1
|
Kibbey MM, DiBello AM, Fedorenko EJ, Farris SG. Testing a brief, self-guided values affirmation for behavioral activation intervention during COVID-19. Cogn Behav Ther 2024; 53:544-560. [PMID: 38593029 PMCID: PMC11272427 DOI: 10.1080/16506073.2024.2339315] [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] [Received: 08/24/2023] [Accepted: 04/01/2024] [Indexed: 04/11/2024]
Abstract
This pilot study tested a single-session digital values affirmation for behavioral activation (VABA) intervention. Hypotheses predicted the VABA intervention would be more effective than an active control condition in improving mood, decreasing COVID-19 fear/worry and depressive symptoms, and promoting positively reinforcing behaviors during early weeks of the COVID-19 pandemic. Participants were a diverse sample of undergraduate students (N = 296) under a state-wide lockdown. Students were randomized to either VABA, a 10-min values clarification and affirmation task, or Control, a time- and attention-matched task. Positive and negative affects were assessed pre- and post-intervention. At next-day follow-up, positive and negative affects were reassessed, as well as past 24-h behavioral activation and depressive symptoms. Within-group increases in positive affect were observed in both conditions (VABA d = 0.39; Control d = 0.19). However, VABA produced a significantly larger increase than Control (F[2] = 3.856, p = .022, d = 0.22). At 24-h follow-up, behavioral activation, which was significantly higher in VABA versus Control (t[294] = -5.584, p < .001, d = 0.65), predicted fewer depressive symptoms (R2 change = .019, β = -.134, p = .003). VABA is an ultra-brief intervention that appears to have acute effects on mood-enhancement and behavioral activation.
Collapse
Affiliation(s)
- Mindy M Kibbey
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Angelo M DiBello
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Erick J Fedorenko
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Samantha G Farris
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| |
Collapse
|
2
|
Gurcan H, Couturier J, Matheson B, Jo B, Lock J. Protocol for a randomized clinical trial to confirm the effectiveness of online guided self-help family-based treatment for adolescent anorexia nervosa. Contemp Clin Trials 2024; 144:107618. [PMID: 38971303 PMCID: PMC11323053 DOI: 10.1016/j.cct.2024.107618] [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] [Received: 02/12/2024] [Revised: 06/17/2024] [Accepted: 07/03/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND The leading evidence-based treatment for anorexia nervosa (AN) in adolescents is Family-based Treatment (FBT). However, due to the intensive training requirements and lack of practitioners, it is often difficult for families to access FBT. Thus, innovations that improve access to care are needed. A pilot randomized study of a guided self-help version of Family-based Treatment (GSH-FBT) that utilized approximately 1/4 the amount of therapist time compared to FBT found that the approach was acceptable and appeared to achieve similar outcomes. The study protocol detailed in this manuscript compares the efficiency (clinician time) of GSH-FBT to Family-based Treatment via Videoconferencing (FBT-V) in a fully powered study in achieving clinical outcomes through a multi-site randomized clinical trial across the US and Ontario, Canada. METHODS This study will randomize the families of adolescents ages 12-18 (n = 200) who meet DSM-5 criteria for AN to receive either GSH-FBT or FBT-V. Participants will be randomized to 15 sixty-minute sessions of FBT-V or to 10 twenty-minute sessions of online GSH-FBT. Major assessments will be conducted by a masked assessor at baseline, within treatment, at the end of treatment (EOT), and 6 and 12 months after the end of treatment (EOT). The primary outcomes of this study are changes to body weight and eating disorder cognitions relative to clinician time used (relative efficiency of treatment modality). CONCLUSIONS The findings of this study may help increase access to care by providing a time efficient, affordable, more scalable intervention for adolescent AN compared to standard FBT.
Collapse
Affiliation(s)
- Hazal Gurcan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Jennifer Couturier
- Department of Psychiatry & Behavioural Neurosciences, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Brittany Matheson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Booil Jo
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - James Lock
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
| |
Collapse
|
3
|
Wang Q, Luan Y, Liu D, Dai J, Wang H, Zhang Y, Wang S, Dong X, Bi H. Guided self-help mindfulness-based intervention for increasing psychological resilience and reducing job burnout in psychiatric nurses: A randomized controlled trial. Int J Nurs Pract 2024; 30:e13204. [PMID: 37727093 DOI: 10.1111/ijn.13204] [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] [Received: 01/11/2023] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 09/21/2023]
Abstract
AIMS The present study aimed to explore the effects of a guided self-help mindfulness intervention on psychological resilience and job burnout among psychiatric nurses. BACKGROUND Psychiatric nurses work in challenging and potentially high stress settings. Mindfulness interventions can improve psychological resilience and reduce job burnout of nurses. However, face-to-face delivery of mindfulness interventions may be inconvenient for individuals. Guided self-help interventions may be more accessible. METHODS This randomized controlled trial was conducted from January to August 2022. One hundred and eighteen psychiatric nurses were randomized into the intervention and control groups. The individuals in the intervention group received an 8-week guided self-help mindfulness intervention, while the individuals in the control group received a psycho-educational brochure. The Five Facet Mindfulness Questionnaire, the Connor-Davidson Resilience Scale and the Maslach Burnout Inventory-Human Services Survey were used to evaluate the levels of mindfulness, psychological resilience and job burnout, respectively. RESULTS After an 8-week intervention, compared with the control group, the levels of mindfulness and psychological resilience were higher, while the level of job burnout was lower in the intervention group. CONCLUSIONS The guided self-help mindfulness intervention can improve psychological resilience and reduce job burnout among psychiatric nurses.
Collapse
Affiliation(s)
- Qi Wang
- Department of Psychiatry and Psychology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Yue Luan
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Dandan Liu
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Jiali Dai
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Haina Wang
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Yang Zhang
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Shuang Wang
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Xiaomei Dong
- Department of Psychiatry and Psychology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Hongsheng Bi
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| |
Collapse
|
4
|
Saberi S, Ahmadi R, Khakpoor S, Pirzeh R, Hasani M, Moradveisi L, Saed O. Comparing the effectiveness of behavioral activation in group vs. self-help format for reducing depression, repetitive thoughts, and enhancing performance of patients with major depressive disorder: a randomized clinical trial. BMC Psychiatry 2024; 24:516. [PMID: 39030505 PMCID: PMC11264713 DOI: 10.1186/s12888-024-05973-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 07/17/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND Behavioral activation has gained increasing attention as an effective treatment for depression. However, the effectiveness of Behavioral Activation Group Therapy (BAGT) in controlled conditions compared to its self-help programs requires more investigation. The present study aimed to compare their effectiveness on depressive symptoms, repetitive negative thinking (RNT), and performance in patients with major depressive disorder (MDD). METHODS In this randomized clinical trial, 40 patients diagnosed with Major Depressive Disorder (MDD) were recruited based on a structured clinical interview for DSM-5 (SCID-5). Participants were allocated to BAGT (n = 20) and self-help behavioral activation (SBA; n = 20) groups. BAGT received ten weekly sessions (90 min), while the SBA group followed the same protocol as the self-help intervention. Participants were evaluated at pre-treatment, post-treatment, and the 2-month follow-up using the Beck Depression Inventory-II (BDI-II), repetitive thinking questionnaire (RTQ-31), and work and social adjustment scale (WSAS). RESULTS The results of a Mixed ANOVA analysis revealed that participants who underwent BAGT showed significant improvement in depression, rumination, work, and social functioning post-treatment and at the 2-month follow-up. However, the SBA group did not show significant changes in any outcome. The study also found that, based on clinical significance, 68% of the BAGT participants were responsive to treatment, and 31% achieved a high final performance status at the 2-month follow-up. DISCUSSION BAGT was more effective than SBA in MDD patients. Participants' engagement with self-help treatment is discussed. TRIAL REGISTRATION The present trial has been registered in the Iranian Registry of Clinical Trials Center (IRCT ID: IRCT20181128041782N1|| http://www.irct.ir/ ) (Registration Date: 04/03/2019).
Collapse
Affiliation(s)
- Soleiman Saberi
- Department of Clinical Psychology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Reza Ahmadi
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahel Khakpoor
- Department of Clinical Psychology, School of Behavioural Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Reza Pirzeh
- Department of Psychiatry, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mohsen Hasani
- Department of Clinical Psychology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Latif Moradveisi
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Omid Saed
- Department of Clinical Psychology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
| |
Collapse
|
5
|
Bastoni S, van Lotringen CM, Kip H, Sanderman R, van Gemert-Pijnen LJEWC, van Dongen A. From theory to practice in implementation science: qualitative insights from the implementation model developed by a commercial eMental Health provider. Implement Sci Commun 2024; 5:72. [PMID: 38965581 PMCID: PMC11225237 DOI: 10.1186/s43058-024-00610-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 06/28/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Although eMental health interventions are a viable solution to address disparities in access to mental healthcare and increase its efficiency, they still face challenges of implementation. Literature highlights numerous barriers such as diffusion of responsibility and unclear expectations of what implementation entails might hinder this process. While research mostly focuses on analyzing these barriers, there is an urgent need to increase uptake in practice. In turn, commercial companies focus mostly on increasing uptake, while overlooking research outputs. To bridge the gap between research and practice, attention to how implementation occurs in practice is required. This study investigates "Make it Happen" (MiH), the implementation model developed by the eMental Health company Minddistrict, aiming to gain more insight into operationalizing implementation frameworks by 1) describing MiH and its conceptual underpinnings, and 2) gaining lessons learned from the development of MiH. Ultimately, this work aims at improving existing scientific frameworks by extending them with knowledge from practice. METHODS First, individual interviews and focus groups with Minddistrict implementation managers were performed. Second, individual interviews with project leads in mental healthcare organizations that were involved in the implementation of Minddistrict were conducted. Within Minddistrict, 7 implementation managers and account managers were involved, in addition to 11 project leads from mental healthcare organizations. Data were elaborated with thematic analysis. RESULTS A comprehensive description of MiH and its 5 main phases was achieved. During the 1) Onboarding phase, implementing organizations are guided by Minddistrict to build a team responsible for implementation, which then 2) designs patient and client journeys, 3) builds, tailors and configures their offer, 4) trains key-users and, 5) evaluates the success of implementation. All participants had extensive and aligned definitions and articulated expectations on implementation. Points of improvement for the model such as role ambiguity and excessive workload were identified. As strengths, internal motivation and good relationships with the provider were valued. CONCLUSION The present study highlights the importance of clear role division and stakeholder engagement in implementation processes, and suggest that a strong collaboration between companies and academia could optimize implementation efforts and ensure a better fit between humans, context, and technologies.
Collapse
Affiliation(s)
- Sofia Bastoni
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands.
| | - Charlotte Marijne van Lotringen
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Hanneke Kip
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
- Department of Research, Transfore, Deventer, Netherlands
| | - Robbert Sanderman
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, 9712, Groningen, The Netherlands
| | - Lisette J E W C van Gemert-Pijnen
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Anne van Dongen
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| |
Collapse
|
6
|
Zhong W, Luo J, Zhang H. The therapeutic effectiveness of artificial intelligence-based chatbots in alleviation of depressive and anxiety symptoms in short-course treatments: A systematic review and meta-analysis. J Affect Disord 2024; 356:459-469. [PMID: 38631422 DOI: 10.1016/j.jad.2024.04.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND The emergence of artificial intelligence-based chatbot has revolutionized the field of clinical psychology and psychotherapy, granting individuals unprecedented access to professional assistance, overcoming time constraints and geographical limitations with cost-effective convenience. However, despite its potential, there has been a noticeable gap in the literature regarding their effectiveness in addressing common mental health issues like depression and anxiety. This meta-analysis aims to evaluate the efficacy of AI-based chatbots in treating these conditions. METHODS A systematic search was executed across multiple databases, including PubMed, Cochrane Library, Web of Science, PsycINFO, and Embase on April 4th, 2024. The effect size of treatment efficacy was calculated using the standardized mean difference (Hedge's g). Quality assessment measures were implemented to ensure trial's quality. RESULTS In our analysis of 18 randomized controlled trials involving 3477 participants, we observed noteworthy improvements in depression (g = -0.26, 95 % CI = -0.34, -0.17) and anxiety (g = -0.19, 95 % CI = -0.29, -0.09) symptoms. The most significant benefits were evident after 8 weeks of treatment. However, at the three-month follow-up, no substantial effects were detected for either condition. LIMITATIONS Several limitations should be considered. These include the lack of diversity in the study populations, variations in chatbot design, and the use of different psychotherapeutic approaches. These factors may limit the generalizability of our findings. CONCLUSION This meta-analysis highlights the promising role of AI-based chatbot interventions in alleviating depressive and anxiety symptoms among adults. Our results indicate that these interventions can yield substantial improvements over a relatively brief treatment period.
