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Harith H, Nik Farid ND, Yahya A, Mohd Shuib NL. The Effectiveness of EduMind for Mental Health Promotion Among Youths. Cureus 2024; 16:e61462. [PMID: 38826914 PMCID: PMC11143080 DOI: 10.7759/cureus.61462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2024] [Indexed: 06/04/2024] Open
Abstract
Introduction The global surge in mental health issues, particularly among the youth, is evident. Despite the proliferation of digital mental health services, their adoption remains limited, hindered by various barriers. To address this issue, an evidence-based, validated digital mental health intervention is necessary. Although much research has explored the effectiveness of such interventions, there was limited evidence supporting those within the youth population. The objective of this research is to assess the effects of an interventional module on depression, anxiety, and stress symptoms among youths. Methods The EduMind online mental health intervention contents were developed from a needs assessment and a scoping review of effective psychotherapies, achieving a high content validation index (CVI) of 0.96. The contents were integrated into a web application to assess its effectiveness among the target population which consisted of university students of a local institution. A quasi-experimental study compared the intervention group (n=264) to a waitlist-control group (n=200), evaluating changes in mental health status with the Depression, Anxiety and Stress Scale 21 (DASS-21) questionnaire using analysis of covariance (ANCOVA) to analyse mean differences. Results Participants in the intervention group indicated a significant decrease (p < 0.001) in depression, anxiety, and stress. The pre-test and post-test mean scores in the intervention group were 15.81 and 8.97 for depression, 11.46 and 7.02 for anxiety and 14.64 and 6.33 for stress, respectively. In the control group, there was no significant difference between the pre-test and post-test mean scores for depression. However, there was a slight significant reduction for anxiety with pre- and post-test scores of 13.31 and 12.95. Stress mean scores exhibited a slight increase, rising from 13.55 to 14.24. The final phase revealed significant improvements in mental health status between groups, with significant effect sizes for stress (ƞp2 = 0.57, p < 0.001), depression (ƞp2 = 0.71, p < 0.001), and anxiety (ƞp2 = 0.27, p < 0.001). Conclusion The findings contribute to the advancement of technology-assisted health services, facilitating greater uptake among the population. This study utilized a comprehensive module development framework and demonstrated the effectiveness of the expert-guided mental health intervention module. Furthermore, the study suggests potential integration with the National Strategic Plan for Mental Health 2020-2025 and the National Mental Health Policy, proposing the web application as a potential compulsory student screening tool administered by universities. The information gathered by this application could inform future research directions, propelling technological-assisted mental health services to new heights.
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Affiliation(s)
- Hazwa Harith
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MYS
| | - Nik Daliana Nik Farid
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MYS
| | - Abqariyah Yahya
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MYS
| | - Nor Liyana Mohd Shuib
- Department of Information Systems, Faculty of Computer Science and Information Technology, Universiti Malaya, Kuala Lumpur, MYS
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Zhu B, Hou Y, Yu X, Jiang M, Lu M, Shang M, Zhen H, Gu Y, Li H, Tao F. A hybrid effectiveness-implementation trial of application-based tiered care (Mom's Good Mood) in treating perinatal anxiety within a primary health care system in China. BMJ Glob Health 2024; 9:e013604. [PMID: 38195154 PMCID: PMC10806923 DOI: 10.1136/bmjgh-2023-013604] [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: 08/02/2023] [Accepted: 11/25/2023] [Indexed: 01/11/2024] Open
Abstract
INTRODUCTION Perinatal anxiety (PNA) is a major public health concern. METHODS A hybrid effectiveness-implementation trial was conducted in two antenatal clinics in Hefei, China, to assess the effectiveness and cost-effectiveness of application-based tiered care (Mom's Good Mood, MGM) in treating PNA and to understand how well it fits into routine practices. Pregnant women who scored at least 5 points on the 7-Item Generalised Anxiety Disorder Scale (GAD-7) scale were successively assigned to the control group or the intervention group, which were given the usual care and MGM on usual care, respectively. At 6 months post partum, anxiety, depression and life satisfaction were assessed. Intention-to-treat analysis and the Reach, Effectiveness, Adoption, Implementation and Maintenance framework were adopted. RESULTS A total of 214 women were assigned to the control group and 341 to the intervention group. The mean changes in GAD-7 scores (Least-squares means, LSM, -1.42, 95% CI -2.18 to -0.66) and the risk of anxiety (adjusted odds ratio, aOR 0.30, 95% CI 0.18 to 0.51) were decreased, and the anxiety remission rate (aOR 2.72, 95% CI 1.69 to 4.40) were improved in the intervention group. Similar findings were observed regarding the change in Edinburgh Postnatal Depression Scale scores (LS -1.92, 95% CI -2.85 to -0.99), depression remission rate (aOR 2.24, 95% CI 1.39 to 3.63) and the risk of depression (aOR 0.57, 95% CI 0.33 to 0.98). MGM only costs ¥1.88 (US$0.27) per pregnant woman to boost the postpartum anxiety remission rate by 1% and was revealed to have a high reach rate of 78.3%, an adoption rate of 51.3%-80.8%. CONCLUSION MGM is a cost-effective and accessible tool in coping with PNA. TRIAL REGISTRATION NUMBER ChiCTR2100053419.
