gurpreet Reen
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Katherine Reid
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Charles Vincent
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | | | - Paul J Harrison
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Keith Hawton
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Alexandra Pitman
- Division of Psychiatry, University College London, London, United Kingdom
| | - Rob Bale
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - John R Geddes
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
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Hurtte E, Rogers BD, Richards C, Gyawali CP. The clinical value of psycho-gastroenterological interventions for functional esophageal symptoms. Neurogastroenterol Motil 2022; 34:e14315. [PMID: 34994058 DOI: 10.1111/nmo.14315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/09/2021] [Accepted: 12/21/2021] [Indexed: 12/10/2022]
Abstract
BACKGROUND Disorders of gut-brain interaction (DGBI) are associated with high symptom burden and poor quality of life. We evaluated the clinical value of multimodal therapy with psycho-gastroenterological interventions in patients with refractory functional symptoms. METHODS Of 80 DGBI patients managed over a 12-month period, 26 patients undergoing multimodal therapy (median age 60.0 years, 73.1%F) were compared to 54 patients (median age 56.0 years, 68.5%F) managed using conventional approaches. Psycho-gastroenterological multimodal therapy was individualized and included relaxation training (diaphragmatic breathing, passive muscle relaxation) and gut-direct hypnotherapy/guided imagery. All patients completed documentation of symptom frequency and severity using a 100 mm visual analog scale (VAS) and assessment of health-related quality of life (BEST score) before and following therapy. Data were analyzed to determine comparative change in symptom burden between the two cohorts. KEY RESULTS Baseline demographics and symptom burden were similar between the two treatment subgroups. While patients improved with both multimodal and conventional therapies, BEST score demonstrated greater improvement with multimodal therapy (p = 0.03). Physician perception of symptom burden at baseline and on follow-up did not correspond to self-reported questionnaire data. On multivariable analysis, multimodal therapy (OR 7.9, 95% CI 1.8-34.6, p = 0.006) and functional esophageal disorders (OR 17.6, 95% CI 2.6-121.1, p = 0.004) predicted >50% improvement in BEST score, while the presence of psychiatric disease was a negative predictor (OR 0.22, CI 0.05-0.94, p = 0.04). CONCLUSIONS & INFERENCES Psychological intervention using multimodal therapy provides clinical value to the management of functional esophageal symptoms among patients refractory to conventional therapy.
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Affiliation(s)
- Edward Hurtte
- Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Benjamin D Rogers
- Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA.,Division of Gastroenterology, Hepatology, and Nutrition, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Cheryl Richards
- Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA
| | - C Prakash Gyawali
- Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA
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Carr A, Toloza C, Li Z, Nazar BP, Himmerich H. Therapy outcome of day treatment for people with anorexia nervosa before and during the COVID-19 pandemic. Brain Behav 2022; 12:e2604. [PMID: 35588369 PMCID: PMC9226813 DOI: 10.1002/brb3.2604] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 04/08/2022] [Accepted: 04/15/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE The current research aimed to compare clinical outcome measures of two National Eating Disorder (ED) Day Services at the Maudsley Hospital from before the COVID-19 lockdown, when treatment was face to face, with after the lockdown when treatment moved online. METHOD Clinical outcome measures collected as part of the admission and discharge process were compared from the beginning and end of treatment for patients treated either via face-to-face or online delivery. Twenty-nine patients' data were analyzed (89% of them female, 11% male, 89% from White ethnic backgrounds, 11% from BAME ethnic backgrounds and a mean age of 25.99 years). Additionally, the mean change in outcome measures was also compared between the two groups (pre-lockdown face to face and during lockdown online). RESULTS Treatment delivered face to face led to significant improvements in body mass index (BMI) but not in Eating Disorder Examination Questionnaire (EDEQ) Global and Work and Social Adjustment Scale (WSAS) Total scores. In contrast, treatment delivered online led to significant improvements in EDEQ Global and WSAS Total scores but not in BMI. Neither one of the delivery modalities created significantly larger mean changes in any of the clinical outcome measures than the other. CONCLUSIONS Both face-to-face and online delivery of eating disorder day treatment show some success. Suggested improvements for using online delivery of treatment include implementing additional support opportunities, adapting the online format to improve communication and commitment and using a hybrid model of specific face-to-face elements with some online treatment.
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Affiliation(s)
- Anna Carr
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Cindy Toloza
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Zhuo Li
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Hubertus Himmerich
- South London and Maudsley NHS Foundation Trust, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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28
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Gorrell S, Reilly EE, Brosof L, Le Grange D. Use of Telehealth in the Management of Adolescent Eating Disorders: Patient Perspectives and Future Directions Suggested from the COVID-19 Pandemic. Adolesc Health Med Ther 2022; 13:45-53. [PMID: 35401019 PMCID: PMC8992734 DOI: 10.2147/ahmt.s334977] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/26/2022] [Indexed: 01/13/2023] Open
Abstract
Efforts to increase accessibility of eating disorder (ED) treatment via telemedicine have been ongoing for the past decades. However, there has been a recent surge in research focused on remote delivery of interventions since the onset of the novel coronavirus pandemic (COVID-19) in 2020, the related lockdowns, and an exponential increase in ED symptoms in youth secondary to the pandemic worldwide. In the current review, we provide a focused summary of existing literature regarding telehealth for the treatment of EDs in adolescents using a frame of past, present, and future work. Specifically, we begin with a brief overview of research in remote delivery for EDs in youth prior to 2020. Then, we detail more recent studies in this domain, with a focus on research conducted during the COVID-19 pandemic. We close by outlining limitations of the existing data and future steps necessary to expand the rigor and impact of this work. Overall, there are considerable limitations associated with research conducted during the pandemic, but an increase in the acceptability of remote delivery methods and interest in hybrid care appears to be feasible, and likely to be lasting. Future work must replicate more recent research in non-pandemic contexts and prioritize evaluation of factors that will aid in matching patients to the most efficient and effective modalities of care moving forward.
