Effect of Rational Emotive Behavior Therapy Program on Depressive Symptoms Among University Students with Blindness in Nigeria

A comparison of the effectiveness of cognitive behavioural interventions based on delivery features for elevated symptoms of depression in adolescents: A systematic review

Background

Depression is a public health problem and common amongst adolescents. Cognitive behavioural therapy (CBT) is widely used to treat adolescent depression but existing research does not provide clear conclusions regarding the relative effectiveness of different delivery modalities.

Objectives

The primary aim is to estimate the relative efficacy of different modes of CBT delivery compared with each other and control conditions for reducing depressive symptoms in adolescents. The secondary aim is to compare the different modes of delivery with regard to intervention completion/attrition (a proxy for intervention acceptability).

Search Methods

The Cochrane Depression, Anxiety and Neurosis Clinical Trials Register was searched in April 2020. MEDLINE, PsycInfo, EMBASE, four other electronic databases, the CENTRAL trial registry, Google Scholar and Google were searched in November 2020, together with reference checking, citation searching and hand-searching of two databases.

Selection Criteria

Randomised controlled trials (RCTs) of CBT interventions (irrespective of delivery mode) to reduce symptoms of depression in young people aged 10-19 years with clinically relevant symptoms or diagnosis of depression were included.

Data Collection and Analysis

Screening and data extraction were completed by two authors independently, with discrepancies addressed by a third author. CBT interventions were categorised as follows: group CBT, individual CBT, remote CBT, guided self-help, and unguided self-help. Effect on depressive symptom score was estimated across validated self-report measures using Hedges' g standardised mean difference. Acceptability was estimated based on loss to follow-up as an odds ratio. Treatment rankings were developed using the surface under the cumulative ranking curve (SUCRA). Pairwise meta-analyses were conducted using random effects models where there were two or more head-to-head trials. Network analyses were conducted using random effects models.

Main Results

Sixty-eight studies were included in the review. The mean age of participants ranged from 10 to 19.5 years, and on average 60% of participants were female. The majority of studies were conducted in schools (28) or universities (6); other settings included primary care, clinical settings and the home. The number of CBT sessions ranged from 1 to 16, the frequency of delivery from once every 2 weeks to twice a week and the duration of each session from 20 min to 2 h. The risk of bias was low across all domains for 23 studies, 24 studies had some concerns and the remaining 21 were assessed to be at high risk of bias. Sixty-two RCTs (representing 6435 participants) were included in the pairwise and network meta-analyses for post-intervention depressive symptom score at post-intervention. All pre-specified treatment and control categories were represented by at least one RCT. Although most CBT approaches, except remote CBT, demonstrated superiority over no intervention, no approaches performed clearly better than or equivalent to another. The highest and lowest ranking interventions were guided self-help (SUCRA 83%) and unguided self-help (SUCRA 51%), respectively (very low certainty in treatment ranking). Nineteen RCTs (3260 participants) were included in the pairwise and network meta-analyses for 6 to 12 month follow-up depressive symptom score. Neither guided self-help nor remote CBT were evaluated in the RCTs for this time point. Effects were generally attenuated for 6- to 12-month outcomes compared to posttest. No interventions demonstrated superiority to no intervention, although unguided self-help and group CBT both demonstrated superiority compared to TAU. No CBT approach demonstrated clear superiority over another. The highest and lowest ranking approaches were unguided self-help and individual CBT, respectively. Sixty-two RCTs (7347 participants) were included in the pairwise and network meta-analyses for intervention acceptability. All pre-specified treatment and control categories were represented by at least one RCT. Although point estimates tended to favour no intervention, no active treatments were clearly inferior. No CBT approach demonstrated clear superiority over another. The highest and lowest ranking active interventions were individual CBT and group CBT respectively. Pairwise meta-analytic findings were similar to those of the network meta-analysis for all analyses. There may be age-based subgroup effects on post-intervention depressive symptoms. Using the no intervention control group as the reference, the magnitudes of effects appear to be larger for the oldest age categories compared to the other subgroups for each given comparison. However, they were generally less precise and formal testing only indicated a significant difference for group CBT. Findings were robust to pre-specified sensitivity analyses separating out the type of placebo and excluding cluster-RCTs, as well as an additional analysis excluding studies where we had imputed standard deviations.