Collapse
Affiliation(s)
- Wenjun Zhong
- Center for Studies of Education and Psychology of Ethnic Minorities in Southwest China, Southwest University, Chongqing, China
| | - Jianghua Luo
- Center for Studies of Education and Psychology of Ethnic Minorities in Southwest China, Southwest University, Chongqing, China.
| | - Hong Zhang
- Center for Psychological Health Education, Xinjiang University of Finance & Economics, Urumqi, Xinjiang, China
| |
Collapse
|
7
|
Postma MR, Vrancken S, Daemen M, Meulen IHVD, Volbragt N, Delespaul P, Haan LD, Pluijm MVD, Breedvelt JJF, Gaag MVD, Lindauer R, Berg DVD, Bockting C, Amelsvoort TV, Schwannauer M, Doi L, Reininghaus U. Working mechanisms of the use and acceptability of ecological momentary interventions: a realist evaluation of a guided self-help ecological momentary intervention targeting self-esteem. BMC Public Health 2024; 24:1633. [PMID: 38898412 PMCID: PMC11186172 DOI: 10.1186/s12889-024-19143-z] [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] [Received: 10/06/2023] [Accepted: 06/14/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Technology improves accessibility of psychological interventions for youth. An ecological momentary intervention (EMI) is a digital intervention geared toward intervening in daily life to enhance the generalizability and ecological validity, and to be able to intervene in moments most needed. Identifying working mechanisms of the use of ecological momentary interventions might generate insights to improve interventions. METHODS The present study investigates the working mechanisms of the use and acceptability of an ecological momentary intervention, named SELFIE, targeting self-esteem in youth exposed to childhood trauma, and evaluates under what circumstances these mechanisms of use and acceptability do or do not come into play. A realist evaluation approach was used for developing initial program theories (data: expert interviews and a stakeholders focus group), and subsequently testing (data: 15 interviews with participants, a focus group with therapists, debriefing questionnaire), and refining them. RESULTS The SELFIE intervention is offered through a smartphone application enabling constant availability of the intervention and thereby increasing accessibility and feasibility. When the intervention was offered on their personal smartphone, this enhanced a sense of privacy and less hesitance in engaging with the app, leading to increased disclosure and active participation. Further, the smartphone application facilitates the practice of skills in daily life, supporting the repeated practice of exercises in different situations leading to the generalizability of the effect. Buffering against technical malfunction seemed important to decrease its possible negative effects. CONCLUSIONS This study enhanced our understanding of possible working mechanisms in EMIs, such as the constant availability supporting increased accessibility and feasibility, for which the use of the personal smartphone was experienced as a facilitating context. Hereby, the current study contributes to relatively limited research in this field. For the field to move forward, mechanisms of use, and acceptability of EMIs need to be understood. It is strongly recommended that alongside efficacy trials of an EMI on specific target mechanisms, a process evaluation is conducted investigating the working mechanisms of use. TRIAL REGISTRATION The current paper reports on a realist evaluation within the SELFIE trial (Netherlands Trial Register NL7129 (NTR7475)).
Collapse
Affiliation(s)
- Mary Rose Postma
- Department of Psychiatry and Neuropychology, School for Mental Health and Neuroscience, Maastricht University, Vijverdalseweg 1, Maastricht, 6226 NB, the Netherlands.
- Mondriaan Mental Health Center, Heerlen, The Netherlands.
| | | | - Maud Daemen
- Department of Psychiatry and Neuropychology, School for Mental Health and Neuroscience, Maastricht University, Vijverdalseweg 1, Maastricht, 6226 NB, the Netherlands
| | | | - Nele Volbragt
- Department of Psychiatry and Neuropychology, School for Mental Health and Neuroscience, Maastricht University, Vijverdalseweg 1, Maastricht, 6226 NB, the Netherlands
| | - Philippe Delespaul
- Department of Psychiatry and Neuropychology, School for Mental Health and Neuroscience, Maastricht University, Vijverdalseweg 1, Maastricht, 6226 NB, the Netherlands
- Mondriaan Mental Health Center, Heerlen, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Centers (location AMC), Amsterdam, The Netherlands
| | - Marieke van der Pluijm
- Department of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Centers (location AMC), Amsterdam, The Netherlands
| | - Josefien Johanna Froukje Breedvelt
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, London, UK
| | - Mark van der Gaag
- Department of Clinical Psychology, VU University, Amsterdam, The Netherlands
| | - Ramon Lindauer
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, location Academic Medical Center, Amsterdam, The Netherlands
- Levvel, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - David van den Berg
- Department of Clinical Psychology, VU University, Amsterdam, The Netherlands
- Parnassia Academy, The Hague, The Netherlands
| | - Claudi Bockting
- Department of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Centers (location AMC), Amsterdam, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropychology, School for Mental Health and Neuroscience, Maastricht University, Vijverdalseweg 1, Maastricht, 6226 NB, the Netherlands
- Mondriaan Mental Health Center, Heerlen, The Netherlands
| | | | - Lawrence Doi
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Ulrich Reininghaus
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
- ESRC Centre for Society and Mental Health and Social Epidemiology Research Group, King's College London, London, UK
- Health Service and Population Research Department, Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| |
Collapse
|
8
|
Berry C, Fountain J, Forbes L, Bogen-Johnston L, Thomson A, Zylko Y, Tunks A, Hotham S, Michelson D. Developing a hope-focused intervention to prevent mental health problems and improve social outcomes for young women who are not in education, employment, or training (NEET): A qualitative co-design study in deprived coastal communities in South-East England. PLoS One 2024; 19:e0304470. [PMID: 38820387 PMCID: PMC11142577 DOI: 10.1371/journal.pone.0304470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 05/13/2024] [Indexed: 06/02/2024] Open
Abstract
Young women who are not in education, employment, or training (NEET) experience poorer health and social outcomes compared to non-NEET young women and to NEET young men, especially in deprived areas with intersecting inequalities. The evidence on effective public health approaches is scarce. Interventions that target hope, which NEET young women notably lack, offer a promising theory-driven and intuitive means to prevent mental health problems and improve social outcomes. Hope can be defined as a goal-focused mindset comprising self-agency (motivation and self-belief) and pathways (identifying routes to achieving goals). Hope is implicated in a variety of evidence-based psychosocial interventions for young people, but is not directly targeted by existing prevention programmes for NEET populations. The current study used a phased qualitative research design and participatory methods to model a hope-focused intervention for NEET young women. Phase 1 investigated population needs and intervention parameters through semi-structured interviews with 28 key informants living or working in disadvantaged coastal communities in South-East England. The sample comprised eight NEET young women, four family members, and 16 practitioners from relevant support organisations. Phase 2 refined intervention parameters and outcomes through co-design sessions with four NEET young women, followed by a theory of change workshop with 10 practitioners. The resulting intervention model is articulated as a mentor-supported, in-person psychosocial intervention that builds hope by enhancing positive sense of self and time spent in meaningful activities, before explicitly teaching the skills needed to identify, set, and pursue personally meaningful goals.
Collapse
Affiliation(s)
- Clio Berry
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, University of Brighton, Falmer, Brighton, United Kingdom
| | - Julia Fountain
- Research and Development, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Hove, United Kingdom
| | - Lindsay Forbes
- Centre for Health Services Studies, University of Kent, Canterbury, Kent, United Kingdom
| | | | - Abigail Thomson
- School of Psychology, University of Sussex, Falmer, Brighton, United Kingdom
| | - Yelena Zylko
- School of Psychology, University of Sussex, Falmer, Brighton, United Kingdom
| | - Alice Tunks
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, University of Brighton, Falmer, Brighton, United Kingdom
| | - Sarah Hotham
- Centre for Health Services Studies, University of Kent, Canterbury, Kent, United Kingdom
| | - Daniel Michelson
- School of Psychology, University of Sussex, Falmer, Brighton, United Kingdom
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King’s College London, London, United Kingdom
| |
Collapse
|
9
|
Sasaki N, Shimazu T, Takeno H, Ogawa S, Sawada U, Tsutsumi A, Imamura K. Implementation of an internet-based stress management program in micro- and small-sized enterprises: a study protocol for a pre-post feasibility study of the effectiveness-implementation hybrid type 2 trial. Pilot Feasibility Stud 2024; 10:56. [PMID: 38581058 PMCID: PMC10996202 DOI: 10.1186/s40814-024-01481-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/12/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Although internet-based stress management programs are proven effective in improving mental health among workers, micro- and small-sized enterprises (MSEs), lacking in occupational healthcare services, face challenges implementing them. To address this gap, this study will develop the program with stakeholders at MSEs to aim for real-world implementation. OBJECTIVES This paper describes a study protocol for a pre-post feasibility study of an effectiveness-implementation hybrid type 2 trial of text-based internet-based programs ("WellBe-LINE") in MSEs with less than 50 employees. This feasibility study primarily aims to evaluate trial methods for future effectiveness-implementation hybrid type 2 trials. METHODS For this study protocol, an internet- and text-based self-care intervention program using the LINE app (a popular message tool in Japan) will be prepared according to evidence-based psychoeducational topics. Based on our online survey findings, personalized algorithms will be implemented according to employees' gender, age, and psychological distress levels. A personalized program using a popular pre-existing text app is expected to reduce employees' burdens and be attractive to them, resulting in successful implementation outcomes and mental health benefits. A pre-post design feasibility study will be conducted on ten companies to evaluate trial methods (e.g., recruitment and procedures). The primary outcome will involve individual-level penetration, defined as the proportion of the number of employees who register for the program divided by the total number of invited employees at the company. The progression criterion to go next trial specifies that more than 50% of the recruited companies obtain 60% individual penetration, which is set based on the findings of the prior survey of employees at MSEs and of interviews of stakeholders involved in this study, and will be measured by LINE system. Finally, acceptability, appropriateness, and feasibility will be measured using internet-based questionnaires and interviews. DISCUSSION This pre-post feasibility study for future effectiveness-implementation hybrid type 2 trials will provide in-depth knowledge about the successful implementation of text-based, semi-personalized, self-care mental health interventions in real-world settings using both quantitative and qualitative data. CONCLUSIONS This feasibility study will help validate the effectiveness of text-based interventions using a widely used social networking service (SNS) tool for employees in MSEs. TRIAL REGISTRATION UMIN clinical trial registration, UMIN000046960. Registered on February 21, 2022. https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000053570.
Collapse
Affiliation(s)
- Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Hajime Takeno
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sayaka Ogawa
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Utako Sawada
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
| |
Collapse
|
10
|
Rask MT, Frostholm L, Hansen SH, Petersen MW, Ørnbøl E, Rosendal M. Self-help interventions for persistent physical symptoms: a systematic review of behaviour change components and their potential effects. Health Psychol Rev 2024; 18:75-116. [PMID: 36651573 DOI: 10.1080/17437199.2022.2163917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/22/2022] [Indexed: 01/19/2023]
Abstract
Persistent physical symptoms (PPS) remain a challenge in the healthcare system due to time-constrained consultations, uncertainty and limited specialised care capacity. Self-help interventions may be a cost-effective way to widen the access to treatment. As a foundation for future interventions, we aimed to describe intervention components and their potential effects in self-help interventions for PPS. A systematic literature search was made in PubMed, EMBASE, PsycINFO and CENTRAL. Fifty-one randomised controlled trials were included. Interventions were coded for effect on outcomes (standardised mean difference ≥0.2) related to symptom burden, anxiety, depression, quality of life, healthcare utilisation and sickness absence. The Behaviour Change Technique (BCT) Taxonomy v1 was used to code intervention components. An index of potential was calculated for each BCT within an outcome category. Each BCT was assessed as 'potentially effective' or 'not effective' based on a two-sided test for binomial random variables. Sixteen BCTs showed potential effect as treatment components. These BCTs represented the themes: goals and planning, feedback and monitoring, shaping knowledge, natural consequences, comparison of behaviour, associations, repetition and substitution, regulation, antecedents and identity. The results suggest that specific BCTs should be included in new PPS self-help interventions aiming to improve the patients' physical and mental health.
Collapse
Affiliation(s)
- Mette Trøllund Rask
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus N, Denmark
| | - Lisbeth Frostholm
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Sofie Høeg Hansen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus N, Denmark
| | - Marie Weinreich Petersen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus N, Denmark
| | - Eva Ørnbøl
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus N, Denmark
| | - Marianne Rosendal
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus N, Denmark
- Research Unit for General Practice, Aarhus C, Denmark
| |
Collapse
|
11
|
Bjornstad G, Sonthalia S, Rouse B, Freeman L, Hessami N, Dunne JH, Axford N. A comparison of the effectiveness of cognitive behavioural interventions based on delivery features for elevated symptoms of depression in adolescents: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1376. [PMID: 38188230 PMCID: PMC10771715 DOI: 10.1002/cl2.1376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/03/2023] [Indexed: 01/09/2024]
Abstract
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.
Collapse
Affiliation(s)
- Gretchen Bjornstad
- NIHR Applied Research Collaboration South West Peninsula (PenARC)University of Exeter Medical SchoolExeterUK
- Dartington Service Design LabBuckfastleighUK
| | - Shreya Sonthalia
- Dartington Service Design LabBuckfastleighUK
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Benjamin Rouse
- Center for Clinical Evidence and Guidelines, ECRI InstitutePlymouth MeetingPennsylvaniaUSA
| | | | | | - Jo Hickman Dunne
- The Centre for Youth ImpactLondonUK
- University of ManchesterManchesterUK
| | - Nick Axford
- NIHR Applied Research Collaboration South West Peninsula (PenARC)University of PlymouthPlymouthUK
| |
Collapse
|
12
|
Yaffe MJ, McCusker J, Lambert SD, Haggerty J, Meguerditchian AN, Pineault M, Barnabé A, Belzile E, Minotti S, de Raad M. Self-care interventions to assist family physicians with mental health care of older patients during the COVID-19 pandemic: Feasibility, acceptability, and outcomes of a pilot randomized controlled trial. PLoS One 2024; 19:e0297937. [PMID: 38358971 PMCID: PMC10868770 DOI: 10.1371/journal.pone.0297937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 01/10/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has required family physicians to rapidly address increasing mental health problems with limited resources. Vulnerable home-based seniors with chronic physical conditions and commonly undermanaged symptoms of anxiety and depression were recruited in this pilot study to compare two brief self-care intervention strategies for the management of symptoms of depression and/or anxiety. METHODS We conducted a pilot RCT to compare two tele-health strategies to address mental health symptoms either with 1) validated CBT self-care tools plus up to three telephone calls from a trained lay coach vs. 2) the CBT self-guided tools alone. The interventions were abbreviated from those previously trialed by our team, to enable their completion in 2 months. Objectives were to assess the feasibility of delivering the interventions during a pandemic (recruitment and retention); and assess the comparative acceptability of the interventions across the two groups (satisfaction and tool use); and estimate preliminary comparative effectiveness of the interventions on severity of depression and anxiety symptoms. Because we were interested in whether the interventions were acceptable to a wide range of older adults, no mental health screening for eligibility was performed. RESULTS 90 eligible patients were randomized. 93% of study completers consulted the self-care tools and 84% of those in the coached arm received at least some coaching support. Satisfaction scores were high among participants in both groups. No difference in depression and anxiety outcomes between the coached and non-coached participants was observed, but coaching was found to have a significant effect on participants' use and perceived helpfulness of the tools. CONCLUSION Both interventions were feasible and acceptable to patients. Trained lay coaching increased patients' engagement with the tools. Self-care tools offer a low cost and acceptable remote activity that can be targeted to those with immediate needs. While effectiveness results were inconclusive, this may be due to the lack of eligibility screening for mental health symptoms, abbreviated toolkit, and fewer coaching sessions than those used in our previous effective interventions. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0460937.