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Affiliation(s)
- Sasha Gorrell
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Erin E Reilly
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Psychology, Hofstra University, Hempstead, NY, USA
| | - Leigh Brosof
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Neurosciences, The University of Chicago (Emeritus), Chicago, IL, USA
- Correspondence: Daniel Le Grange, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA, Email
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Building and Realizing the Obstetrics and Gynecology Nursing Management Platform by Computer Information Technology under the Concept of Mindfulness Intervention. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:6297934. [PMID: 35356622 PMCID: PMC8959969 DOI: 10.1155/2022/6297934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/05/2022] [Accepted: 01/17/2022] [Indexed: 11/17/2022]
Abstract
Nursing management of the gynecology department is one of the challenging issues and needed to be resolved through effective utilization of the available technology. In this paper, we are going to address this issue and try to establish an obstetrics and gynecology nursing management platform used to monitor and evaluate the mental health of pregnant women. Firstly, computer information technology is adopted, and the obstetrics and gynecology nursing management system is established. Secondly, after adopting the system to intervene in the mental state of patients with mindfulness, the system timely monitors the pregnant women's physical health indicators and mental health level data. With the help of the computer data analysis system, the obstetrics and gynecology management platform is built to carry out timely mindfulness interventions for pregnant women. The established system can reach high accuracy in identifying negative emotions of pregnant women, and the accuracy can reach 89.7%. It shows that the established system can timely and accurately intervene and regulate the pregnant woman's bad psychological state, effectively improve the pregnant woman's sleep quality during pregnancy, and enhance the pregnant woman's sleep effect. The effectiveness and feasibility of Internet mindfulness interventions for improving sleep quality during pregnancy has been confirmed. This has important practical significance for the digital and intelligent development of the medical care management platform.
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30
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Clough B, Yousif C, Miles S, Stillerova S, Ganapathy A, Casey L. Understanding client engagement in digital mental health interventions: An investigation of the eTherapy Attitudes and Process Questionnaire. J Clin Psychol 2022; 78:1785-1805. [PMID: 35266551 PMCID: PMC9546019 DOI: 10.1002/jclp.23342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 02/16/2022] [Accepted: 02/25/2022] [Indexed: 12/02/2022]
Abstract
Aims Digital mental health services may increase the accessibility and affordability of mental health treatments. However, client dropout a low use is often reported. The purpose of the current study was to investigate the structural validity of the e‐Therapy Attitudes and Process (eTAP) questionnaire, as a theoretically based (theory of planned behavior) tool for understanding ongoing client engagement intentions with digital mental health treatments. The possible role of eHealth literacy in predicting behavioral intentions to use digital mental health treatments was also examined. Methods Participants were 244 Australian‐based adults aged between 18 and 56 years, who were currently using a digital mental health tool. Data were collected via online survey. Results Confirmatory Factor Analysis was conducted, with good model fit obtained following two theoretically supported modifications. Moderated hierarchical regression supported the utility of the theory of planned behavior in predicting behavioral intentions, with attitudes emerging as a strong and consistent individual predictor. No support was found for the moderating role or individual significance of eHealth literacy. Conclusions These findings support the clinical and research use of the eTAP as a theory‐based measure to understand client engagement in digital mental health interventions. The study also highlights the need for interventions to target attitudes to improve clients' ongoing engagement in digital mental health.
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Affiliation(s)
- Bonnie Clough
- School of Applied Psychology, Griffith University, Mount Gravatt, Queensland, Australia.,Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
| | - Christina Yousif
- School of Applied Psychology, Griffith University, Mount Gravatt, Queensland, Australia
| | - Sasha Miles
- School of Applied Psychology, Griffith University, Mount Gravatt, Queensland, Australia
| | - Sophia Stillerova
- School of Applied Psychology, Griffith University, Mount Gravatt, Queensland, Australia
| | - Aarthi Ganapathy
- School of Applied Psychology, Griffith University, Mount Gravatt, Queensland, Australia
| | - Leanne Casey
- School of Applied Psychology, Griffith University, Mount Gravatt, Queensland, Australia.,Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
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31
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Cuthbert K, Parsons EM, Smith L, Otto MW. Acceptability of telehealth CBT during the time of COVID-19: Evidence from patient treatment initiation and attendance records. JOURNAL OF BEHAVIORAL AND COGNITIVE THERAPY 2022; 32:67-72. [PMID: 35018352 PMCID: PMC8739019 DOI: 10.1016/j.jbct.2022.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/31/2021] [Accepted: 01/03/2022] [Indexed: 05/22/2023]
Abstract
The COVID-19 pandemic provided unique conditions for examining outpatient psychotherapy clinics' rapid transition to telehealth. The current study utilized data from a large, specialty CBT clinic to investigate attendance and treatment engagement changes when services were provided via telehealth versus in-person. Results indicate that, following a complete transition to telehealth services, clinic referrals were maintained. Further, telehealth treatment appeared to be entirely acceptable as assessed by a decreased missed visit rate of telehealth appointments compared to in-person appointments. Given the elimination of commuting times, telehealth has the potential to address disparities in care linked to physical distance from the clinic and/or differential ability to take time off work for appointments.