Authors' Conclusions

At posttreatment, all active treatments (group CBT, individual CBT, guided self-help, and unguided self-help) except for remote CBT were more effective than no treatment. Guided self-help was the most highly ranked intervention but only evaluated in trials with the oldest adolescents (16-19 years). Moreover, the studies of guided self-help vary in the type and amount of therapist support provided and longer-term results are needed to determine whether effects persist. The magnitude of effects was generally attenuated for 6- to 12-month outcomes. Although unguided self-help was the lowest-ranked active intervention at post-intervention, it was the highest ranked at follow-up. This suggests the need for further research into whether interventions with self-directed elements enable young people to maintain effects by continuing or revisiting the intervention independently, and whether therapist support would improve long-term outcomes. There was no clear evidence that any active treatments were more acceptable to participants than any others. The relative effectiveness of intervention delivery modes must be taken into account in the context of the needs and preferences of individual young people, particularly as the differences between effect sizes were relatively small. Further research into the type and amount of therapist support that is most acceptable to young people and most cost-effective would be particularly useful.

Effect of a religious coping intervention of rational emotive behavior therapy on mental health of adult learners with type II diabetes

BACKGROUND

Some previous studies have highlighted the high rate of mental health problems associated with type II diabetes (T2DM). The primary purpose of this study was to investigate the effect of a religious coping intervention of rational emotive behavior therapy (REBT) on the mental health of adult learners with T2DM.

METHODS

This study utilized a randomized controlled trial to select 146 adult learners with T2DM and mental health-related problems. The treatment group was made up of 73 adult learners, while the control group was also made up of 73 adult learners. The experimental group received 8 sessions of a religious coping intervention of REBT, while the control group received usual care. Data were collected using the patient health questionnaire, Warwick-Edinburgh mental well-being scale, and Kessler psychological distress scale. Repeated ANOVA and univariate analysis of covariance were used for data analyses.

RESULTS

The religious coping intervention of REBT substantially enhanced the mental health of adult learners with T2DM as measured by Warwick-Edinburgh mental well-being scale (P < .000) and patient health questionnaire (P < .000). The religious coping intervention of REBT significantly alleviated the psychological distress of adult learners with T2DM as measured by Kessler psychological distress scale (P < .000).

CONCLUSION

In this study, it has been demonstrated that a religious coping intervention of REBT effectively improves the mental health of adult learners with T2DM. The study concludes that the religious coping intervention of REBT is a practical alternative medicine approach to enhancing the mental health of adult learners with T2DM.

Examining the impact of randomized control intervention on depressive symptoms in schoolchildren with atypical behaviors

BACKGROUND

The need to investigate depression among disadvantaged groups motivated this study. This study investigated the impacts of rational emotive behavior therapy (REBT) on depressive symptoms in schoolchildren with atypical behaviors in Enugu State Nigeria.

METHOD

A group randomized controlled design was used to assign 37 schoolchildren to the intervention group and 37 schoolchildren to the waitlisted control group. These people were evaluated at three times (pretest, post-test, and later test) using a dependent measure. The outcome demonstrated that there was no discernible difference between the participants in the treatment group and those in the waitlisted control group at the time of the pretest. The post-treatment test results revealed a considerable improvement among participants as a result of REBT therapy.

RESULTS

The later test result revealed that the treatment's significant improvement was maintained in favor of the REBT group. The outcome of REBT treatment was not moderated due to location. The data showed a significant interaction impact on participants' depression levels in relation to the interaction between groups and gender during therapy.