Collapse
Affiliation(s)
- Mark J. Yaffe
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
- St. Mary’s Hospital Department of Family Medicine, Montreal, Quebec, Canada
- St. Mary’s Research Centre, Montreal, Quebec, Canada
| | - Jane McCusker
- St. Mary’s Research Centre, Montreal, Quebec, Canada
- Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
| | - Sylvie D. Lambert
- St. Mary’s Research Centre, Montreal, Quebec, Canada
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Jeannie Haggerty
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
- St. Mary’s Research Centre, Montreal, Quebec, Canada
| | - Ari N. Meguerditchian
- St. Mary’s Research Centre, Montreal, Quebec, Canada
- Departments of Surgery and Oncology, McGill University, Montreal, Quebec, Canada
| | | | - Alexandra Barnabé
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Eric Belzile
- St. Mary’s Research Centre, Montreal, Quebec, Canada
| | - Simona Minotti
- St. Mary’s Research Centre, Montreal, Quebec, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
- Biostatistics Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Manon de Raad
- St. Mary’s Research Centre, Montreal, Quebec, Canada
| |
Collapse
|
13
|
Wuthrich VM, Dickson SJ, Pehlivan M, Chen JTH, Zagic D, Ghai I, Neelakandan A, Johnco C. Efficacy of low intensity interventions for geriatric depression and anxiety - A systematic review and meta-analysis. J Affect Disord 2024; 344:592-599. [PMID: 37858732 DOI: 10.1016/j.jad.2023.10.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 10/13/2023] [Accepted: 10/14/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND This systematic review and meta-analysis examined the efficacy of low intensity psychological interventions for older adults (60+ years) with clinical anxiety and/or depressive disorders. METHOD Systematic review and meta-analysis of randomised control trials of low-intensity psychological interventions for anxiety and/or depression with an active or passive control condition (e.g., waitlist, treatment-as-usual or active control) in any setting. Low intensity psychological interventions (e.g., cognitive behaviour therapy [CBT]) targeted anxiety and/or depression as primary outcomes, were primarily self-help, and included support from trained practitioners/facilitators with <6 h total contact time (typically <30 min p/contact). RESULTS Seven studies consisting of 304 older adults (65-78 years, Mage = 70, SD = 4) were identified and six included in the meta-analysis of depression outcomes and three for anxiety. A random effects meta-analysis of group differences in symptom change from pre-post treatment found evidence favouring low intensity psychological interventions over passive control groups for the treatment of depressive and anxiety symptoms, with moderate effect sizes for depression (Cohen's d = -0.62) and large effect sizes for anxiety (Cohen's d = -0.84) at post-treatment. LIMITATIONS Results are limited by study design of included studies such that the efficacy of interventions compared to treatment-as-usual, non-CBT approaches, in adults >80 years and long-term effects are unknown. CONCLUSIONS There is some evidence supporting the clinical benefits of low intensity psychological interventions for depressive and anxiety symptoms in older adults compared to passive controls. More research is needed to examine efficacy compared to active control conditions, and among those over 80 years.
Collapse
Affiliation(s)
- Viviana M Wuthrich
- Macquarie University Lifespan Health & Wellbeing Research Centre, Macquarie University, Sydney 2109, Australia.
| | - Sophie J Dickson
- Macquarie University Lifespan Health & Wellbeing Research Centre, Macquarie University, Sydney 2109, Australia
| | - Melissa Pehlivan
- Macquarie University Lifespan Health & Wellbeing Research Centre, Macquarie University, Sydney 2109, Australia
| | - Jessamine T-H Chen
- Macquarie University Lifespan Health & Wellbeing Research Centre, Macquarie University, Sydney 2109, Australia
| | - Dino Zagic
- Macquarie University Lifespan Health & Wellbeing Research Centre, Macquarie University, Sydney 2109, Australia
| | - Ishaan Ghai
- Macquarie University Lifespan Health & Wellbeing Research Centre, Macquarie University, Sydney 2109, Australia
| | - Aswathi Neelakandan
- Macquarie University Lifespan Health & Wellbeing Research Centre, Macquarie University, Sydney 2109, Australia
| | - Carly Johnco
- Macquarie University Lifespan Health & Wellbeing Research Centre, Macquarie University, Sydney 2109, Australia
| |
Collapse
|
14
|
He J, Lin J, Sun W, Cheung T, Cao Y, Fu E, Chan SHW, Tsang HWH. The effects of psychosocial and behavioral interventions on depressive and anxiety symptoms during the COVID-19 pandemic: a systematic review and meta-analysis. Sci Rep 2023; 13:19094. [PMID: 37925535 PMCID: PMC10625531 DOI: 10.1038/s41598-023-45839-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/24/2023] [Indexed: 11/06/2023] Open
Abstract
Psychosocial and behavioral interventions have been shown to significantly reduce depressive and anxiety symptoms in different populations. Recent evidence suggests that the mental health of the general population has deteriorated significantly since the start of Coronavirus Disease 2019 (COVID-19) pandemic. We conducted a systematic review and meta-analysis of studies on the therapeutic effects of psychosocial and behavioral interventions on depression and anxiety during the COVID-19 pandemic. We systematically searched six electronic databases between December 2019 and February 2022 including PubMed, PsycINFO, Scopus, Web of Science, CNKI, and Wanfang Data. We included randomized clinical trials of psychosocial and behavioral interventions in individuals with depressive or anxiety symptoms during the COVID-19 outbreak compared to various control conditions. A total of 35 eligible studies with 5457 participants were included. The meta-analysis results showed that psychosocial and behavioral interventions had statistically significant moderate effects on depression [SMD = - 0.73, 95% CI (- 1.01, - 0.45), I2 = 90%] and large effects on anxiety [SMD = - 0.90, 95% CI (- 1.19, - 0.60), I2 = 92%], especially in the general population and COVID-19 survivors. Exercise and cognitive behavioral therapy were found to be the most effective treatments with moderate-to-large effect size for depression and anxiety during the outbreak of COVID-19. We also found the internet-based approach could also achieve almost equally significant effects on depression and anxiety compared with face-to-face traditional approach. Our findings suggest that cognitive behavioral therapy and physical exercise intervention are significantly effective for depression and anxiety related to the COVID-19 pandemic regardless of the delivery modes, and gender differences should be taken into consideration for better implementation of interventions in clinical and community practice.
Collapse
Affiliation(s)
- Jiali He
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Jingxia Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Mental Health Research Center, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Wen Sun
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Teris Cheung
- Mental Health Research Center, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Yuan Cao
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Mental Health Research Center, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Eugene Fu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Sunny H W Chan
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | - Hector W H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
- Mental Health Research Center, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
| |
Collapse
|
15
|
Ozmen S, Amarnath A, Struijs S, de Wit L, Cuijpers P. A Guided Web-Based Intervention Targeting Procrastination in College Students: Protocol for an Open Trial. JMIR Res Protoc 2023; 12:e44907. [PMID: 37921841 PMCID: PMC10656662 DOI: 10.2196/44907] [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: 12/08/2022] [Revised: 05/22/2023] [Accepted: 06/15/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Academic procrastination is a widespread problem among college students. It is linked to poor academic performance and increased college dropout intentions, as well as several mental health problems such as depression, anxiety, and stress. Guided web-based interventions can help reduce procrastination. However, guidance by professional clinicians draws upon valuable and limited societal resources, and a more efficient, scalable form of guidance is needed. Guidance by trained clinical psychology students has not yet been examined. OBJECTIVE The aim of this open trial is to examine the feasibility and acceptability of a web-based procrastination intervention for college students under the guidance of student digital coaches (e-coaches). METHODS We developed a single-arm trial of a guided web-based intervention targeting procrastination for the Dutch student population. Guidance is delivered by trained clinical psychology students asynchronously in the form of textual feedback on intervention progress, with the aim of supporting and motivating the participant. Participants are recruited at 7 Dutch universities. Primary outcomes are intervention satisfaction, usability, and adherence, which are assessed by the Client Satisfaction Scale (CSQ-8), System Usability Scale (SUS-10), and number of completed modules, respectively. The primary outcomes will be examined by calculating descriptive statistics. Secondary outcomes are e-coach satisfaction and changes to procrastination, depression, stress, and quality of life from pre- to posttest and follow-up. RESULTS The project was funded in 2019, and recruitment began in January 2021. As of May 2023, a total of 985 participants were enrolled, of which 372 had completed the posttest and 192 had completed the follow-up. The expected date of analysis and publication of the results is 2024. CONCLUSIONS The results are expected to contribute to the body of literature regarding eHealth in 3 ways. First, we will examine whether students who procrastinate adhere to and are satisfied with an eHealth intervention targeting this problem. Second, we will explore whether an intervention targeting procrastination can also decrease depression and stress. Lastly, we will investigate whether trained psychology students can effectively guide their peers in web-based interventions. Given the shortage of licensed psychologists, exploring alternative sources of guidance is much needed in order to provide students with the mental health support they need. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44907.
Collapse
Affiliation(s)
- Sevin Ozmen
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Arpana Amarnath
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Sascha Struijs
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Leonore de Wit
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Pim Cuijpers
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
16
|
Roos R, Witteveen AB, Ayuso-Mateos JL, Barbui C, Bryant RA, Felez-Nobrega M, Figueiredo N, Kalisch R, Haro JM, McDaid D, Mediavilla R, Melchior M, Nicaise P, Park AL, Petri-Romão P, Purgato M, van Straten A, Tedeschi F, Underhill J, Sijbrandij M. Effectiveness of a scalable, remotely delivered stepped-care intervention to reduce symptoms of psychological distress among Polish migrant workers in the Netherlands: study protocol for the RESPOND randomised controlled trial. BMC Psychiatry 2023; 23:801. [PMID: 37919694 PMCID: PMC10623706 DOI: 10.1186/s12888-023-05288-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has negatively affected the mental health of international migrant workers (IMWs). IMWs experience multiple barriers to accessing mental health care. Two scalable interventions developed by the World Health Organization (WHO) were adapted to address some of these barriers: Doing What Matters in times of stress (DWM), a guided self-help web application, and Problem Management Plus (PM +), a brief facilitator-led program to enhance coping skills. This study examines whether DWM and PM + remotely delivered as a stepped-care programme (DWM/PM +) is effective and cost-effective in reducing psychological distress, among Polish migrant workers with psychological distress living in the Netherlands. METHODS The stepped-care DWM/PM + intervention will be tested in a two-arm, parallel-group, randomized controlled trial (RCT) among adult Polish migrant workers with self-reported psychological distress (Kessler Psychological Distress Scale; K10 > 15.9). Participants (n = 212) will be randomized into either the intervention group that receives DWM/PM + with psychological first aid (PFA) and care-as-usual (enhanced care-as-usual or eCAU), or into the control group that receives PFA and eCAU-only (1:1 allocation ratio). Baseline, 1-week post-DWM (week 7), 1-week post-PM + (week 13), and follow-up (week 21) self-reported assessments will be conducted. The primary outcome is psychological distress, assessed with the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS). Secondary outcomes are self-reported symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), resilience, quality of life, and cost-effectiveness. In a process evaluation, stakeholders' views on barriers and facilitators to the implementation of DWM/PM + will be evaluated. DISCUSSION To our knowledge, this is one of the first RCTs that combines two scalable, psychosocial WHO interventions into a stepped-care programme for migrant populations. If proven to be effective, this may bridge the mental health treatment gap IMWs experience. TRIAL REGISTRATION Dutch trial register NL9630, 20/07/2021, https://www.onderzoekmetmensen.nl/en/trial/27052.
Collapse
Affiliation(s)
- Rinske Roos
- Department of Clinical, Neuro- and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands.
| | - Anke B Witteveen
- Department of Clinical, Neuro- and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Corrado Barbui
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Mireia Felez-Nobrega
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Natasha Figueiredo
- Equipe de Recherche en Epidémiologie Sociale (ERES), Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), INSERM, Sorbonne Université, Faculté de Médecine St Antoine, Paris, France
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Focus Program Translational Neuroscience (FTN), Neuroimaging Center (NIC), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Maria Melchior
- Equipe de Recherche en Epidémiologie Sociale (ERES), Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), INSERM, Sorbonne Université, Faculté de Médecine St Antoine, Paris, France
| | - Pablo Nicaise
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Marianna Purgato
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Annemieke van Straten
- Department of Clinical, Neuro- and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands
| | - Federico Tedeschi
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | | | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands
| |
Collapse
|
17
|
Scodari BT, Chacko S, Matsumura R, Jacobson NC. Using machine learning to forecast symptom changes among subclinical depression patients receiving stepped care or usual care. J Affect Disord 2023; 340:213-220. [PMID: 37541599 PMCID: PMC10548339 DOI: 10.1016/j.jad.2023.08.004] [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: 08/05/2022] [Revised: 03/08/2023] [Accepted: 08/01/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND Subclinical depression (SD) is a mental health disorder characterized by minor depressive symptoms. Most SD patients are treated in the primary practice, but many respond poorly to treatment at the expense of provider resources. Stepped care approaches are appealing for tiering SD care to efficiently allocate scarce resources while jointly optimizing patient outcomes. However, stepped care can be time inefficient, as some persons may respond poorly and be forced to suffer with their symptoms for prolonged periods. Machine learning can offer insight into optimal treatment paths and inform clinical recommendations for incident patients. METHODS As part of the Step-Dep trial, participants with SD were randomized to receive stepped care (N=96) or usual care (N=140). Machine learning was used to predict changes in depressive symptoms every three months over a year for each treatment group. RESULTS Tree-based models were effective in predicting PHQ-9 changes among patients who received stepped care (r=0.35-0.46, MAE=0.14-0.17) and usual care (r=0.34-0.49, MAE=0.15-0.18). Patients who received stepped care were more likely to reduce PHQ-9 scores if they had high PHQ-9 but low HADS-A scores at baseline, a low number of chronic illnesses, and an internal locus of control. LIMITATIONS Models may suffer from potential overfitting due to sample size limitations. CONCLUSION Our findings demonstrate the promise of machine learning for predicting changes in depressive symptoms for SD patients receiving different treatments. Trained models can intake incident patient information and predict outcomes to inform personalized care.