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Affiliation(s)
- Kristy Cuthbert
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Avenue, Floor 2, Boston, MA 02215, USA
| | - E Marie Parsons
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Avenue, Floor 2, Boston, MA 02215, USA
| | - Lisa Smith
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Avenue, Floor 2, Boston, MA 02215, USA
| | - Michael W Otto
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Avenue, Floor 2, Boston, MA 02215, USA
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Webb H, Dalton B, Irish M, Mercado D, McCombie C, Peachey G, Arcelus J, Au K, Himmerich H, Johnston AL, Lazarova S, Pathan T, Robinson P, Treasure J, Schmidt U, Lawrence V. Clinicians' perspectives on supporting individuals with severe anorexia nervosa in specialist eating disorder intensive treatment settings during the COVID-19 pandemic. J Eat Disord 2022; 10:30. [PMID: 35209957 PMCID: PMC8867458 DOI: 10.1186/s40337-022-00555-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 02/07/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has significantly affected intensive treatment settings (i.e., inpatient [IP] and day patient [DP]) in specialist eating disorder services. However, the impact on clinicians working in these services is largely unknown. We therefore explored the perspectives of those supporting individuals with severe anorexia nervosa (AN) in intensive treatment settings during the pandemic. METHODS Between May 2020 and June 2021, we interviewed clinicians (n = 21) who delivered IP and/or DP treatment to patients with severe AN in four specialist eating disorder services in the United Kingdom. Data relating to experiences during COVID-19 were analysed using reflexive thematic analysis. RESULTS We identified six themes: Disruptions to Routine Treatment; Introduction of Virtual Treatment; Separation from Treatment, Others and the World; Impact on Recovery; Impact on Staff; and Pressure on Referral Pathways. COVID-19 posed significant challenges to IP and DP services: forcing closures, operating with restrictions and virtual treatment, and impacting delivery of essential treatment components, referral pathways, clinician wellbeing, risk management, and patient isolation and recovery trajectories. Opportunities arose, in particular in DP services offering virtual support. CONCLUSIONS COVID-19 challenged the continuation of multidisciplinary treatment. The findings underline the necessity for medical, psychological, practical, and nutritional support, as well as carer involvement and fostering social connections to remain at the forefront of intensive treatment for severe AN. They also emphasise the uncertainty surrounding which intensive treatment may be best suited to which patient when, particularly within the context of virtual DP support.
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Affiliation(s)
- Hannah Webb
- PO59 Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Bethan Dalton
- PO59 Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Madeleine Irish
- PO59 Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Daniela Mercado
- PO59 Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Catherine McCombie
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gemma Peachey
- South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK
| | - Jon Arcelus
- Institute of Mental Health, University of Nottingham, Jubilee Campus, Triumph Road, Nottingham, NG7 2TU, UK
| | - Katie Au
- South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK
| | - Hubertus Himmerich
- PO59 Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK
| | | | | | - Tayeem Pathan
- Surrey and Boarder Partnership, NHS Foundation Trust, Surrey, UK
| | - Paul Robinson
- Division of Medicine, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Janet Treasure
- PO59 Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK
| | - Ulrike Schmidt
- PO59 Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK. .,South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK.
| | - Vanessa Lawrence
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Kartini Y, Faizah I, Nursalam N, Ahsan A, Sari RY. Carative Caring and Cognitive Behavior Therapy on Self Efficacy and Self Care of Covid-19 Patients. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: The COVID-19 pandemic in Indonesia is increasing in which it has an impact on psychosocial conditions for everyone. COVID-19 patients feel low and afraid because of without family assistance while being treated in the room so that the patient's self-efficacy and confidence decrease in carrying out patient self-care.
Objective: This study aims to analyze the effect of giving carative caring and cognitive behavioral therapy on self-efficacy and self-care for COVID-19 patients.
Methods: The sampling technique used consecutive sampling to determine the sample according to the inclusion and exclusion criteria, with a total sample of 106 respondents who were divided into 53 intervention groups and 53 control group respondents. The instruments used in this study were the caring behaviors assessment tool to measure carative caring. General self-efficacy was used to measure self-efficacy and exercise of self-care agency was used to measure self-care for COVID-19 patients. The data were analyzed using the t-test with a significant level of p<0.5.
Main Findings: The results showed that in the group the difference in the mean self-efficacy before and before the intervention was 10.17, while the difference in the mean of self-care before and after the intervention was 10.81. In the control group, the difference in the mean of self-efficacy before and after the intervention was 0.13, while the difference in the mean of self-care before and after the intervention was 0.02. Analysis of the data obtained showed that carative caring and cognitive-behavioral therapy had an effect on self-efficacy and self-care for COVID-19 patients with a p-value = 0.00.
Conclusion: Research that aims to analyze the effect of giving carative caring and cognitive behavioral therapy on self-efficacy and self-care for COVID-19 patients proves that carative caring and cognitive behavioral therapy have an effect on self-efficacy and self-care for COVID-19 patients.
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COVID 19 and Implementing E-Mental Health using the VRIO Strategic Planning Framework. INTERNATIONAL JOURNAL OF E-COLLABORATION 2022. [DOI: 10.4018/ijec.299005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Coronavirus has disrupted normalcy for communities and businesses across the globe. With massive shutdowns across the world, organizations were forced to assess their business operations and determine how to sustain in such turbulent times. Mental health clinics faced equivalent barriers as the structure of engaging with clients in a face to face setting was similarly disrupted. The implementation of e-mental health structures were clear targets of change as clinics needed to continue to serve the mentally fragile. Strategic planning calls for thoughtful collaboration, collection, and consideration of the necessary adaptations to meet the mission and vision of the organization. Strategic frameworks like the Value, Rarity, Imitability, and Organization are useful tools for mental health clinics to plan on shifting their operations from an in-person to a virtual environment.
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Bera L, Souchon M, Ladsous A, Colin V, Lopez-Castroman J. Emotional and Behavioral Impact of the COVID-19 Epidemic in Adolescents. Curr Psychiatry Rep 2022; 24:37-46. [PMID: 35102536 PMCID: PMC8803571 DOI: 10.1007/s11920-022-01313-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE OF REVIEW This review of the literature aims to explore the impact of the COVID-19 pandemic and the lockdown on teenagers' mental health. We distinguish two groups: adolescents who had already been diagnosed with a mental disorder and the general population of adolescents. RECENT FINDINGS An increase in the number of mental health-related difficulties in adolescents has already been reported in previous health crises. Accordingly, the perceived well-being of teenagers declined during the COVID-19 pandemic. Adolescents with mental disorders were significantly more affected by the lockdown than those in the general population. The effect of the COVID-19 crisis on the mental health of adolescents has been heterogeneous. The first pandemic wave was essentially associated with an increase of internalizing symptoms in adolescents, particularly anxiety, depression and eating disorders. The impact on externalizing symptoms was less clear, and seem to concern mostly adolescents with pre-existing behavioral disorders. During the second and later waves of the pandemic, an upsurge of suicidal ideation and attempts among adolescents have been reported in many countries.