CONCLUSION

Following the outcomes, we concluded that REBT is a long-term efficacious intervention for treating depressive symptoms in schoolchildren with atypical behaviors in Enugu State Nigeria regardless of location and gender.

Effectiveness of rational emotive behavior therapy in reducing depression among undergraduate medical students

BACKGROUND

Studies reporting the incidence of depression among medical students have been on the increase. This research sought to determine whether rational emotive behavior therapy (REBT) can be applied to help manage depression in Nigerian undergraduate medical students.

METHODS

A randomized pretest/posttest control group design was used in this study. Ninety medical students with depression participated in the study and were assisted using the REBT depression manual. Using a mixed-model repeated measures analysis of variance, the researchers examined the intervention data.

RESULTS

The depressive symptoms and its associated irrational beliefs among medical students in the treatment arm were significantly altered by REBT intervention at posttest and this positive outcome was sustained at follow-up in contrast to the control arm.

CONCLUSION

REBT intervention significantly improves medical students' ability to overcome depression and irrational beliefs. Similar studies could be conducted in a variety of academic settings where these students can be found to expand the findings of this study.

Intervention for depression among undergraduate religious education students: A randomized controlled trial

BACKGROUND

This research was designed to investigate the management of depression among undergraduate religious education students and identify the research implications for school-based religious intervention.

METHODS

This research is a randomized controlled trial. The treatment condition had 34 undergraduate religious education students but 33 undergraduate religious education students were in the control condition. The treatment process involved a 12-week application of religious rational emotive behavior therapy (RREBT). With Beck's depression inventory, version 2 (BDI-II), data collection was made possible.

RESULTS

Compared to students in the control condition, undergraduate religious education students in the treatment condition demonstrated a significant drop in mean BDI-II scores at post-test (F [1, 65] = 592.043, P < .05, η2p = .90). The effect of RREBT among students in the treatment condition stayed consistent at 2 weeks follow-up (F [1, 65] = 786.396, P < .05, η2p = .92, ΔR2 = .922).

CONCLUSION

The effect of RREBT on depression treatment among undergraduate religious education students was positive and can be consistent. The study results underscore the importance of expanding this treatment approach for these undergraduate education students in Nigeria.

Analysis and Research on the Rehabilitation Effect of Physical Exercise on College Students' Mental Depression Based on Multidimensional Data Mining

In order to explore the physical exercise and psychological changes of college students, this study adopts the method of multidimensional data mining, taking 23,146 undergraduates from a university in Guangzhou, Guangdong Province, as the research object. On the basis of summarizing and analyzing the previous research literature, this study expounds the development background, current situation, and future challenges of multidimensional data mining technology. This paper introduces the methods and principles of sample selection and multidimensional assessment of the physical and mental depression of college students, analyzes the physical health status of college students, summarizes the psychological changes of college students before and after the intervention, and discusses the relationship between physical exercise and mental health of college students. In addition, this paper analyzes the influencing factors and psychological changes of college students' physical exercise and puts forward suggestions for improving the physical and mental health of college students. The results of this study show that with increasing age, college students have a lower risk of moderate anxiety and mild depression; girls are more prone to mild depression than boys; rural college students are more prone to mild, moderate anxiety; college students with nonmedical backgrounds were more likely to experience moderate anxiety than college students with medical backgrounds. During the intervention control period, continuous connection with others may encourage college students to actively use internal resources to actively cope with obstacles and setbacks, and as a protective factor, psychological resilience can appropriately weaken the association between risk factors in life and anxiety and relieve anxiety. The results of this study can provide a reference for further research on the physical exercise and psychological changes of college students.

Managing social anxiety among undergraduate adult education and extra-mural studies students: An intervention study

BACKGROUND/OBJECTIVE

Anxiety is a significant problem affecting University students including undergraduate adult education and extra-mural studies students. This research evaluated the impact of a group rational-emotive behavioral education intervention (group rational-emotive behavioral education intervention [REBEI]) on social anxiety symptoms among undergraduate adult education and extra-mural studies students.