Collapse
Affiliation(s)
- Bruno T Scodari
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
| | - Sarah Chacko
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Rina Matsumura
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Nicholas C Jacobson
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA; Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA; Department of Computer Science, Dartmouth College, Hanover, NH, USA
| |
Collapse
|
18
|
McCusker J, Lambert S, Yaffe M, Schwartz H, Haggerty J, Belzile E, Pelland ME, Minotti SC, de Raad M. Adaptation and outcomes of a lay-guided mental health self-care model: Results of six trials. Gen Hosp Psychiatry 2023; 85:63-70. [PMID: 37820547 DOI: 10.1016/j.genhosppsych.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/16/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE To synthesize results of six controlled trials of self-care interventions for depression and/or anxiety, focusing on five trials in which lay guidance was compared to self-directed use of the same self-care tools. METHODS The trials were conducted in Canada in different target populations. Self-care tools were adapted to each population. Guidance was provided in 3-15 calls over a period of 6-26 weeks. Depression and/or anxiety were assessed at follow-up (6-26 weeks). Pooled analyses used a meta-analytic approach. Engagement with the self-care tools was compared using the standardized difference or Cohen's d effect size. RESULTS In studies with homogeneous outcomes (three for depression, four for anxiety), the pooled effect sizes of guidance vs. self-directed use of the self-care tools were 0.36 (95% CI 0.10, 0.62, N = 235) for depression and 0.21 (95% CI -0.03, 0.44, N = 285) for anxiety. Guidance consistently led to greater engagement with the tools. CONCLUSIONS The intervention model is a potentially sustainable and accessible alternative to professionally guided self-care for people with mild-moderate depression. Factors which may have limited implementation success include: co-interventions, reduced number of guide calls (3 vs 6 or more), and delivery to dyads (patient-caregiver).
Collapse
Affiliation(s)
- Jane McCusker
- Department of Epidemiology and Biostatistics, McGill University, 1020 Pine Ave, Montreal, Quebec H3A 1A2, Canada; St. Mary's Research Centre, 3830 Lacombe Ave, Hayes Pavilion, Suite 4720, Montreal, Quebec H3T 1M5, Canada.
| | - Sylvie Lambert
- St. Mary's Research Centre, 3830 Lacombe Ave, Hayes Pavilion, Suite 4720, Montreal, Quebec H3T 1M5, Canada; Ingram School of Nursing, McGill University, 80 Sherbrooke St W, Suite1800, Montreal, Quebec H3A 2M7, Canada.
| | - Mark Yaffe
- St. Mary's Research Centre, 3830 Lacombe Ave, Hayes Pavilion, Suite 4720, Montreal, Quebec H3T 1M5, Canada; Department of Family Medicine, McGill University, 5858 Chem de la Côte des Neiges, Montreal, Quebec H3S 1Z1, Canada; St. Mary's Hospital Department of Family Medicine, 3777 Jean Brillant St, Montreal, Quebec H3T 1M5, Canada.
| | - Hannah Schwartz
- Department of Psychiatry, McGill University, 1033 Pine Ave W, Montreal, Quebec H3A 1A1, Canada; Department of Psychiatry, St. Mary's Hospital Centre, 3830 Lacombe Ave, Montreal, Quebec H3T 1M5, Canada.
| | - Jeannie Haggerty
- St. Mary's Research Centre, 3830 Lacombe Ave, Hayes Pavilion, Suite 4720, Montreal, Quebec H3T 1M5, Canada; Department of Family Medicine, McGill University, 5858 Chem de la Côte des Neiges, Montreal, Quebec H3S 1Z1, Canada.
| | - Eric Belzile
- St. Mary's Research Centre, 3830 Lacombe Ave, Hayes Pavilion, Suite 4720, Montreal, Quebec H3T 1M5, Canada.
| | - Marie-Eve Pelland
- Department of Radiology, Radiation Oncology and Nuclear Medicine, Université de Montréal, Pavillon Roger-Gaudry, S-716, 2900, boul Édouard-Montpetit, Montreal, Quebec H3T 1A4, Canada; Radio-oncology Department, Centre hospitalier de l'Université de Montréal, 1000, rue Saint-Denis, Montreal, Quebec H2X 0C1, Canada.
| | - Simona C Minotti
- St. Mary's Research Centre, 3830 Lacombe Ave, Hayes Pavilion, Suite 4720, Montreal, Quebec H3T 1M5, Canada; Institute for Better Health, Trillium Health Partners, 100 Queensway W, Mississauga, Ontario L58 1B8, Canada; Biostatistics Division, Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, Ontario M5T 3M7, Canada.
| | - Manon de Raad
- St. Mary's Research Centre, 3830 Lacombe Ave, Hayes Pavilion, Suite 4720, Montreal, Quebec H3T 1M5, Canada.
| |
Collapse
|
19
|
Leresche E, Hossain M, De Rubeis ML, Hermans V, Burtscher D, Rossi R, Lonsdale C, Singh NS. How is the implementation of empirical research results documented in conflict-affected settings? Findings from a scoping review of peer-reviewed literature. Confl Health 2023; 17:39. [PMID: 37605198 PMCID: PMC10464477 DOI: 10.1186/s13031-023-00534-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 07/19/2023] [Indexed: 08/23/2023] Open
Abstract
Implementation science scholars argue that knowing 'what works' in public health is insufficient to change practices, without understanding 'how', 'where' and 'why' something works. In the peer reviewed literature on conflict-affected settings, challenges to produce research, make decisions informed by evidence, or deliver services are documented, but what about the understanding of 'how', 'where' and 'why' changes occur? We explored these questions through a scoping review of peer-reviewed literature based on core dimensions of the Extended Normalization Process Theory. We selected papers that provided data on how something might work (who is involved and how?), where (in what organizational arrangements or contexts?) and why (what was done?). We searched the Global Health, Medline, Embase databases. We screened 2054 abstracts and 128 full texts. We included 22 papers (of which 15 related to mental health interventions) and analysed them thematically. We had the results revised critically by co-authors experienced in operational research in conflict-affected settings. Using an implementation science lens, we found that: (a) implementing actors are often engaged after research is produced to discuss feasibility; (b) new interventions or delivery modalities need to be flexible; (c) disruptions affect how research findings can lead to sustained practices; (d) strong leadership and stable resources are crucial for frontline actors; (e) creating a safe learning space to discuss challenges is difficult; (f) feasibility in such settings needs to be balanced. Lastly, communities and frontline actors need to be engaged as early as possible in the research process. We used our findings to adapt the Extended Normalization Process Theory for operational research in settings affected by conflicts. Other theories used by researchers to document the implementation processes need to be studied further.
Collapse
Affiliation(s)
- Enrica Leresche
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
| | - Mazeda Hossain
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
- Global Health, Nottingham Trent University, Nottingham, UK
| | | | - Veerle Hermans
- LuxOR, Médecins Sans Frontières Operational Centre Brussels, Luxembourg, Luxembourg
| | - Doris Burtscher
- Médecins Sans Frontières Vienna Evaluation Unit, Vienna, Austria
| | - Rodolfo Rossi
- Centre for Operational Research and Experience (CORE), International Committee of the Red Cross, Geneva, Switzerland
| | - Cordelia Lonsdale
- Elrha's Research for Health in Humanitarian Crises Programme, Cardiff, UK
| | - Neha S Singh
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
20
|
Peipert A, Adams S, Lorenzo-Luaces L. "I would not want the mechanic to direct me to an engine repair manual": a qualitative analysis of provider perspectives on low-intensity treatments for patients on waiting lists. BMC Psychiatry 2023; 23:600. [PMID: 37592212 PMCID: PMC10436418 DOI: 10.1186/s12888-023-05055-6] [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: 05/12/2023] [Accepted: 07/26/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Low-intensity treatments (LITs), such as bibliotherapy or online self-help, have the potential to reach more individuals than traditional face-to-face care by circumventing many of the common barriers to mental health treatment. Despite substantial research evidence supporting their usability and efficacy across several clinical presentations, prior work suggests that mental health providers rarely recommend LITs for patients waiting for treatment. METHODS The present study analyzed provider open responses to a prompt asking about perceived barriers, thoughts, and comments related to additional treatment resources for patients on treatment waiting lists. We surveyed 141 practicing mental health providers, 65 of whom responded to an open text box with additional thoughts on using LITs for patients on treatment waiting lists. Responses were qualitatively coded using a thematic coding process. RESULTS Qualitative outcomes yielded 11 codes: patient appropriateness, research evidence, feasibility, patient barriers, liability, patient personal contact, additional resources, positive attitudes, trust in programs, systemic problems, and downplaying distress. CONCLUSIONS Results suggest providers are predominantly concerned about the potential of suggesting a LIT that would be ultimately inappropriate for their patient due to a lack of assessment of the patient's needs. Furthermore, providers noted ambiguity around the legal and ethical liability of recommending a LIT to someone who may not yet be a patient. Guidelines and standards for recommending LITs to patients on treatment waiting lists may help address ambiguity regarding their use in routine care.
Collapse
Affiliation(s)
- Allison Peipert
- Department of Psychological and Brain Sciences, Indiana University Bloomington, 1101 E 10th Street, Bloomington, IN, 47405, USA
| | - Sydney Adams
- Department of Psychological and Brain Sciences, Indiana University Bloomington, 1101 E 10th Street, Bloomington, IN, 47405, USA
| | - Lorenzo Lorenzo-Luaces
- Department of Psychological and Brain Sciences, Indiana University Bloomington, 1101 E 10th Street, Bloomington, IN, 47405, USA.
| |
Collapse
|
21
|
Vowels LM, Sever Z. Are Digital Interventions the Next Frontier in Sex Therapy? A Mixed Methods Study Examining Attitudes toward Digital Sex Therapy. JOURNAL OF SEX & MARITAL THERAPY 2023; 49:1043-1061. [PMID: 37553901 DOI: 10.1080/0092623x.2023.2243266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
Digital health interventions can address governments' aims of providing better care, better outcomes, and lower costs. No previous research has examined attitudes toward digital sex therapy to understand what might facilitate, or hinder, the uptake of these interventions. This sequential mixed-methods study with qualitative structured interviews (n = 27) followed by a quantitative survey (n = 334) aimed to understand participants' expectations and attitudes toward digital sex therapy interventions. Participants reported a mixture of positive and negative attitudes to digital sex therapy. More positive attitudes, higher education level, and previous engagement in therapy predicted greater openness to using these interventions.
Collapse
Affiliation(s)
- Laura M Vowels
- FAmily and DevelOpment research center (FADO), Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Zoe Sever
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| |
Collapse
|
22
|
Darcy A, Beaudette A, Chiauzzi E, Daniels J, Goodwin K, Mariano TY, Wicks P, Robinson A. Anatomy of a Woebot® (WB001): agent guided CBT for women with postpartum depression. Expert Rev Med Devices 2023; 20:1035-1049. [PMID: 37938145 DOI: 10.1080/17434440.2023.2280686] [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: 09/19/2023] [Accepted: 11/03/2023] [Indexed: 11/09/2023]
Abstract
INTRODUCTION Postpartum depression (PPD) is common, persistent, and stigmatized. There are insufficient trained professionals to deliver appropriate screening, diagnosis, and treatment. AREAS COVERED WB001 is a Software as a Medical Device (SaMD) based Agent-Guided Cognitive-Behavioral Therapy (AGCBT) program for the treatment of PPD, for which Breakthrough Device Designation was recently granted by the US Food and Drug Administration. WB001 combines therapeutic alliance, human-centered design, machine learning techniques, and established principles from CBT and interpersonal therapy (IPT). We introduce AGCBT as a new model of service delivery, whilst describing Woebot, the agent technology that enables guidance through the replication of some elements of human relationships. The profile describes the device's design principles, enabling technology, risk handling, and efficacy data in PPD. EXPERT OPINION WB001 is a dynamic and personalized tool with which patients may establish a therapeutic bond. Woebot is designed to augment (rather than replace) human healthcare providers, unlocking the therapeutic potency associated with guidance, whilst retaining the scalability and agency that characterizes self-help approaches. WB001 has the potential to improve both the quality and the scalability of care through providing support to patients on waiting lists, in between clinical encounters, and enabling automation of measurement-based-care.