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Affiliation(s)
- Laure Bera
- Département de psychiatrie, CHU Nîmes, Nîmes, France
| | | | | | - Vincent Colin
- Département de psychiatrie, CHU Nîmes, Nîmes, France
| | - Jorge Lopez-Castroman
- Département de psychiatrie, CHU Nîmes, Nîmes, France. .,IGF, CNRS-INSERM, Montpellier, France. .,University of Montpellier, Montpellier, France.
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Christensen KA, Hagan KE, Forbush KT. Clinical science can address rising eating disorder psychopathology during the COVID-19 pandemic: Comment on Gruber et al. (2020). AMERICAN PSYCHOLOGIST 2022; 77:140-142. [PMID: 35357857 PMCID: PMC8988432 DOI: 10.1037/amp0000765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Eating disorders (EDs) are serious psychiatric disorders that affect 13%-18% of young men and women. EDs are associated with substantial psychiatric and medical morbidity and mortality, indicating a critical need for improved identification and treatment. Despite the relatively high prevalence and severity of EDs, they are often omitted from discussions of mental health. This comment is in response to Gruber et al. (2020), who wrote an important article on the challenges and opportunities facing clinical scientists in the time of COVID-19. Our response extends Gruber et al.'s article by noting additional challenges facing people with an ED during COVID-19 and recognizing opportunities for improved evidence-based assessment and treatment of this important population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | - Kelsey E. Hagan
- Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York City, NY USA
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Albano G, Bonfanti RC, Gullo S, Salerno L, Lo Coco G. The psychological impact of COVID-19 on people suffering from dysfunctional eating behaviours: a linguistic analysis of the contents shared in an online community during the lockdown. RESEARCH IN PSYCHOTHERAPY (MILANO) 2021; 24:557. [PMID: 35047429 PMCID: PMC8715260 DOI: 10.4081/ripppo.2021.557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/08/2021] [Indexed: 12/15/2022]
Abstract
The coronavirus disease 2019 (COVID-19) spread several months ago from China and it is now a global pandemic. The experience of lockdown has been an undesirable condition for people with mental health problems, including eating disorders. The present study has the aim of understanding the impact of the first wave of the COVID-19 pandemic on people with selfreported disordered eating behaviours. A linguistic analysis was carried out with regard to the online posts and comments published by 1971 individuals (86% women) in a Facebook online community focusing on EDs during the lockdown. A total of 244 posts and 3603 comments were collected during the 56 days of lockdown (from the 10th of March until the 4th of May 2020) in Italy and were analysed by Linguistic Inquiry and Word Count (LIWC) software. The results showed that words related to peer support decreased in posts over time, and that anxiety and anger increased in the published comments. Moreover, greater feelings of negativity and anxiety were found in posts and comments throughout the COVID-19 pandemic, as well as lesser use of words related to positive emotions. Thematic qualitative analysis revealed eight themes that described the main subjective components of ED symptomatology and distress during the first COVID-19 lockdown. The current findings can help in delivering tailored treatments to people with eating disorders during the COVID-19 pandemic.
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Affiliation(s)
- Gaia Albano
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Rubinia Celeste Bonfanti
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Salvatore Gullo
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Laura Salerno
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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Mannino G, Salerno L, Bonfanti RC, Albano G, Lo Coco G. The impact of Facebook use on self-reported eating disorders during the COVID-19 lockdown. BMC Psychiatry 2021; 21:611. [PMID: 34876064 PMCID: PMC8651245 DOI: 10.1186/s12888-021-03628-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/02/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The social isolation due to the COVID-19-related lockdown has had an impact on social media consumption around the world. This study examines the relationship between fear of COVID-19, Facebook use and disordered eating. METHODS Structural Equation Modeling was used to analyse two-wave survey data (T0: Italian first lockdown; T1: after two months) during the pandemic. Young adults with self-reported dysfunctional eating behaviors (N = 115; 91.3% females; mean age = 28.60 ± 7.31) were recruited to complete an online survey at T0; 66 participants (92.4% females; mean age = 28.85 ± 7.85) completed the survey at T1. They were assessed on Facebook use, dysfunctional eating cognitions, and fear of COVID-19. RESULTS Participants' disordered eating cognitions increased during the pandemic. At T0, higher fear of COVID-19 was positively associated to time spent on Facebook, which in turn predicted disordered eating cognitions at T1. Moreover, maladaptive Facebook use mediated the relationship between daily time on Facebook and Shape concerns. CONCLUSIONS The findings of this study suggest an influence of dysfunctional Facebook use in increasing disordered eating cognitions during the pandemic.
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Affiliation(s)
| | - Laura Salerno
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Viale delle Scienze, Edificio 15, 90128, Palermo, Italy.