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Affiliation(s)
- Beibei Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yanyan Hou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Xiayan Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Minmin Jiang
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Mengjuan Lu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Mengqing Shang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Hualong Zhen
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yue Gu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Haiyan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
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Dale M, Eccles FJR, Melvin K, Khan Z, Jones L, Zarotti N, Kiani R, Johnson J, Wells R, Simpson J. Guided self-help for anxiety among Huntington's disease gene expansion carriers (GUIDE-HD) compared to treatment as usual: a randomised controlled feasibility trial. Pilot Feasibility Stud 2023; 9:159. [PMID: 37700320 PMCID: PMC10496323 DOI: 10.1186/s40814-023-01364-5] [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: 12/13/2022] [Accepted: 07/15/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Huntington's disease (HD) is an adult-onset genetic neurodegenerative condition associated with cognitive decline, motor impairments, and emotional difficulties. Anxiety affects up to 71% of HD gene expansion carriers (i.e., those with the version of the gene that causes HD) and can negatively impact quality of life, worsen other HD symptoms, and increase suicide risk. Therefore, helping people with their anxiety should be a clinical priority. A significant evidence base now exists for low-cost talking therapies for anxiety, such as guided self-help, and with people with other neurodegenerative conditions (e.g., Parkinson's disease). However, this type of intervention has not been specifically assessed with HD gene expansion carriers. METHODS This protocol describes an exploratory randomised controlled feasibility study of a psychological intervention for anxiety for HD gene expansion carriers. The 10 session guided self-help intervention ('GUIDE-HD') is based on a blend of second and third wave cognitive behavioural models of anxiety (cognitive behaviour therapy [CBT] and acceptance and commitment therapy [ACT]) and is adapted to meet the specific needs of an HD population. This study will compare guided self-help with treatment as usual (TAU), with 15 HD gene expansion carriers randomly allocated to each group. Participants will be recruited across the UK. Quantitative data will be collected pre-intervention, immediately post-intervention, 3-month post-intervention and 6-month post-intervention. Qualitative data will be collected at one month post-intervention from participants, including HD carers. The data will be analysed to assess whether the current intervention and study design are feasible to progress to a larger randomised controlled trial. Feasibility has been defined in terms of recruitment rate, retention rate to both trial arms, intervention adherence, and acceptability of the intervention and measurement tools. DISCUSSION Given the lack of evidenced interventions to date to support the wellbeing of people with the expanded Huntington's gene, this study will assess the feasibility of progressing this particular intervention to a full trial. To try and increase the acceptability of the intervention, a number of stakeholders, including those affected by HD and in caring roles, have been fundamental to the creation of the intervention (e.g., therapy manual, planned therapy process) to date. TRIAL REGISTRATION Trial ID: ISRCTN47330596 . Date registered: 28/09/2022. Protocol version and date: Version 2, 09/06/22. Trial sponsor organisation and contact: Leicestershire Partnership NHS Trust (Dave Clarke). Role of sponsor: Overall responsibility for the conduct and governance of the trial. Role of funder: Review of initial research proposal.
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Affiliation(s)
- Maria Dale
- Leicestershire Partnership NHS Trust, Mill Lodge, Narborough, Leicestershire, LE19 4SL, Leicester, UK
| | - Fiona J R Eccles
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4AH, UK
| | - Katie Melvin
- Leicestershire Partnership NHS Trust, Mill Lodge, Narborough, Leicestershire, LE19 4SL, Leicester, UK
| | - Zaynah Khan
- Leicestershire Partnership NHS Trust, Mill Lodge, Narborough, Leicestershire, LE19 4SL, Leicester, UK
| | - Lee Jones
- Leicestershire Partnership NHS Trust, Mill Lodge, Narborough, Leicestershire, LE19 4SL, Leicester, UK
| | - Nicolò Zarotti
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4AH, UK
- Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Salford, M6 8HD, UK
| | - Reza Kiani
- Leicestershire Partnership NHS Trust, Mill Lodge, Narborough, Leicestershire, LE19 4SL, Leicester, UK
| | | | | | - Jane Simpson
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4AH, UK.