Collapse
Affiliation(s)
| | | | | | | | | | - Timothy Y Mariano
- Woebot Health, San Francisco, CA, USA
- RR&D Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | | | | |
Collapse
|
23
|
Vogel L, Färber T, Hölzl I, Deliens T, Henning C, Liel C, Löchner J, Lux U, Opitz A, Seiferth C, Versele V, Wolstein J, van Poppel MNM. I-PREGNO - prevention of unhealthy weight gain and psychosocial stress in families during pregnancy and postpartum using an mHealth enhanced intervention: a study protocol of two cluster randomized controlled trials. BMC Pregnancy Childbirth 2023; 23:418. [PMID: 37280529 DOI: 10.1186/s12884-023-05735-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/24/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND The transition to parenthood represents a critical life period with psychosocial, and behavioral changes and challenges for parents. This often increases stress and leads to unhealthy weight gain in families, especially in psychosocially burdened families. Although universal and selective prevention programs are offered to families, specific support often fails to reach psychosocially burdened families. Digital technologies are a chance to overcome this problem by enabling a low-threshold access for parents in need. However, there is currently a lack of smartphone-based interventions that are tailored to the needs of psychosocially burdened families. AIMS The research project I-PREGNO aims to develop and evaluate a self-guided, smartphone-based intervention in combination with face-to-face counseling delivered by healthcare professionals for the prevention of unhealthy weight gain and psychosocial problems. The intervention is specifically tailored to the needs of psychosocially burdened families during the pregnancy and postpartum period. METHODS In two cluster randomized controlled trials in Germany and Austria (N = 400) psychosocially burdened families will be recruited and randomized to i) treatment as usual (TAU), or ii) I-PREGNO intervention (self-guided I-PREGNO app with counseling sessions) and TAU. We expect higher acceptance and better outcomes on parental weight gain and psychosocial stress in the intervention group. DISCUSSION The intervention offers a low cost and low-threshold intervention and considers the life situation of psychosocially burdened families who are a neglected group in traditional prevention programs. After positive evaluation, the intervention may easily be implemented in existing perinatal care structures in European countries such as Germany and Austria. TRIAL REGISTRATION Both trials were registered prospectively at the German Clinical Trials Register (Germany: DRKS00029673; Austria: DRKS00029934) in July and August 2022.
Collapse
Affiliation(s)
- Lea Vogel
- Department of Psychology, LMU Munich, Munich, Germany.
- National Center for Early Prevention, German Youth Institute, Department of Families and Family Policies, Munich, Germany.
| | - Tanja Färber
- Department of Pathopsychology, University of Bamberg, Bamberg, Germany
| | - Ingrid Hölzl
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Tom Deliens
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Carmen Henning
- Department of Pathopsychology, University of Bamberg, Bamberg, Germany
| | - Christoph Liel
- National Center for Early Prevention, German Youth Institute, Department of Families and Family Policies, Munich, Germany
| | - Johanna Löchner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy Tuebingen, Tuebingen, Germany
| | - Ulrike Lux
- National Center for Early Prevention, German Youth Institute, Department of Families and Family Policies, Munich, Germany
| | - Ansgar Opitz
- National Center for Early Prevention, German Youth Institute, Department of Families and Family Policies, Munich, Germany
| | - Caroline Seiferth
- Department of Pathopsychology, University of Bamberg, Bamberg, Germany
| | - Vicka Versele
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Faculty of Medicine, Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Jörg Wolstein
- Department of Pathopsychology, University of Bamberg, Bamberg, Germany
| | | |
Collapse
|
24
|
Lukenga MP, Billonnet L, Gaugue J, Denis J. Exploring female students' perceptions of the use of digital technologies in managing academic stress. Front Psychol 2023; 14:1199038. [PMID: 37333588 PMCID: PMC10274148 DOI: 10.3389/fpsyg.2023.1199038] [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: 04/02/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Objective The purpose of this research is to explore the perceptions of female students regarding the implementation of digital technologies for academic stress management. We aim to determine if the contribution of these technologies could offer to female students a better management of the stress related to their studies and thus, a better deployment of strategies to cope with academic difficulties. Method A qualitative study using the focus group methodology was conducted. Our inductive and exploratory approach allowed us to focus on the experience and perception of eleven female students from the University of Mons. The cohort was divided into two groups according to their score on the Perceived Stress Scale-10. Results The data collected was analyzed using the thematic analysis of which allowed us to identify fourteen sub-themes divided into three axes: coping strategies used to manage academic stress, students' needs to improve their management of academic stress, and the implementation of technology for managing academic stress. Conclusion Our results show that the issues present in the academic context lead students to use various coping strategies, some of which are harmful to their physical and mental health. The implementation of digital technologies and biofeedback seems to be an approach that could help students adopt more functional coping strategies and alleviate their daily difficulties in managing academic stress.
Collapse
Affiliation(s)
| | | | - Justine Gaugue
- Department of Clinical Psychology, University of Mons, Mons, Belgium
| | - Jennifer Denis
- Department of Clinical Psychology, University of Mons, Mons, Belgium
| |
Collapse
|
25
|
Lo HKY, Wong GHS, Chan JKN, Wong CSM, Lei JHC, So YK, Fung VSC, Chu RST, Chung AKK, Lee KCK, Cheng CPW, Chan WC, Chang WC. COVID-19 perseverative cognition and depressive symptoms in Hong Kong: The moderating role of resilience, loneliness and coping strategies. J Affect Disord 2023:S0165-0327(23)00699-7. [PMID: 37230268 DOI: 10.1016/j.jad.2023.05.058] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/11/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND The COVID-19 pandemic significantly increased depression prevalence in general population. However, the relationship between persistent dysfunctional thinking associated with COVID-19 (perseverative-cognition) and depression, and its potential moderators are understudied. We aimed to examine the association between COVID-19 perseverative-cognition and depression, and the moderating effect of potential risk and protective factors on this association in general public during the peak of fifth COVID-19 wave in Hong Kong. METHODS This survey recruited 14,269 community-dwelling adults between March 15-April 3, 2022 to investigate association between COVID-19 perseverative-cognition and depression, and the moderating effect of resilience, loneliness and three coping strategies (including emotion-focused, problem-focused and avoidant coping) on this association, using hierarchical regression models and simple slope analyses. COVID-19 perseverative cognition was assessed by the Obsession with COVID-19 Scale (OCS) and depressive symptoms were measured by the Patient Health Questionnaire-9 (PHQ-9). RESULTS Perseverative-cognition was positively associated with depression severity. Resilience, loneliness and three coping strategies moderated the association between perseverative-cognition and depression. Specifically, greater resilience and emotion-focused coping ameliorated the association between perseverative-cognition and depression, while higher levels of loneliness, avoidant and problem-focused coping accentuated such association. LIMITATIONS Cross-sectional design precluded establishing causality among variables. CONCLUSION This study affirms that COVID-19 perseverative-cognition is significantly related to depression. Our findings indicate the potential critical role of enhanced personal resilience and social support, and adoption of emotion-focused coping in mitigating negative effect of COVID-19 related maladaptive thinking on depression severity, thereby facilitating development of targeted strategies to reduce psychological distress amidst the prolonged pandemic.
Collapse
Affiliation(s)
- Heidi Ka Ying Lo
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Gabbie Hou Sem Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Joe Kwun Nam Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Corine Sau Man Wong
- School of Public Health, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Janet Hiu Ching Lei
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Yuen Kiu So
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Vivian Shi Cheng Fung
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Ryan Sai Ting Chu
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Albert Kar Kin Chung
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Krystal Chi Kei Lee
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Calvin Pak Wing Cheng
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Wai Chi Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Wing Chung Chang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, the University of Hong Kong, Hong Kong.
| |
Collapse
|
26
|
von Below C, Bergsten J, Midbris T, Philips B, Werbart A. It turned into something else: patients' long-term experiences of transitions to or from telepsychotherapy during the COVID-19 pandemic. Front Psychol 2023; 14:1142233. [PMID: 37251023 PMCID: PMC10213395 DOI: 10.3389/fpsyg.2023.1142233] [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: 01/11/2023] [Accepted: 04/21/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction The shift from in-person therapy to telepsychotherapy during the COVID-19 pandemic was unprepared for, sudden, and inevitable. This study explored patients' long-term experiences of transitions to telepsychotherapy and back to the office. Methods Data were collected approximately two years after the declaration of COVID-19 as a pandemic. Eleven patients were interviewed (nine women and two men, aged 28 to 56, six in psychodynamic psychotherapy, five in CBT). Treatments switched between in-person and video/telephone sessions. Interview transcripts were analyzed applying the qualitative methodology of inductive thematic analysis. Results (1) The patients experienced the process in telepsychotherapy as impeded. Interventions were difficult to understand and lost impact. Routines surrounding the therapy sessions were lost. Conversations were less serious and lost direction. (2) Understanding was made more difficult when the nuances of non-verbal communication were lost. (3) The emotional relationship was altered. Remote therapy was perceived as something different from regular therapy, and once back in the therapy room, the patients felt that therapy started anew. The emotional presence was experienced as weakened, but some of the patients found expressing their feelings easier in the absence of bodily co-presence. According to the patients, in-person presence contributed to their security and trust, whereas they felt that the therapists were different when working remotely, behaving in a more easygoing and familiar way, as well as more solution-focused, supportive and unprofessional, less understanding and less therapeutic. Despite this, (4) telepsychotherapy also gave the patients an opportunity to take therapy with them into their everyday lives. Discussion The results suggest that in the long run, remote psychotherapy was seen as a good enough alternative when needed. The present study indicates that format alternations have an impact on which interventions can be implemented, which can have important implications for psychotherapy training and supervision in an era when telepsychotherapy is becoming increasingly common.
Collapse
|
27
|
Danaher BG, Seeley JR, Silver RK, Tyler MS, Kim JJ, La Porte LM, Cleveland E, Smith DR, Milgrom J, Gau JM. Trial of a patient-directed eHealth program to ameliorate perinatal depression: the MomMoodBooster2 practical effectiveness study. Am J Obstet Gynecol 2023; 228:453.e1-453.e10. [PMID: 36174746 PMCID: PMC10039954 DOI: 10.1016/j.ajog.2022.09.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Depression is one of the most common complications of childbirth, and is experienced by approximately 17% of pregnant women and 13% of postpartum women. An estimated 85% of these women go untreated-an alarming statistic given the serious consequences for the mother, her child, other family members, and society. Professional societies (the American College of Obstetricians and Gynecologists and American Academy of Pediatrics) have recommended improvements in screening and treatment. Meta-analyses indicate that cognitive behavioral therapy eHealth interventions are efficacious for depression, generally, and for perinatal depression, specifically. Earlier controlled trials have established the effectiveness and acceptability of MomMoodBooster (including an Australian version, MumMoodBooster), an eHealth program for ameliorating postpartum depression. OBJECTIVE This study aimed to evaluate the effectiveness of a perinatal version of MomMoodBooster encompassing both prenatal and postpartum content in a healthcare delivery setting already providing universal screening and referral of at-risk patients as part of routine care. STUDY DESIGN A practical effectiveness study randomly assigned 95 pregnant and 96 postpartum women screened as depressed and satisfying eligibility criteria to experimental groups: the healthcare organization's perinatal depression care program (routine-care group) and routine care+MomMoodBooster2 program (eHealth group). Eligibility criteria included: pregnant or <1 year postpartum, ≥18 years of age, no active suicidal ideation, access to broadband internet via desktop/laptop, tablet, or smartphone, and English language proficiency. RESULTS Intent-to-treat analyses of group effects used fixed-effects growth models to assess 12-week posttest change in outcomes. Results showed that both groups had significantly decreased depression severity, anxiety, stress, and automatic thoughts, and increased behavioral activation and self-efficacy. Relative to the routine-care group, the eHealth group displayed significantly greater decreases in depression severity and stress. These group comparisons were not moderated by depression severity (screening or baseline), anxiety, stress, or pregnant/postpartum status. Almost all (93%; n=89) women in the eHealth group visited their program, of whom 99% visited program sessions (M sessions visited=4.3±2.0; M total session duration=73.0±70.2 minutes; 49% viewed all 6 sessions). Among confirmed eHealth program users who provided ratings, 96% (79/82) rated their program as easy to use, 83% rated it helpful, and 93% (76/82) indicated that they would recommend it. CONCLUSION Results support the effectiveness of using MomMoodBooster2 as a treatment option for perinatal women with depression, especially when combined with universal depression screening and referral. Consequently, the eHealth program shows promise as a tool to increase the reach of treatment delivery and to potentially reduce the number of untreated perinatal women with depression.
Collapse
Affiliation(s)
- Brian G Danaher
- Influents Innovations, Eugene, OR; Oregon Research Institute, Eugene, OR.
| | | | | | | | - J Jo Kim
- NorthShore University HealthSystem, Chicago, IL
| | | | | | | | - Jeannette Milgrom
- Parent-Infant Research Institute, Melbourne, Australia; The University of Melbourne, Melbourne, Australia
| | | |
Collapse
|
28
|
Tomczyk S, Heineck S, McLaren T, Peter LJ, Schomerus G, Schmidt S, Muehlan H. Yes, I can! Development and validation of the self-efficacy for self-help scale. J Affect Disord 2023; 331:279-286. [PMID: 36933667 DOI: 10.1016/j.jad.2023.03.028] [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] [Received: 03/08/2022] [Revised: 03/09/2023] [Accepted: 03/12/2023] [Indexed: 03/20/2023]
Abstract
BACKGROUND Self-help interventions for health complaints promise alleviation, for instance, of depressive symptoms, and have become increasingly popular. However, despite constant progress regarding digitally supported self-help, real-world uptake is low and motivational processes, like task-specific self-efficacy, are rarely investigated. Therefore, this study developed and tested the Self-Efficacy for Self-Help Scale (SESH). METHODS In a randomized controlled trial of a positive psychological online intervention to foster self-help, 344 adults (mean age = 49.26 years, SD = 27.85; 61.9 % female) completed SESH at three time points (pretest, posttest, 2-week follow-up). Psychometric testing included factorial validity, reliability (internal consistency, split-half), convergent validity (via depression coping self-efficacy), discriminant validity (via depression severity, depression literacy), sensitivity to change (due to the intervention), and predictive validity (via a theory of planned behavior questionnaire on self-help). RESULTS The unidimensional scale showed excellent reliability, construct validity, and predictive validity regarding self-help (the theory of planned behavior explained 49 % of variance in self-help intentions). The analysis did not clearly support sensitivity to change, however, as SESH scores did not change in the intervention group but were lower in the control group at posttest. LIMITATIONS The study was not representative of the population, and the intervention was not previously tested. Studies with longer follow-ups and more diverse samples are needed. CONCLUSIONS This study closes a gap in current self-help research by presenting a psychometrically sound measure to capture self-efficacy for self-help that can be used in epidemiological studies as well as clinical practice.