| | - Rubinia Celeste Bonfanti
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Viale delle Scienze, Edificio 15, 90128, Palermo, Italy
| | - Gaia Albano
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Viale delle Scienze, Edificio 15, 90128, Palermo, Italy
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Viale delle Scienze, Edificio 15, 90128, Palermo, Italy
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Abraham A, Jithesh A, Doraiswamy S, Al-Khawaga N, Mamtani R, Cheema S. Telemental Health Use in the COVID-19 Pandemic: A Scoping Review and Evidence Gap Mapping. Front Psychiatry 2021; 12:748069. [PMID: 34819885 PMCID: PMC8606591 DOI: 10.3389/fpsyt.2021.748069] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/15/2021] [Indexed: 01/07/2023] Open
Abstract
Background: The COVID-19 pandemic has highlighted telemedicine use for mental illness (telemental health). Objective: In the scoping review, we describe the scope and domains of telemental health during the COVID-19 pandemic from the published literature and discuss associated challenges. Methods: PubMed, EMBASE, and the World Health Organization's Global COVID-19 Database were searched up to August 23, 2020 with no restrictions on study design, language, or geographical, following an a priori protocol (https://osf.io/4dxms/). Data were synthesized using descriptive statistics from the peer-reviewed literature and the National Quality Forum's (NQF) framework for telemental health. Sentiment analysis was also used to gauge patient and healthcare provider opinion toward telemental health. Results: After screening, we identified 196 articles, predominantly from high-income countries (36.22%). Most articles were classified as commentaries (51.53%) and discussed telemental health from a management standpoint (86.22%). Conditions commonly treated with telemental health were depression, anxiety, and eating disorders. Where data were available, most articles described telemental health in a home-based setting (use of telemental health at home by patients). Overall sentiment was neutral-to-positive for the individual domains of the NQF framework. Conclusions: Our findings suggest that there was a marked growth in the uptake of telemental health during the pandemic and that telemental health is effective, safe, and will remain in use for the foreseeable future. However, more needs to be done to better understand these findings. Greater investment into human and financial resources, and research should be made by governments, global funding agencies, academia, and other stakeholders, especially in low- and middle- income countries. Uniform guidelines for licensing and credentialing, payment and insurance, and standards of care need to be developed to ensure safe and optimal telemental health delivery. Telemental health education should be incorporated into health professions curricula globally. With rapidly advancing technology and increasing acceptance of interactive online platforms amongst patients and healthcare providers, telemental health can provide sustainable mental healthcare across patient populations. Systematic Review Registration: https://osf.io/4dxms/.
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Affiliation(s)
- Amit Abraham
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Anupama Jithesh
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | | | | | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
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Mishna F, Milne B, Sanders J, Greenblatt A. Social Work Practice During COVID-19: Client Needs and Boundary Challenges. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2021; 9:113-120. [PMID: 34754722 PMCID: PMC8569291 DOI: 10.1007/s40609-021-00219-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/25/2021] [Indexed: 06/13/2023]
Abstract
While information and communication technologies (ICTs) permeated social work practice long before the onset of COVID-19, the abrupt need to close non-essential workplaces resulted in an unparalleled incorporation of digital technology into practice across the globe. The onset of COVID-19 occurred during phase two of research in which we were investigating social workers' informal use of ICT with clients. Prior to COVID-19, we were conducting interviews with practitioners and clients from four agencies serving diverse client populations in a large city in Canada. With the onset of COVID-19, we adapted to the COVID-19 context and amended the questions to investigate ICT use during the pandemic. In addition, with ethics approval, we conducted second interviews with practitioners interviewed prior to COVID-19 with a revised guide to address the pandemic context; and we continued to recruit and interview practitioners and clients using an amended interview guide incorporating pandemic-related questions. The sample comprised 27 practitioners and 22 clients. Eleven practitioners participated in interviews prior to and during COVID-19. Analysis of transcribed interviews revealed that the COVID-19 context had led to a paradigm shift in practitioners' ICT use, with two key themes identified: (1) boundary challenges and (2) clients' diverging ICT needs. We discuss these themes and present implications for policy and practice in a post-COVID-19 world.
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Affiliation(s)
- Faye Mishna
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON M5S 1V4 Canada
| | - Betsy Milne
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON M5S 1V4 Canada
| | - Jane Sanders
- Present Address: School of Social Work, King’s University College at Western University, London, ON Canada
| | - Andrea Greenblatt
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON M5S 1V4 Canada
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41
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Sideli L, Lo Coco G, Bonfanti RC, Borsarini B, Fortunato L, Sechi C, Micali N. Effects of COVID-19 lockdown on eating disorders and obesity: A systematic review and meta-analysis. EUROPEAN EATING DISORDERS REVIEW 2021; 29:826-841. [PMID: 34460991 PMCID: PMC8652707 DOI: 10.1002/erv.2861] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/27/2021] [Accepted: 08/09/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to examine: the pooled prevalence of symptomatic behaviours and mental health deterioration amongst individuals with eating disorders (EDs) and obesity during the COVID-19 confinement. Moreover, we examined changes in EDs and distress before and during the confinement, and the association between psychosocial factors and EDs symptoms. METHOD A systematic search was carried out in biomedical databases from January 2020 to January 2021. Both cross-sectional and longitudinal studies that used quantitative measures of ED symptoms and psychological distress during and after the COVID-19 confinement were included. RESULTS A total of 26 studies met inclusion criteria (n = 3399, 85.7% female). The pooled prevalence of symptomatic deterioration in EDs was 65% (95% CI[48,81], k = 10). The pooled prevalence of increased weight in obesity was 52% (95% CI[25,78], k = 4). More than half of the participants experienced depression and anxiety. Moreover, at least 75% of the individuals with EDs reported shape and eating concerns, and increased thinking about exercising. However, the pooled analyses of longitudinal studies showed no significant differences from pre-pandemic levels to the first lockdown phase in Body Mass Index and ED symptoms, whereas only few studies suggested increased distress, particularly among individuals with anorexia nervosa. CONCLUSIONS The majority of individuals with EDs and obesity reported symptomatic worsening during the lockdown. However, further longitudinal studies are needed to identify vulnerable groups, as well as the long-term consequences of COVID-19.