METHOD

Eighty six students participated in the study by belonging to either treatment group (n = 43) or control group (n = 43). A REBEI treatment program was developed by the researchers was used to implement the experiment and data was collected using a 22-item questionnaire on social anxiety. Analyzes of data were done using repeated measures ANOVA and paired t-test.

RESULTS

Results showed that despite the social anxiety experienced before exposure to the intervention, the social anxiety symptoms of the undergraduate adult education and extra-mural studies students in the treatment group reduced significantly at post-treatment and follow-up compared to students in the control group.

CONCLUSION

REBEI demonstrated its clinical usefulness in treating undergraduate adult education and extra-mural studies students with social anxiety problem.

Chronic disease interventions for people with visual impairment: A systematic review

AIM

To identify the characteristics of chronic disease interventions for people with visual impairment (PVI) and provide suggestions for future interventions.

BACKGROUND

Chronic diseases are more common in PVI than people without visual impairment, and PVI have difficulty managing chronic diseases due to physical, social, and psychological problems associated with visual impairment. However, evidence regarding chronic disease intervention for PVI is limited.

METHODS

This review was guided by the PRISMA methodology. Data were extracted and checked, and each study was evaluated to ensure their methodological quality using appropriate tools based on the study design. Findings were described through a qualitative synthesis, and the above process was carried out by all four researchers.

RESULTS

28 studies were selected. The intervention for mental disorders was the most common with about 39.3%, followed by stroke (25.0%), diabetes (17.8%), various chronic diseases (10.7%), chronic pain (3.6%), and scoliosis (3.6%). Most of the intervention was delivered individually, and the place of intervention often depends on the preference or convenience of PVI. A wide range of intervention materials was used, from large print, audio, or braille version reading materials to technology products. Based on the results, the main areas of the outcomes were daily living function, psychological conditions, and quality of life.

CONCLUSIONS

This review identified the components of interventions for PVI and provided intervention strategies. In particular, chronic disease interventions for PVI should be planned by considering how and where appropriate interventions are provided, various available materials, and the problems to be addressed.

Challenges with Institutional Support Services for Undergraduate Students with Visual Impairment in University of Nigeria Nsukka

PURPOSE

The purpose of this article was to discover available institutional support services for undergraduate students with visual impairment within the University of Nigeria, Nsukka. The study also examined challenges with institutional support services and the urgent need for sustainable social work services for undergraduate students with visual impairment.

METHOD

The study reports the result of a qualitative study using focus group discussion with 17 undergraduate students with visual impairment.

RESULT

Findings revealed discontent by the majority of study participants over institutional support services. Social work services were reported by study participants as invisible.

DISCUSSION

Based on the findings of our study, there is a need to develop sustainable social work services and also engage relevant stakeholders to improve on available support services for undergraduate students with visual impairment.

Impacts of cognitive behavior therapy on occupational stress among science and social science education facilitators in open and distance learning centers and its implications for community development: A randomized trial group

BACKGROUND

Extensive review of literature showed that no available study in Nigeria has explored the impact of cognitive behavior therapy (CBT) on the management of occupational stress among open and distance learning (ODL) centers science and social science education facilitators. Thus, this study determined the impacts of CBT on the management of occupational stress among science and social science education facilitators in ODL centers in South-South Nigeria.

METHODS

A randomized controlled trial experimental design was adopted for the study with a sample size of 68 science and social science education facilitators in ODL centers in South-South states, Nigeria. Perceived stress scale (PSS) and Occupational stress index (OSI) were used for data collection. Using Cronbach alpha method, internal consistency reliability indices of 0.81 and 0.85 for PSS and OSI respectively were obtained in the Nigerian context. A 12-week cognitive behavior therapy intervention was conducted after which the participants in both the intervention group and the non-intervention group were administered posttest, while a follow-up assessment was administered after 2 months. Data collected were analyzed using mixed-design repeated-measures analysis of variance for the within-groups and between-groups effects.