Collapse
Affiliation(s)
- Samuel Tomczyk
- University of Greifswald, Institute of Psychology, Department Health and Prevention, Germany.
| | - Sascha Heineck
- University of Greifswald, Institute of Psychology, Department Health and Prevention, Germany
| | - Thomas McLaren
- University of Greifswald, Institute of Psychology, Department Health and Prevention, Germany
| | - Lina-Jolien Peter
- University of Leipzig Medical Center, Department of Psychiatry and Psychotherapy, Germany
| | - Georg Schomerus
- University of Leipzig Medical Center, Department of Psychiatry and Psychotherapy, Germany
| | - Silke Schmidt
- University of Greifswald, Institute of Psychology, Department Health and Prevention, Germany
| | - Holger Muehlan
- University of Greifswald, Institute of Psychology, Department Health and Prevention, Germany
| |
Collapse
|
29
|
Herbert KL, Brennan JMM. Use of Mobile Apps & Stepped-Care Model for Treating Depression in Primary Care. Prim Care 2023; 50:11-19. [PMID: 36822721 DOI: 10.1016/j.pop.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Stepped-care (SC) models have been adopted in primary care settings as a method for treating mental health conditions within primary care. In a SC model, a patient's symptoms are assessed, and an intervention is prescribed that matches the severity of symptoms. Thus, the SC model offers a variety of steps and levels of treatment that range from low to high intensity. Progression in treatment is monitored on a weekly basis and patients are stepped up or down in level of care depending on their clinical response to the intervention.
Collapse
Affiliation(s)
- Krista L Herbert
- VA Portland Health Care System, 3710 Southwest US Veterans Hospital Road, Portland, OR 97239, USA.
| | | |
Collapse
|
30
|
Sasaki N, Imamura K, Nishi D, Watanabe K, Asaoka H, Sekiya Y, Tsuno K, Kobayashi Y, Obikane E, Kawakami N. The effect of internet-based acceptance and commitment therapy (iACT) on psychological well-being among working women with a pre-school child: A randomized controlled trial. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
|
31
|
Sharp P, Kealy D, Rice SM, Seidler ZE, Oliffe JL, Ogrodniczuk JS. Existential isolation and psychological distress during COVID-19: The role of loneliness and resilient coping in Canadian help-seeking men. J Affect Disord 2023; 324:279-285. [PMID: 36586598 PMCID: PMC9795796 DOI: 10.1016/j.jad.2022.12.133] [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: 11/01/2021] [Revised: 05/23/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND The COVID-19 pandemic has had a significant impact on men's lives. Investigating specific constructs and pathways related to men's mental health outcomes may help to more fully understand the short and long-term impact of the pandemic and illuminate opportunities to better promote men's mental health. In this study, we assessed the mediating effect of loneliness on the relationship between existential isolation and psychological distress, and the moderating effect of resilient coping on that relationship. METHODS This cross-sectional study included a sample of help-seeking Canadian men in the first year of the COVID-19 pandemic (N = 434). Participants completed measures of existential isolation, loneliness, resilient coping, and psychological distress. A moderated mediation analysis was conducted. RESULTS Over half (54 %) of the participants reported psychological distress in a clinical range. Findings indicated that loneliness was a significant mediator in the association between existential isolation and psychological distress. Furthermore, findings revealed that resilient coping moderated the relationship between loneliness and psychological distress, such that men who were low on resilient coping experienced the greatest effect on psychological distress. LIMITATIONS The employed mediation analyses were cross-sectional in nature, limiting any firm conclusions regarding causality. CONCLUSIONS Efforts to reduce psychological distress may be targeted at decreasing men's experiences of existential isolation or improving resilient coping. Consideration should be given to contextual factors related to COVID-19 as well as men's preferences for help-seeking and mental health support.
Collapse
Affiliation(s)
- Paul Sharp
- School of Nursing, University of British Columbia, Vancouver, Canada; Department of Psychiatry, University of British Columbia, Vancouver, Canada; School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Australia.
| | - David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Simon M. Rice
- Orygen, Parkville, Melbourne, Australia,Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Zac E. Seidler
- Orygen, Parkville, Melbourne, Australia,Centre for Youth Mental Health, The University of Melbourne, Australia,Movember, Melbourne, Australia
| | - John L. Oliffe
- School of Nursing, University of British Columbia, Vancouver, Canada,Department of Nursing, The University of Melbourne, Australia
| | | |
Collapse
|
32
|
Kukafka R, Eysenbach G, Wang J, Mao F, Wu L, Huang Y, Sun J, Cao F. Effectiveness of Digital Guided Self-help Mindfulness Training During Pregnancy on Maternal Psychological Distress and Infant Neuropsychological Development: Randomized Controlled Trial. J Med Internet Res 2023; 25:e41298. [PMID: 36763452 PMCID: PMC9960047 DOI: 10.2196/41298] [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: 07/21/2022] [Revised: 12/17/2022] [Accepted: 01/09/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Maternal psychological distress during pregnancy is associated with unfavorable outcomes in infants. Mindfulness-based interventions (MBIs) can effectively alleviate psychological distress, but there are often barriers to the access of face-to-face interventions. OBJECTIVE This study aimed to investigate the effectiveness of a digital guided self-help (GSH) MBI (GSH-MBI) in reducing maternal psychological distress and improving infant neuropsychological performance. METHODS This was a randomized controlled trial. We recruited 160 women who were 12 to 20 weeks pregnant and exhibited psychological distress. We randomized them into a digital GSH-MBI group and a control group (usual perinatal care). The digital GSH-MBI consisted of a 6-week intervention through a WeChat mini program, with a daily reminder sent to the participants by a research assistant via WeChat. The primary outcomes consisted of maternal psychological distress, including depression, anxiety, and pregnancy-related anxiety symptoms, which were assessed at 6 time points from baseline to 6 months post partum (only pregnancy-related anxiety symptoms were assessed 3 times during pregnancy). The secondary outcomes were infant neuropsychological outcomes, including temperament and developmental behaviors, which were assessed at 6 weeks and 6 months post partum. RESULTS Compared with the control group, the digital GSH-MBI group showed a significant reduction in depression, anxiety, and pregnancy-related anxiety symptoms. In addition, the scores of the digital GSH-MBI group were lower than those of the control group for the 3 types of infant temperament at 6 weeks post partum, including quality of mood, distractibility, and adaptability. CONCLUSIONS Digital GSH-MBIs are effective in alleviating psychological distress among pregnant women and protecting infant outcomes. TRIAL REGISTRATION Chinese Clinical Trial Register ChiCTR2000040717; https://www.chictr.org.cn/showproj.aspx?proj=65376.
Collapse
Affiliation(s)
| | | | - Juan Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Fangxiang Mao
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Liuliu Wu
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Yongqi Huang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Jiwei Sun
- Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fenglin Cao
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| |
Collapse
|
33
|
Papola D, Ostuzzi G, Tedeschi F, Gastaldon C, Purgato M, Del Giovane C, Pompoli A, Pauley D, Karyotaki E, Sijbrandij M, Furukawa TA, Cuijpers P, Barbui C. CBT treatment delivery formats for panic disorder: a systematic review and network meta-analysis of randomised controlled trials. Psychol Med 2023; 53:614-624. [PMID: 37132646 PMCID: PMC9975966 DOI: 10.1017/s0033291722003683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 11/03/2022] [Accepted: 11/10/2022] [Indexed: 12/13/2022]
Abstract
Several in-person and remote delivery formats of cognitive-behavioural therapy (CBT) for panic disorder are available, but up-to-date and comprehensive evidence on their comparative efficacy and acceptability is lacking. Our aim was to evaluate the comparative efficacy and acceptability of all CBT delivery formats to treat panic disorder. To answer our question we performed a systematic review and network meta-analysis of randomised controlled trials. We searched MEDLINE, Embase, PsycINFO, and CENTRAL, from inception to 1st January 2022. Pairwise and network meta-analyses were conducted using a random-effects model. Confidence in the evidence was assessed using Confidence in Network Meta-Analysis (CINeMA). The protocol was published in a peer-reviewed journal and in PROSPERO. We found a total of 74 trials with 6699 participants. Evidence suggests that face-to-face group [standardised mean differences (s.m.d.) -0.47, 95% confidence interval (CI) -0.87 to -0.07; CINeMA = moderate], face-to-face individual (s.m.d. -0.43, 95% CI -0.70 to -0.15; CINeMA = Moderate), and guided self-help (SMD -0.42, 95% CI -0.77 to -0.07; CINeMA = low), are superior to treatment as usual in terms of efficacy, whilst unguided self-help is not (SMD -0.21, 95% CI -0.58 to -0.16; CINeMA = low). In terms of acceptability (i.e. all-cause discontinuation from the trial) CBT delivery formats did not differ significantly from each other. Our findings are clear in that there are no efficacy differences between CBT delivered as guided self-help, or in the face-to-face individual or group format in the treatment of panic disorder. No CBT delivery format provided high confidence in the evidence at the CINeMA evaluation.
Collapse
Affiliation(s)
- Davide Papola
- Department of Neuroscience, Biomedicine and Movement Science, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Giovanni Ostuzzi
- Department of Neuroscience, Biomedicine and Movement Science, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Federico Tedeschi
- Department of Neuroscience, Biomedicine and Movement Science, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Chiara Gastaldon
- Department of Neuroscience, Biomedicine and Movement Science, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Marianna Purgato
- Department of Neuroscience, Biomedicine and Movement Science, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Cinzia Del Giovane
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | | | - Darin Pauley
- Department of Clinical, Neuro and Developmental Psychology, WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro and Developmental Psychology, WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Toshi A. Furukawa
- Departments of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Corrado Barbui
- Department of Neuroscience, Biomedicine and Movement Science, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| |
Collapse
|
34
|
Mavragani A, Svedberg P, Lexén A, Tjörnstrand C, Strid C, Bejerholm U. Co-design Process of a Digital Return-to-Work Solution for People With Common Mental Disorders: Stakeholder Perception Study. JMIR Form Res 2023; 7:e39422. [PMID: 36652285 PMCID: PMC9892984 DOI: 10.2196/39422] [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: 05/09/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Service users and other stakeholders have had few opportunities to influence the design of their mental health and return-to-work services. Likewise, digital solutions often fail to align with stakeholders' needs and preferences, negatively impacting their utility. mWorks is a co-design initiative to create a digital return-to-work solution for persons with common mental disorders that is acceptable and engaging for those receiving and delivering the intervention. OBJECTIVE This study aimed to describe stakeholder perceptions and the involvement of a design process during the prototype development of mWorks. METHODS A co-design approach was used during the iterative development of mWorks. Overall, 86 stakeholders were recruited using a combination of purposeful and convenience sampling. Five stakeholder groups represented service users with experience of sick leave and common mental disorders (n=25), return-to-work professionals (n=19), employers (n=1), digital design and system developers (n=4), and members of the public (n=37). Multiple data sources were gathered using 7 iterations, from March 2018 to November 2020. The rich material was organized and analyzed using content analysis to generate themes and categories that represented this study's findings. RESULTS The themes revealed the importance of mWorks in empowering service users with a personal digital support solution that engages them back in work. The categories highlighted that mWorks needs to be a self-management tool that enables service users to self-manage as a supplement to traditional return-to-work services. It was also important that content features helped to reshape a positive self-narrative, with a focus on service users' strengths and resources to break the downward spiral of ill health during sick leave. Additional crucial features included helping service users mobilize their own strategies to cope with thoughts and feelings and formulate goals and a plan for their work return. Once testing of the alpha and beta prototypes began, user engagement became the main focus for greater usability. It is critical to facilitate the comprehension and purpose of mWorks, offer clear guidance, and enhance motivational and goal-setting strategies. CONCLUSIONS Stakeholders' experience-based knowledge asserted that mWorks needs to empower service users by providing them with a personal support tool. To enhance return-to-work prospects, users must be engaged in a meaningful manner while focusing on their strengths and resources.
Collapse
Affiliation(s)
| | - Petra Svedberg
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Annika Lexén
- Department of Health Science, Lund University, Lund, Sweden
| | | | | | | |
Collapse
|
35
|
Alavi N, Moghimi E, Stephenson C, Gutierrez G, Jagayat J, Kumar A, Shao Y, Miller S, Yee CS, Stefatos A, Gholamzadehmir M, Abbaspour Z, Shirazi A, Gizzarelli T, Khan F, Patel C, Patel A, Yang M, Omrani M. Comparison of online and in-person cognitive behavioral therapy in individuals diagnosed with major depressive disorder: a non-randomized controlled trial. Front Psychiatry 2023; 14:1113956. [PMID: 37187863 PMCID: PMC10175610 DOI: 10.3389/fpsyt.2023.1113956] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/10/2023] [Indexed: 05/17/2023] Open
Abstract
Objective The increased prevalence of major depressive disorder (MDD) amid the COVID-19 pandemic has resulted in substantial growth in online mental health care delivery. Compared to its in-person counterpart, online cognitive behavioral therapy (e-CBT) is a time-flexible and cost-effective method of improving MDD symptoms. However, how its efficacy compares to in-person CBT is yet to be explored. Therefore, the current study compared the efficacy of a therapist-supported, electronically delivered e-CBT program to in-person therapy in individuals diagnosed with MDD. Methods Participants (n = 108) diagnosed with MDD selected either a 12 week in-person CBT or an asynchronous therapist-supported e-CBT program. E-CBT participants (n = 55) completed weekly interactive online modules delivered through a secure cloud-based online platform (Online Psychotherapy Tool; OPTT). These modules were followed by homework in which participants received personalized feedback from a trained therapist. Participants in the in-person CBT group (n = 53) discussed sessions and homework with their therapists during one-hour weekly meetings. Program efficacy was evaluated using clinically validated symptomatology and quality of life questionnaires. Results Both treatments yielded significant improvements in depressive symptoms and quality of life from baseline to post-treatment. Participants who opted for in-person therapy presented significantly higher baseline symptomatology scores than the e-CBT group. However, both treatments demonstrated comparable significant improvements in depressive symptoms and quality of life from baseline to post-treatment. e-CBT seems to afford higher participant compliance as dropouts in the e-CBT group completed more sessions on average than those in the in-person CBT group. Conclusion The findings support e-CBT with therapist guidance as a suitable option to treat MDD. Future studies should investigate how treatment accessibility is related to program completion rates in the e-CBT vs. in-person group. Clinical Trial Registration ClinicalTrials.Gov Protocol Registration and Results System (NCT04478058); clinicaltrials.gov/ct2/show/NCT04478058.