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Affiliation(s)
- Lucia Sideli
- Department of Human ScienceLUMSA UniversityRomeItaly
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human MovementUniversity of PalermoPalermoItaly
| | - Rubinia Celeste Bonfanti
- Department of Psychology, Educational Science and Human MovementUniversity of PalermoPalermoItaly
| | - Bianca Borsarini
- Department of PsychiatryFaculty of MedicineUniversity of GenevaGenevaSwitzerland
| | - Lucia Fortunato
- Department of Psychology, Educational Science and Human MovementUniversity of PalermoPalermoItaly
| | - Cristina Sechi
- Department of Pedagogy, Psychology, PhilosophyUniversity of CagliariCagliariItaly
| | - Nadia Micali
- Department of PsychiatryFaculty of MedicineUniversity of GenevaGenevaSwitzerland
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Abstract
PURPOSE OF REVIEW This review summarizes recent developments in cognitive-behavioural therapy for eating disorders (CBT-ED). More specifically, the past five years were covered, with the latest UK and Dutch guidelines for eating disorders as a starting benchmark, and with special consideration of the past 18 months. RECENT FINDINGS The new research can be divided into findings that have: (1) reinforced our existing understanding of CBT-ED's models and impact; (2) advanced our understanding and the utility of CBT-ED, including its application for the 'new' disorder Avoidant/Restrictive Food Intake Disorder (ARFID); (3) suggested new directions, which require further exploration in clinical and research terms. These include learning from the circumstances of the COVID-19 pandemic. SUMMARY CBT-ED has developed substantially in the past 5 years, with consolidation of its existing evidence base, further support for real-life implementation, extension of methods used, and the development of new approaches for working with younger people - particularly in the form of treatments for ARFID. Over the past 18 months, even more promising changes in delivery occurred in response to the COVID19 pandemic, showing that we can adapt our methods in order to work effectively via remote means. Challenges remain regarding poor outcomes for anorexia nervosa.
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Affiliation(s)
- Sandra Mulkens
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine, and Life Sciences, School for Mental Health and Neuroscience
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Glenn Waller
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
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Gibbs V, Cai RY, Aldridge F, Wong M. Autism assessment via telehealth during the Covid 19 pandemic: Experiences and perspectives of autistic adults, parents/carers and clinicians. RESEARCH IN AUTISM SPECTRUM DISORDERS 2021; 88:101859. [PMID: 34512797 PMCID: PMC8421202 DOI: 10.1016/j.rasd.2021.101859] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 08/19/2021] [Accepted: 08/30/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND The COVID-19 pandemic has seen a rapid increase in the use of telehealth to deliver services to autistic individuals and their families. Research into the provision of autism assessments via telehealth is limited and few studies have explored clinician perspectives of conducting diagnostic assessments for autism in this way. The objective of this study was to examine the acceptability of a new telehealth model from the perspective of key stakeholder groups in an Australian community-based sample i.e. clients undergoing assessment, parent/carers and expert clinicians. METHODS Sixteen adult clients (M age = 39.00, SD age = 14.39) and fifty-six parent/carers of children and adults (M age = 44.09, SD age = 9.87) undergoing autism assessments completed an online survey about their experiences of assessments via telehealth. Of these, six clients and twelve parent/carers agreed to participate in follow up interviews. Seven clinicians were also interviewed. RESULTS In this study, the majority of adults and parent/carers reported that they, or the person they cared for, felt comfortable interacting with the clinician, would be willing to undergo future assessments via telehealth and were not concerned that important information had been missed during the assessment. Although the clinicians were slightly less satisfied with tele-assessment process compared to face-to-face and relied on external sources of information more than they would during a face-to-face assessment, their overall confidence in their diagnostic decision making remained high. CONCLUSION Autism assessment via telehealth may be an acceptable alternative in some circumstances. However, a telehealth service should consider screening clients for suitability and adequately preparing clients for tele-assessments.
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Affiliation(s)
- Vicki Gibbs
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, Sydney, Australia
| | - Ru Ying Cai
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, Sydney, Australia
| | - Fiona Aldridge
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, Sydney, Australia
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Shpigelman CN, Tal A, Zisman-Ilani Y. Digital Community Inclusion of Individuals With Serious Mental Illness: A National Survey to Map Digital Technology Use and Community Participation Patterns in the Digital Era. JMIR Ment Health 2021; 8:e28123. [PMID: 34546177 PMCID: PMC8493452 DOI: 10.2196/28123] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/21/2021] [Accepted: 06/25/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Despite the growing interest in developing and using mobile health (mHealth) and digital technologies in mental health, little is known about the scope and nature of virtual community inclusion. OBJECTIVE The overarching goal of this study was to understand and conceptualize virtual community inclusion of individuals with serious mental illness (SMI). Specific objectives of this study were as follows: (1) mapping the prevalence, trends, and experiences related to mHealth and digital technology use among individuals with SMI; (2) comparing patterns of technology use by individuals with and those without SMI; and (3) examining whether use of mHealth and digital technologies predicts recovery among individuals with SMI. METHODS A web-based survey of technology use and virtual participation was developed and distributed among adults with and those without SMI via social media, national email discussion lists, nonprofit organizations, and advocacy groups. RESULTS A total of 381 adults aged 18 years or older participated in the survey, of whom 199 (52%) identified as having a SMI. Participants with SMI reported significantly greater access to technology and significantly fewer days of face-to-face participation in community activities than those without SMI. Among participants with SMI, greater technology use was positively associated with positive emotions and significantly predicted recovery. CONCLUSIONS This study is the first to explore, map, and conceptualize virtual community inclusion among adults with SMI. Our findings indicate a gap in the literature and research on community inclusion and participation, and emphasize the need for virtual community inclusion, particularly during the COVID-19 pandemic and its future implications.