RESULTS

It was found that CBT intervention led to a significant decrease in the occupational stress among science and social science education facilitators in ODL in the South-South region of Nigeria.

CONCLUSION

Cognitive behavior therapy is effective in the management of occupational stress among science and social science education facilitators in distance learning centers.

Multidisciplinary visual rehabilitation in low- and middle-income countries: a systematic review

OBJECTIVE

To systematically review the evidence for effectiveness of rehabilitation interventions in people who are visually impaired, living in low- and middle-income countries.

METHODS

Fifteen databases and the grey literature were searched up until February 2020; papers were identified according to eligibility criteria, and assessed for risk of bias. Eligible studies were controlled trials (randomised or non-randomised) of rehabilitation interventions for blind or visually impaired adults or children from low- and middle-income countries. Possible outcomes included visual acuity, activities of daily living, safety, quality of life and psychological status.

RESULTS

Fifteen eligible studies were identified from India, Turkey, Nigeria, Croatia and Iran. Six studies were randomised, seven were non-randomised trials, and in two the method of allocation was not clear. Participants were adults, children and both adults and children. Seven studies were small (n ≤ 65) and examined the effect of training programmes. Remaining studies compared the effect of low vision aids, economic rehabilitation, goalball, rehabilitation compliance and service delivery methods, including one large four-arm randomised trial (n = 436). Studies measured a variety of outcomes, and mostly showed a positive effect of interventions for pre- and post-intervention assessment, although between intervention group comparisons were often inconclusive. Overall, only four studies had a low risk of bias.

CONCLUSIONS

A lack of high-quality evidence for rehabilitation interventions is a barrier to provision of low vision services in low- and middle-income countries. Future research should focus on establishing effectiveness and cost-effectiveness of devices and models of vision rehabilitation appropriate for low-resource settings.IMPLICATIONS FOR REHABILITATIONThe systematic review found a lack of high-quality evidence for rehabilitation interventions is a barrier to provision of low vision services in low- and middle-income countries.Consider how visual rehabilitation interventions which have been shown to be effective can be delivered by non-specialists.Ensure that service providers for people who are visually impaired are trained in recognising depression and anxiety and have pathways for referral to mental health services, as appropriate.

Intervention for depression among chemistry education undergraduates in a Nigerian university

Objective

We assessed the efficacy of a rational-emotive behaviour therapy psycho-educational programme in reducing depression among chemistry education undergraduates in a Nigerian university.

Methods

Twenty-three chemistry education undergraduates with major depressive disorder were randomised to a treatment group (12) or control group (11). Students were scored using Beck’s Depression Inventory three times (pre-test, post-treatment, and follow-up). An evidence-based protocol for combating depression was used in the treatment. Controls received counselling. Data were evaluated using univariate analysis of variance and two-way mixed analysis of variance.

Results

Mean depression scores did not differ between groups prior to the intervention. Rational-emotive behaviour therapy was effective in reducing depression scores.

Conclusion

Rational-emotive behaviour therapy is an effective tool in assisting university undergraduates (of chemistry education) to manage depression.

Rational-emotive behavioral intervention helped patients with cancer and their caregivers to manage psychological distress and anxiety symptoms

There is a dearth of evidence-based data on how psychological distress and death anxiety symptoms experienced by cancer patients and caregivers are treated in developing regions. This article sheds light on the report of the findings from a 2016 study that revealed a rational-emotive behavioral intervention helped a select group of cancer patients and their family caregivers to manage problematic assumptions, psychological distress, and death anxiety symptoms in Nigeria. Based on my experience as a co-investigator and corresponding author of this previous study, I addressed the challenges of conducting such a study and the implications for future research in this article. This article encourages future researchers to replicate the study and endeavor to overcome the limitations of the previous study. Funders were also encouraged to ensure increased access to funds for conducting similar studies with cancer patients and their family caregivers in developing countries and other parts of the world.