Collapse
Affiliation(s)
- Nazanin Alavi
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
- OPTT Inc., Toronto, ON, Canada
- *Correspondence: Nazanin Alavi,
| | - Elnaz Moghimi
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | | | - Gilmar Gutierrez
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Jasleen Jagayat
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
| | - Anchan Kumar
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Yijia Shao
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Shadé Miller
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Caitlin S. Yee
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Anthi Stefatos
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | | | - Zara Abbaspour
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | | | - Tessa Gizzarelli
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Ferwa Khan
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Charmy Patel
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Archana Patel
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Megan Yang
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Mohsen Omrani
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
- OPTT Inc., Toronto, ON, Canada
| |
Collapse
|
36
|
Boutelle KN, Rhee KE, Manzano MA, Bernard RS, Strong DR, Eichen DM, Anderson CCA, Marcus BH, Akshoomoff N, Crow SJ. Design of the FRESH-DOSE study: A randomized controlled noninferiority trial evaluating a guided self-help family-based treatment program for children with overweight or obesity. Contemp Clin Trials 2023; 124:106996. [PMID: 36343880 PMCID: PMC9968239 DOI: 10.1016/j.cct.2022.106996] [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] [Received: 08/26/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
Abstract
Overweight and obesity affect 45% of children and increases the risk for several negative health sequelae. Family-Based Behavioral Treatment (FBT) is the most efficacious treatment for child weight management and consists of nutrition and physical activity education, behavior change skills and parenting skills training. FBT is time and staff intensive and can include 20, 60-min separate groups for parents and children, as well as 20-min behavior coaching sessions to help problem solve barriers to implementing the skills learned and individualize the program. Guided self-help (GSH) therapies involve providing families a manual to review independently and brief coaching sessions by an interventionist to facilitate adherence. We developed a GSH version of FBT (gshFBT) which provides a manual to both parents and children and includes 14, 20-min coaching sessions over 6-months. The current study randomized 150 children (mean age = 10.1 years (SD = 1.38); mean BMI% = 97.3% (SD = 2.84); mean BMIz = 2.09 (SD = 0.40); 49% female; 43% Hispanic) and one of their parents (mean age = 41.8 years (SD = 6.52); mean BMI = 32.0 (SD = 7.24); 87.3% female; 43% Hispanic) to either a group-based FBT program or a gshFBT program. Assessments are conducted at baseline, post-treatment (6 months), 6-month follow-up (12 months) and 12-month follow-up (18 months). Primary outcomes are child weight change (BMIz) and cost effectiveness. Recruitment occurred between May 2017 and October 2021 and follow-up assessments are underway. Given the public health concern for children with obesity and the low level of access to FBT, gshFBT could prove extremely useful to provide intervention to a greater proportion of the population.
Collapse
Affiliation(s)
- Kerri N Boutelle
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Kyung E Rhee
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Michael A Manzano
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court Suite 102, San Diego, CA 92120, USA
| | - Rebecca S Bernard
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - David R Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Dawn M Eichen
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Cheryl C A Anderson
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Bess H Marcus
- Department of Behavioral and Social Sciences, Brown University, School of Public Health, 121 South Main Street, box G-S121-3, Providence, RI 02912-G, USA
| | - Natacha Akshoomoff
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Scott J Crow
- Department of Psychiatry, University of Minnesota, F282/2A West 2450 Riverside Ave, Minneapolis, MN 55454, USA
| |
Collapse
|
37
|
The efficacy of therapist-supported acceptance and commitment therapy-based bibliotherapy for psychological distress after stroke: a single-case multiple-baseline study. Behav Cogn Psychother 2023; 51:87-104. [PMID: 36214628 DOI: 10.1017/s135246582200042x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Psychological distress is common after stroke, and affects recovery. However, there are few evidence-based psychological treatments. This study evaluates a bibliotherapy-based approach to its amelioration. AIMS To investigate a stroke-specific self-management book, based on acceptance and commitment therapy (ACT), as a therapist-supported intervention for psychological distress after stroke. METHOD The design was a single case, randomised non-concurrent multiple-baseline design (MBD). Sixteen stroke survivors, eight males and eight females (mean age 60.6 years), participated in an MBD with three phases: A (randomised-duration baseline); B (intervention); and follow-up (at 3 weeks). During the baseline, participants received therapist contact only. In the bibliotherapy intervention, participants received bi-weekly therapist support. The primary measures of psychological distress (General Health Questionaire-12; GHQ-12) and quality of life (Satisfaction with Life Scale; SWLS) were completed weekly. Secondary measures of mood, wellbeing and illness impact were completed pre- and post-intervention. RESULTS Omnibus whole-group TAU-U analysis was statistically significant for each primary measure with a moderate effect size on both (0.6 and 0.3 for GHQ-12 and SWLS, respectively). Individual TAU-U analyses demonstrated that the majority of individuals exhibited positive change. All the secondary measures showed significant pre-post improvements. Eighty-one per cent of participants reported the book was helpful and 81% also found the ACT-based sections helpful. Relative risk calculations showed finding the book helpful was associated with improvement in GHQ-12 and SWLS scores. CONCLUSIONS ACT-based bibliotherapy, with therapist support, is a promising intervention for psychological difficulties after stroke.
Collapse
|
38
|
Sifat MS, Tasnim N, Stoebenau K, Green KM. A qualitative exploration of university student perspectives on mindfulness-based stress reduction exercises via smartphone app in Bangladesh. Int J Qual Stud Health Well-being 2022; 17:2113015. [PMID: 35980122 PMCID: PMC9397412 DOI: 10.1080/17482631.2022.2113015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose Mental health problems are proliferating, and access to mental health care is difficult due to barriers imposed by the COVID-19 pandemic in low-income countries such as Bangladesh. University students are susceptible to mental health concerns, given their unique stressors (i.e., academic pressure, new social environment). Mindfulness techniques can promote mental health , yet their acceptability has not been examined among Bangladeshi university students. These techniques can be used on a digital app, to decrease barriers to use.Qualitative methods were used to examine the acceptability of mindfulness among university students in Bangladesh. In-depth interviews (n = 12) were conducted to examine student reactions to linguistically (Bangla) and culturally adapted mindfulness exercises. Thematic analysis generated three themes (1) previous experience with mindfulness (2) positive responses to and (3) improvements to mindfulness exercises. Results The results showed favourable attitudes towards the mindfulness content; students expressed positive psychological and physiological reactions. Students welcomed the concept of using these exercises on an app and felt it could overcomepast barriers to help-seeking. Conclusions This evidence suggests the value of exploring the acceptability of an app with mindfulness exercises for mental health promotion through a larger-scale pilot study in university students in Bangladesh.
Collapse
Affiliation(s)
- Munjireen S. Sifat
- The University of Oklahoma Health Science Center, Health Promotion Research Center, Oklahoma City, Oklahoma, USA
| | - Naima Tasnim
- BRAC James P Grant School of Public Health, Dhaka, Bangladesh
| | - Kirsten Stoebenau
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Kerry M. Green
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, Maryland, USA
| |
Collapse
|
39
|
Barakat S, Maguire S. Accessibility of Psychological Treatments for Bulimia Nervosa: A Review of Efficacy and Engagement in Online Self-Help Treatments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010119. [PMID: 36612445 PMCID: PMC9819826 DOI: 10.3390/ijerph20010119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 05/30/2023]
Abstract
Bulimia nervosa is an eating disorder characterised by marked impairment to one's physical health and social functioning, as well as high rates of chronicity and comorbidity. This literature review aims to summarise existing academic research related to the symptom profile of BN, the costs and burden imposed by the illness, barriers to the receipt of care, and the evidence base for available psychological treatments. As a consequence of well-documented difficulties in accessing evidence-based treatments for eating disorders, efforts have been made towards developing innovative, diverse channels to deliver treatment, with several of these attempting to harness the potential of digital platforms. In response to the increasing number of trials investigating the utility of online treatments, this paper provides a critical review of previous attempts to examine digital interventions in the treatment of eating disorders. The results of a focused literature review are presented, including a detailed synthesis of a knowledgeable selection of high-quality articles with the aim of providing an update on the current state of research in the field. The results of the review highlight the potential for online self-help treatments to produce moderately sized reductions in core behavioural and cognitive symptoms of eating disorders. However, concern is raised regarding the methodological limitations of previous research in the field, as well as the high rates of dropout and poor adherence reported across most studies. The review suggests directions for future research, including the need to replicate previous findings using rigorous study design and methodology, as well as further investigation regarding the utility of clinician support and interactive digital features as potential mechanisms for offsetting low rates of engagement with online treatments.
Collapse
Affiliation(s)
- Sarah Barakat
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Camperdown 2050, Australia
- School of Psychology, University of Sydney, Camperdown 2050, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Camperdown 2050, Australia
| |
Collapse
|
40
|
Kriston L, Liebherz S, Köhnen M. Concerns about 'A comparison of electronically-delivered and face to face cognitive behavioural therapies in depressive disorders: A systematic review and meta-analysis'. EClinicalMedicine 2022; 54:101763. [PMID: 36471730 PMCID: PMC9719072 DOI: 10.1016/j.eclinm.2022.101763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
|
41
|
Beerli J, Ehlert U, Amiel Castro RT. Internet-based interventions for perinatal depression and anxiety symptoms: an ethnographic qualitative study exploring the views and opinions of midwives in Switzerland. BMC PRIMARY CARE 2022; 23:172. [PMID: 35836110 PMCID: PMC9281123 DOI: 10.1186/s12875-022-01779-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/15/2022] [Indexed: 11/13/2022]
Abstract
Background Mental disorders such as depression and anxiety are common during pregnancy and postpartum, but are frequently underdiagnosed and untreated. In the last decades, internet-based interventions have emerged as a treatment alternative showing similar effectiveness to face-to-face psychotherapy. We aimed to explore midwives’ perceptions of the acceptability of internet-based interventions for the treatment of perinatal depression and anxiety symptoms. Methods In this ethnographic qualitative study, semi-structured interviews were conducted with 30 midwives. We followed the Consolidated Criteria for Reporting Qualitative Research Checklist (COREQ). Audio-recorded interviews were transcribed verbatim and analysed using framework analysis. The identified framework categories were rated individually by two independent raters. Krippendorff’s alpha coefficient was used to ensure the reliability of the rating. Results Four main themes emerged: midwives’ experience with patients’ mental health issues; the role of healthcare workers in women’s utilisation of internet-based interventions in the perinatal period; the overall perception of internet-based interventions; and recommendation of internet-based interventions to perinatal women. Twenty-five of the 30 participants viewed internet-based interventions as an acceptable type of intervention, which they would recommend to a subgroup of patients (e.g. women who are well-educated or younger). All except for two midwives identified themselves and medical doctors as key figures regarding patients’ utilisation of internet-based interventions, although a third of the interviewees highlighted that they needed sufficient information about such interventions. Finally, several participants suggested features which could be relevant to develop more acceptable and feasible internet-based interventions in the future. Discussion Participants’ overall perception of internet-based interventions for perinatal depression and anxiety symptoms was positive. This study underlines the importance of considering midwives’ views about internet-based interventions for perinatal mental health care. Our findings have implications for the practice not only of midwives but also of other maternity care professionals. Future studies examining the views of other health professionals are warranted. • There is a lack of studies on health professionals’ views about women’s utilisation of internet-based interventions in the perinatal period. • Our findings suggest that midwives have a positive perception of internet-based interventions, despite identifying disadvantages and having concerns about their use. • These findings are encouraging and contribute to the continued efforts to develop internet-based mental health interventions as a way to support perinatal women screened or diagnosed with anxiety and/or depressive symptoms.