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Affiliation(s)
- Carmit Noa Shpigelman
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Amir Tal
- Beit Ekstein, Danel Group, Haifa, Israel
| | - Yaara Zisman-Ilani
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
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Rodríguez Guarin M, Gempeler Rueda J, Castro SM, Ospina MM, Villanueva Betancourth C, Amórtegui JP, Vázquez L. Feasibility and Acceptability of Comprehensive Virtual Treatment in Eating Disorders: Perspectives from Patients, Parents and Therapists During the COVID-19 Pandemic. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 52:S0034-7450(21)00145-1. [PMID: 34561106 PMCID: PMC8455243 DOI: 10.1016/j.rcp.2021.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 06/26/2021] [Accepted: 07/13/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Lockdowns and social distancing as a result of the COVID-19 pandemic have brought about the need to continue treatment virtually in patients with Eating Disorders (ED). OBJECTIVE To evaluate feasibility, acceptability and adherence to virtual treatment in patients, families and therapists. METHODS Fourteen patients, 10 family members and eight therapists from an intensive outpatient program for ED answered online surveys and a SWOT analysis was performed with the responses. RESULTS Virtual treatment during lockdown was considered feasible and useful by all respondents. Fear of contagion and the presence of parents in the home were identified as strengths. Parents reported problems with nutritional plan compliance, especially in anorexia patients. Therapists highlighted the importance of methodological adaptations in sessions to improve participation. Adherence to sessions was 100% for family members and 90% for patients. CONCLUSIONS Adaptation to a virtual program is a valid and useful option during lockdowns. It improves family participation, but does not replace face-to-face treatment.
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Affiliation(s)
| | - Juanita Gempeler Rueda
- Programa Equilibrio para trastornos alimentarios, afectivos y de ansiedad, Bogotá, Colombia
| | - Sergio Mario Castro
- Programa Equilibrio para trastornos alimentarios, afectivos y de ansiedad, Bogotá, Colombia
| | - María Mercedes Ospina
- Programa Equilibrio para trastornos alimentarios, afectivos y de ansiedad, Bogotá, Colombia
| | | | - Juan Pablo Amórtegui
- Programa Equilibrio para trastornos alimentarios, afectivos y de ansiedad, Bogotá, Colombia
| | - Laura Vázquez
- Programa Equilibrio para trastornos alimentarios, afectivos y de ansiedad, Bogotá, Colombia
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Raykos BC, Erceg-Hurn DM, Hill J, Campbell BNC, McEvoy PM. Positive outcomes from integrating telehealth into routine clinical practice for eating disorders during COVID-19. Int J Eat Disord 2021; 54:1689-1695. [PMID: 34184797 DOI: 10.1002/eat.23574] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 06/18/2021] [Accepted: 06/19/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND The coronavirus pandemic (COVID-19) has required telehealth to be integrated into the delivery of evidence-based treatments for eating disorders in many services, but the impact of this on patient outcomes is unknown. OBJECTIVE The present study examined the impact of the first wave of COVID-19 and rapid transition to telehealth on eating disorder symptoms in a routine clinical setting. METHOD Participants were 25 patients with a confirmed eating disorder diagnosis who had commenced face-to-face treatment and rapidly switched to telehealth during the first wave of COVID-19 in Western Australia. Eating disorder symptoms, clinical impairment and mood were measured prospectively before and during lockdowns imposed due to COVID-19. HYPOTHESES We predicted that patients would experience poorer treatment outcomes during COVID-19 and would perceive poorer therapeutic alliance and poorer quality of treatment compared to face-to-face therapy. RESULTS Our hypotheses were not supported. On average, patients achieved large improvements in eating disorder symptoms and mood, and the magnitude of improvement in eating disorder symptoms was comparable to historical benchmarks at the same clinic. Patients rated the quality of treatment and therapeutic alliance highly. DISCUSSION Providing evidence-based treatment for eating disorders via telehealth during COVID-19 lockdown is acceptable to patients and associated with positive treatment outcomes.
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Affiliation(s)
| | | | - James Hill
- Center for Clinical Interventions, Perth, Australia.,School of Psychology, University of Western Australia, Perth, Australia
| | | | - Peter M McEvoy
- Center for Clinical Interventions, Perth, Australia.,School of Population Health, Curtin University, Perth, Australia
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47
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Thomas JJ, Becker KR, Breithaupt L, Murray HB, Jo JH, Kuhnle MC, Dreier MJ, Harshman S, Kahn DL, Hauser K, Slattery M, Misra M, Lawson EA, Eddy KT. Cognitive-behavioral therapy for adults with avoidant/restrictive food intake disorder. ACTA ACUST UNITED AC 2021; 31:47-55. [PMID: 34423319 PMCID: PMC8375627 DOI: 10.1016/j.jbct.2020.10.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
There are currently no evidence-based treatments for adults with avoidant/restrictive food intake disorder (ARFID). The purpose of this study was to evaluate the acceptability, feasibility, and proof-of-concept of cognitive-behavioral therapy for ARFID (CBT-AR) for adults. Males and females (ages 18–55 years) were offered 20–30 outpatient sessions of CBT-AR delivered by one of five therapists. Of 18 eligible adults offered CBT-AR, 15 chose to participate and 14 completed treatment. All patients endorsed high ratings of treatment credibility and expected improvement after the first session, and 93% of completers provided high ratings of satisfaction at the conclusion of treatment. Therapists rated the majority (80%) of patients as “much improved” or “very much improved.” Based on intent-to-treat analyses, ARFID severity on the Pica, ARFID, and Rumination Disorder Interview (PARDI) showed a large and significant decrease from pre- to post-treatment; and patients incorporated a mean of 18.0 novel foods. The underweight subgroup (n = 4) gained an average of 11.38 pounds, showing a large and significant increase in mean BMI from the underweight to the normal-weight range. At post-treatment, 47% of patients no longer met criteria for ARFID. To our knowledge, this is the first prospective treatment study of ARFID in adults. The findings of this study provide preliminary evidence of feasibility, acceptability, and proof-of-concept of CBT-AR for heterogeneous presentations of ARFID in adults. Randomized controlled trials are needed to confirm these findings. ClinicalTrials.gov Identifier: NCT02963220.