Collapse
|
42
|
Sjömark J, Svanberg A, Viirman F, Larsson M, Poromaa I, Skalkidou A, Jonsson M, Parling T. Antepartum and labour-related single predictors of non-participation, dropout and lost to follow up in a randomised controlled trial comparing internet-based cognitive-behaviour therapy with treatment as usual for women with negative birth experiences and/or post-traumatic stress following childbirth. BMJ Open 2022; 12:e063214. [PMID: 36442895 PMCID: PMC9710351 DOI: 10.1136/bmjopen-2022-063214] [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] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Internet-based interventions are often hampered by high dropout rates. The number of individuals who decline to participate or dropout are reported, but reasons for dropout are not. Identification of barriers to participation and predictors of dropout may help improve the efficacy of internet-based clinical trials. The aim was to investigate a large number of possible predictors for non-participation and dropout in a randomised controlled trial for women with a negative birth experience and/or post-traumatic stress following childbirth. SETTING A childbirth clinic at a university hospital in Sweden. PARTICIPANTS The sample included 1523 women who gave birth between September 2013 and February 2018. All women who rated an overall negative birth experience on a Likert scale, and/or had an immediate caesarean section (CS), and/or severe postpartum haemorrhage (≥ 2000 mL) were eligible. METHODS Demographic, antepartum, and labour-related/postpartum predictors were investigated for non-participation (eligible but denied participation), pre-treatment dropout (prior to intervention start), treatment dropout, and loss to follow-up. Descriptive statistics and logistic regression were used in the data analysis. RESULTS A majority (80.3 %) were non-participants. Non-participation was predicted by lower level of education, being foreign-born, no experience of counselling for fear of childbirth, multiparity, vaginal delivery (vs CS and vacuum-assisted delivery) and absence of: preeclampsia, anal sphincter injury and intrapartum fetal distress. Pretreatment dropout was predicted by the absence of severe haemorrhage. Treatment dropout was predicted by vaginal delivery (vs immediate CS), vertex presentation and good overall birth experience. Loss to follow-up was predicted by vaginal delivery (vs immediate CS or vacuum-assisted delivery) and absence of intrapartum fetal distress. CONCLUSIONS Mothers with no obstetric complications were more likely to not participate and dropout at different time points. Both demographic, antepartum and obstetrical variables are important to attend to while designing procedures to maximise participation in internet-delivered cognitive-behavioral therapy. TRIAL REGISTRATION NUMBER ISRCTN39318241.
Collapse
Affiliation(s)
- Josefin Sjömark
- Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Agneta Svanberg
- Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Frida Viirman
- Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Margareta Larsson
- Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Inger Poromaa
- Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Maria Jonsson
- Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Thomas Parling
- Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services Region Stockholm, Stockholm, Sweden
| |
Collapse
|
43
|
Kotera Y, Rennick-Egglestone S, Ng F, Llewellyn-Beardsley J, Ali Y, Newby C, Fox C, Slade E, Bradstreet S, Harrison J, Franklin D, Todowede O, Slade M. Assessing diversity and inclusivity is the next frontier in mental health recovery narrative research and practice (Preprint). JMIR Ment Health 2022; 10:e44601. [PMID: 37067882 PMCID: PMC10152384 DOI: 10.2196/44601] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/24/2022] [Accepted: 01/01/2023] [Indexed: 01/02/2023] Open
Abstract
Demand for digital health interventions is increasing in many countries. The use of recorded mental health recovery narratives in digital health interventions is becoming more widespread in clinical practice. Mental health recovery narratives are first-person lived experience accounts of recovery from mental health problems, including struggles and successes over time. Helpful impacts of recorded mental health recovery narratives include connectedness with the narrative and validation of experiences. Possible harms include feeling disconnected and excluded from others. Diverse narrative collections from many types of narrators and describing multiple ways to recover are important to maximize the opportunity for service users to benefit through connection and to minimize the likelihood of harm. Mental health clinicians need to know whether narrative collections are sufficiently diverse to recommend to service users. However, no method exists for assessing the diversity and inclusivity of existing or new narrative collections. We argue that assessing diversity and inclusivity is the next frontier in mental health recovery narrative research and practice. This is important, but methodologically and ethically complex. In this viewpoint, we propose and evaluate one diversity and two inclusivity assessment methods. The diversity assessment method involves use of the Simpson Diversity Index. The two inclusivity assessment methods are based on comparator demographic rates and arbitrary thresholds, respectively. These methods were applied to four narrative collections as a case study. Refinements are needed regarding a narrative assessment tool in terms of its practicality and cultural adaptation.
Collapse
Affiliation(s)
- Yasuhiro Kotera
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Stefan Rennick-Egglestone
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Fiona Ng
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Joy Llewellyn-Beardsley
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Yasmin Ali
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Chris Newby
- School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Caroline Fox
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Emily Slade
- Department of Computer Science, University of Oxford, Oxford, United Kingdom
| | - Simon Bradstreet
- School of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Julian Harrison
- Narrative Experiences Online Lived Experience Advisory Panel, Nottingham, United Kingdom
| | - Donna Franklin
- Narrative Experiences Online Lived Experience Advisory Panel, Nottingham, United Kingdom
| | - Olamide Todowede
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
- Faculty of Nursing and Health Sciences, Health and Community Participation Division, Nord University, Namsos, Norway
| |
Collapse
|
44
|
Costescu C, Podina IR, Voinescu A. Editorial: Digital mental health: Interventions and assessment. Front Psychol 2022; 13:1014527. [PMID: 36506981 PMCID: PMC9731277 DOI: 10.3389/fpsyg.2022.1014527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022] Open
Affiliation(s)
- Cristina Costescu
- Department of Special Education, Babeş-Bolyai University, Cluj-Napoca, Romania,*Correspondence: Cristina Costescu
| | - Ioana R. Podina
- Laboratory of Cognitive Clinical Sciences, University of Bucharest, Bucharest, Romania,Department of Applied Psychology and Psychotherapy, University of Bucharest, Bucharest, Romania
| | | |
Collapse
|
45
|
Sweetman J, Knapp P, McMillan D, Fairhurst C, Delgadillo J, Hewitt C. Risk factors for initial appointment non-attendance at Improving Access to Psychological Therapy (IAPT) services: A retrospective analysis. Psychother Res 2022; 33:535-550. [DOI: 10.1080/10503307.2022.2140616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Peter Knapp
- Hull York Medical School and Department of Health Sciences, University of York, York, UK
| | - Dean McMillan
- Hull York Medical School and Department of Health Sciences, University of York, York, UK
| | - Caroline Fairhurst
- Department of Health Sciences, University of York, York, UK
- York Trials Unit, University of York, York, UK
| | - Jaime Delgadillo
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
- Rotherham Doncaster and South Humber NHS Foundation Trust, Doncaster, UK
| | - Catherine Hewitt
- Department of Health Sciences, University of York, York, UK
- York Trials Unit, University of York, York, UK
| |
Collapse
|
46
|
Ye Z, Li W, Zhu R. Online psychosocial interventions for improving mental health in people during the COVID-19 pandemic: A systematic review and meta-analysis. J Affect Disord 2022; 316:120-131. [PMID: 35970325 PMCID: PMC9373538 DOI: 10.1016/j.jad.2022.08.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/05/2022] [Accepted: 08/10/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, interventions for public mental health were mostly delivered through online modalities. Although many studies have explored the effectiveness of online psychosocial interventions through randomized controlled trials, there is a lack of quantitative synthesis of the effectiveness of online psychosocial interventions and an examination of their overall application. OBJECTIVE To understand the commonly used psychosocial interventions during the COVID-19 pandemic and the effectiveness of the interventions. METHODS Risk bias was assessed in the included studies according to the Cochrane Collaboration criteria, and data from post-test and follow-up were combined for standardized mean differences using Stata 16.0 software, and sources of heterogeneity were explored by subgroup analysis, and risk bias was assessed in the included studies using Review Manager 5.4 software. The study was written in strict accordance with PRISMA specifications, and registration was completed on the PROSPERO platform (CRD42022302917). RESULTS The online psychosocial intervention had an ameliorating effect on anxiety (SMD = -0.78), depression (SMD = -0.80), and insomnia (SMD = -0.19) in the public during the COVID-19 pandemic, was ineffective for the intervention on stress, and the effectiveness of the intervention on depression continued at follow-up. Subgroup analyses showed that the type of intervention, intervention form, Duration of intervention, and setting of the control group influenced the trial results to some extent, with cognitive behavioral therapy being the most effective intervention for anxiety and depressive symptoms, self-help interventions being more effective than interventions with therapist interventions, and 1-4 week interventions being more effective than 5-8 week interventions. Due to the limited number of studies included in the analysis and variability in quality, more randomized controlled trials are needed to test the findings. CONCLUSION Online psychosocial interventions can be effective in improving symptoms of anxiety, depression, stress, and insomnia in the public during the COVID-19 pandemic. However, additional randomized controlled trial studies are needed to determine which types of interventions are more appropriate for which populations and how they can be implemented to achieve better intervention outcomes.
Collapse
Affiliation(s)
- Zhiyu Ye
- School of Education Research, China University of Geosciences, Wuhan, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| | - Wentian Li
- School of Education Research, China University of Geosciences, Wuhan, China; Wuhan Mental Health Centre, Wuhan, China.
| | - Ruizi Zhu
- Queen's University, Kingston, Canada
| |
Collapse
|
47
|
A Digital Mental Health Intervention for Children and Parents Using a User-Centred Design. ADVANCES IN HUMAN-COMPUTER INTERACTION 2022. [DOI: 10.1155/2022/4322177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The number of children with mental health problems is ever-growing; as a result, nearly 850,000 children in the UK are believed to have clinically significant problems, and only a quarter show evidence of mental illness. Family members often have a hard time dealing with children with mental health problems. As a result, digital mental health interventions are becoming popular for people seeking professional mental health services. Previous studies in this area have also shown that parents who are divorced or working away from home struggle to maintain contact with their children. This lack of communication between the parents and their children can worsen the children’s mental health conditions and prevent early diagnosis. Human-centred design thinking is applied step by step in this paper to provide an intuitive understanding of the design process. Five stages of the design thinking process were examined to follow a correct path. The results were promising, and the feedback received assured that the product helps parents to better monitor their children’s mental health and provides support when needed. The design thinking process was followed in concordance with the user needs identified from previous studies in this area, which led to a working solution that benefits both parents and children in tackling these problems.
Collapse
|
48
|
Maroti D, Hallberg H, Lindqvist K, Mechler J. Using psychodynamic principles in guided internet-delivered therapy (IPDT). PSYCHOANALYTIC PSYCHOTHERAPY 2022. [DOI: 10.1080/02668734.2022.2124441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Affiliation(s)
- Daniel Maroti
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Henrik Hallberg
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Karin Lindqvist
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Jakob Mechler
- Department of Psychology, Stockholm University, Stockholm, Sweden
| |
Collapse
|
49
|
Peipert A, Krendl AC, Lorenzo-Luaces L. Waiting Lists for Psychotherapy and Provider Attitudes Toward Low-Intensity Treatments as Potential Interventions: Survey Study. JMIR Form Res 2022; 6:e39787. [PMID: 36112400 PMCID: PMC9526124 DOI: 10.2196/39787] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/19/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Common mental disorders, including depression and anxiety, are leading causes of disability worldwide. Digital mental health interventions, such as web-based self-help and other low-intensity treatments (LITs) that are not digital (eg, bibliotherapy), have the potential to reach many individuals by circumventing common barriers present in traditional mental health care. It is unclear how often LITs are used in clinical practice, or whether providers would be interested in their use for treatment waiting lists. Objective The aims of this study were to (1) describe current practices for treatment waiting lists, (2) describe providers’ attitudes toward digital and nondigital LITs for patients on a waiting list, and (3) explore providers’ willingness to use digital and nondigital LITs and their decisions to learn about them. Methods We surveyed 141 practicing mental health care providers (eg, therapists and psychologists) and provided an opportunity for them to learn about LITs. Results Most participants reported keeping a waiting list. Few participants reported currently recommending digital or nondigital LITs, though most were willing to use at least one for patients on their waiting list. Attitudes toward digital and nondigital LITs were neutral to positive. Guided digital and nondigital LITs were generally perceived to be more effective but less accessible, and unguided interventions were perceived to be less effective but more accessible. Most participants selected to access additional information on LITs, with the most popular being web-based self-help. Conclusions Results suggest providers are currently not recommending LITs for patients on treatment waiting lists but would be willing to recommend them. Future work should explore barriers and facilitators to implementing digital and nondigital LITs for patients on treatment waiting lists.
Collapse
Affiliation(s)
- Allison Peipert
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, United States
| | - Anne C Krendl
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, United States
| | - Lorenzo Lorenzo-Luaces
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, United States
| |
Collapse
|
50
|
De Jesús-Romero R, Wasil A, Lorenzo-Luaces L. Willingness to Use Internet-Based Versus Bibliotherapy Interventions in a Representative US Sample: Cross-sectional Survey Study. JMIR Form Res 2022; 6:e39508. [PMID: 36001373 PMCID: PMC9453577 DOI: 10.2196/39508] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 11/29/2022] Open
Abstract
Background Self-help interventions have the potential to increase access to evidence-based mental health care. Self-help can be delivered via different formats, including print media or digital mental health interventions (DMHIs). However, we do not know which delivery format is more likely to result in higher engagement. Objective The aims of this study were to identify if there is a preference for engaging in print media versus DMHIs and whether there are individual differences in relative preferences. Methods Participants were 423 adults between the ages of 18 and 82 years (201/423, 47.5% female) recruited on Prolific as a nationally representative sample of the US population, including non-Hispanic White (293/423, 69.2%), non-Hispanic Black (52/423, 12%), Asian (31/423, 7%), Hispanic (25/423, 6%), and other individuals (22/423, 5%). We provided individuals with psychoeducation in different self-help formats and measured their willingness to use print media versus DMHIs. We also assessed participants’ demographics, personality, and perception of each format’s availability and helpfulness and used these to predict individual differences in the relative preferences. Results Participants reported being more willing to engage with print media than with DMHIs (B=0.41, SE 0.08; t422=4.91; P<.001; d=0.24, 95% CI 0.05-0.43). This preference appeared to be influenced by education level (B=0.22, SE 0.09; t413=2.41; P=.02; d=0.13, 95% CI –0.06 to 0.32), perceived helpfulness (B=0.78, SE 0.06; t411=13.66; P<.001; d=0.46, 95% CI 0.27-0.66), and perceived availability (B=0.20, SE 0.58; t411=3.25; P=.001; d=0.12, 95% CI 0.07-0.30) of the self-help format. Conclusions This study suggests an overall preference for print media over DMHIs. Future work should investigate whether receiving mental health treatment via participants’ preferred delivery format can lead to higher engagement.
Collapse
Affiliation(s)
- Robinson De Jesús-Romero
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, United States
| | - Akash Wasil
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, United States
| | - Lorenzo Lorenzo-Luaces
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, United States
| |
Collapse
|