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Affiliation(s)
- Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USA.,Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USA
| | - Kendra R Becker
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USA.,Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USA
| | - Lauren Breithaupt
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USA.,Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USA
| | - Helen Burton Murray
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USA.,Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USA.,Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Jenny H Jo
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USA.,Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457-B, Boston, MA 02114, USA
| | - Megan C Kuhnle
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USA.,Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457-B, Boston, MA 02114, USA
| | - Melissa J Dreier
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USA
| | - Stephanie Harshman
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USA.,Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USA.,Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457-B, Boston, MA 02114, USA
| | - Danielle L Kahn
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USA.,Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457-B, Boston, MA 02114, USA
| | - Kristine Hauser
- Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457-B, Boston, MA 02114, USA
| | - Meghan Slattery
- Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457-B, Boston, MA 02114, USA
| | - Madhusmita Misra
- Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457-B, Boston, MA 02114, USA.,Division of Pediatric Endocrinology, Massachusetts General Hospital, 175 Cambridge Street, Boston, MA 02114, USA.,Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA.,Department of Pediatrics, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Elizabeth A Lawson
- Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457-B, Boston, MA 02114, USA.,Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USA.,Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USA
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48
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Smith-MacDonald L, Jones C, Sevigny P, White A, Laidlaw A, Voth M, Mikolas C, Heber A, Greenshaw AJ, Brémault-Phillips S. The Experience of Key Stakeholders During the Implementation and Use of Trauma Therapy via Digital Health for Military, Veteran, and Public Safety Personnel: Qualitative Thematic Analysis. JMIR Form Res 2021; 5:e26369. [PMID: 34387549 PMCID: PMC8391743 DOI: 10.2196/26369] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/06/2021] [Accepted: 07/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background Exposure to occupational stressors and potentially psychologically traumatic events experienced by public safety personnel (eg, paramedics, police, fire, and correctional officers), military members, and veterans can lead to the development of posttraumatic stress injuries and other mental health disorders. Providing emergency services during COVID-19 has intensified the challenges. Owing to COVID-19 restrictions, mental health service providers offering support to these populations have had to rapidly pivot to use digital versus in-person methods of service delivery. Objective This paper aims to explore the experience of mental health service providers regarding digital health service delivery, including the current state of digital mental health service delivery, barriers to and facilitators of the use of digital health for mental health service delivery experienced during the pandemic, and recommendations for implementing and integrating digital health into regular mental health service delivery. Methods This embedded mixed-methods study included questionnaires and focus groups with key stakeholders (N=31) with knowledge and experience in providing mental health services. Data analysis included descriptive, quantitative, and qualitative thematic analyses. Results The following three themes emerged: being forced into change, daring to deliver mental health services using digital health, and future possibilities offered by digital health. In each theme, participants’ responses reflected their perceptions of service providers, organizations, and clients. The findings offer considerations regarding for whom and at what point in treatment digital health delivery is appropriate; recommendations for training, support, resources, and guidelines for digitally delivering trauma therapy; and a better understanding of factors influencing mental health service providers’ perceptions and acceptance of digital health for mental health service delivery. Conclusions The results indicate the implementation of digital health for mental health service delivery to military members, public safety personnel, and veterans. As the COVID-19 pandemic continues, remote service delivery methods for trauma therapy are urgently needed to support the well-being of those who have served and continue to serve.
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Affiliation(s)
- Lorraine Smith-MacDonald
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Chelsea Jones
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,1 Field Ambulance Physical Rehabilitation Department, Canadian Forces Health Services, Department of National Defense, Edmonton, AB, Canada.,Leiden University Medical Centre, Leiden University, Leiden, Netherlands
| | - Phillip Sevigny
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Department of Educational Psychology, Faculty of Education, University of Alberta, Edmonton, AB, Canada
| | - Allison White
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Alexa Laidlaw
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Melissa Voth
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Cynthia Mikolas
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Military Family Resource Centre, Edmonton, AB, Canada
| | - Alexandra Heber
- Health Professionals Division, Veterans Affairs Canada, Ottawa, ON, Canada.,Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Andrew J Greenshaw
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Suzette Brémault-Phillips
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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49
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Abstract
We discuss the use of tele-mental health in settings serving expectant parents in fetal care centers and parents with children receiving treatment in neonatal intensive care units within a pediatric institution. Our emphasis is on the dramatic rise of tele-mental health service delivery for this population in the wake of the onset of the COVID-19 pandemic in the U.S., including relevant practice regulations, challenges and advantages associated with the transition to tele-mental health in these perinatal settings.
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50
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Jenkins PE, Luck A, Violato M, Robinson C, Fairburn CG. Clinical and cost-effectiveness of two ways of delivering guided self-help for people with an eating disorder: A multi-arm randomized controlled trial. Int J Eat Disord 2021; 54:1224-1237. [PMID: 33998020 DOI: 10.1002/eat.23554] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 04/26/2021] [Accepted: 05/10/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Increasing the availability and accessibility of evidence-based treatments for eating disorders is an important goal. This study investigated the effectiveness and cost-effectiveness of guided self-help via face-to-face meetings (fGSH) and a more scalable method, providing support via email (eGSH). METHOD A pragmatic, randomized controlled trial was conducted at three sites. Adults with binge-eating disorders were randomized to fGSH, eGSH, or a waiting list condition, each lasting 12 weeks. The primary outcome variable for clinical effectiveness was overall severity of eating psychopathology and, for cost-effectiveness, binge-free days, with explorative analyses using symptom abstinence. Costs were estimated from both a partial societal and healthcare provider perspective. RESULTS Sixty participants were included in each condition. Both forms of GSH were superior to the control condition in reducing eating psychopathology (IRR = -1.32 [95% CI -1.77, -0.87], p < .0001; IRR = -1.62 [95% CI -2.25, -1.00], p < .0001) and binge eating. Attrition was higher in eGSH. Probabilities that fGSH and eGSH were cost-effective compared with WL were 93% (99%) and 51% (79%), respectively, for a willingness to pay of £100 (£150) per additional binge-free day. DISCUSSION Both forms of GSH were associated with clinical improvement and were likely to be cost-effective compared with a waiting list condition. Provision of support via email is likely to be more convenient for many patients although the risk of non-completion is greater.
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Affiliation(s)
- Paul E Jenkins
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.,Oxford Health NHS Foundation Trust, Oxford, UK
| | - Amy Luck
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Mara Violato
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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