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Kellett S, Bee C, Smithies J, Aadahl V, Simmonds-Buckley M, Power N, Dugen-Williams C, Fallon N, Delgadillo J. Cognitive-behavioural versus cognitive-analytic guided self-help for mild-to-moderate anxiety: a pragmatic, randomised patient preference trial. Br J Psychiatry 2023; 223:438-445. [PMID: 37395600 PMCID: PMC10895510 DOI: 10.1192/bjp.2023.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/04/2023] [Accepted: 05/16/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Guided self-help (GSH) for anxiety is widely implemented in primary care services because of service efficiency gains, but there is also evidence of poor acceptability, low effectiveness and relapse. AIMS The aim was to compare preferences for, acceptability and efficacy of cognitive-behavioural guided self-help (CBT-GSH) versus cognitive-analytic guided self-help (CAT-GSH). METHOD This was a pragmatic, randomised, patient preference trial (Clinical trials identifier: NCT03730532). The Beck Anxiety Inventory (BAI) was the primary outcome at 8- and 24-week follow-up. Interventions were delivered competently on the telephone via structured workbooks over 6-8 (30-35 min) sessions by trained practitioners. RESULTS A total of 271 eligible participants were included, of whom 19 (7%) accepted being randomised and 252 (93%) chose their treatment. In the preference cohort, 181 (72%) chose CAT-GSH and 71 (28%) preferred CBT-GSH. BAI outcomes in the preference and randomised cohorts did not differ at 8 weeks (-0.80, 95% confidence interval (CI) -4.52 to 2.92) or 24 weeks (0.85, 95% CI -2.87 to 4.57). After controlling for allocation method and baseline covariates, there were no differences between CAT-GSH and CBT-GSH at 8 weeks (F(1, 263) = 0.22, P = 0.639) or at 24 weeks (F(1, 263) = 0.22, P = 0.639). Mean BAI change from baseline was a reduction of 9.28 for CAT-GSH and 9.78 for CBT-GSH at 8 weeks and 12.90 for CAT-GSH and 12.43 for CBT-GSH at 24 weeks. CONCLUSIONS Patients accessing routine primary care talking treatments prefer to choose the intervention they receive. CAT-GSH expands the treatment offer in primary care for patients with anxiety seeking a brief but analytically informed GSH solution.
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Affiliation(s)
- Stephen Kellett
- Rotherham Doncaster and South Humber NHS Foundation Trust, UK; and University of Sheffield, UK
| | | | | | | | | | - Niall Power
- Derbyshire Community Health Services NHS Foundation Trust, UK
| | | | | | - Jaime Delgadillo
- Rotherham Doncaster and South Humber NHS Foundation Trust, UK; and University of Sheffield, UK
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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.
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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
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Abbott D, Lack CW, Anderson P. Does Using a Mindfulness App Reduce Anxiety and Worry? A Randomized-Controlled Trial. J Cogn Psychother 2023; 37:26-42. [PMID: 36787997 DOI: 10.1891/jcpsy-d-20-00058] [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: 02/16/2023]
Abstract
Objectives: the availability of smartphone-based mindfulness training applications (apps) may circumvent many barriers to receiving in-person help, but little controlled research has been conducted on them. This study sought to evaluate the effectiveness of a widely used -mindfulness training app, Headspace, at reducing anxiety and worry. Methods: this study used a randomized-controlled design to examine the app using a 3 (Time; baseline, 4 weeks, 8 weeks) × 2 (Access; immediate, delayed for 4 weeks) design. Participants who reported moderate to high anxiety or worry were randomly assigned to receive -either -immediate access or delayed access to the app. For null hypothesis significance testing (NHST), analyses of variance were used to test the hypotheses that app access for 4 and 8 weeks would reduce anxiety and worry as compared to waitlist or baseline and that app access for 8 weeks would reduce anxiety and worry as compared to 4 weeks. Bayes estimates were used to -determine the level of evidence for the hypothesis that app access reduces anxiety and worry. Results: four weeks of app access significantly reduced anxiety symptoms, as did 8 weeks, but NHST indicated there were no significant difference between 4 and 8 weeks of access. We failed to reject the null for the analysis of variance on worry, but Bayesian estimates indicated substantial evidence for the hypothesis that the mindfulness training app reduces worry. Conclusions: this research shows that using Headspace can reduce anxiety and worry, but that there does not appear to be a consistent dose relation.
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Affiliation(s)
- Deah Abbott
- University of Central Oklahoma, Edmond, Oklahoma, USA
| | - Caleb W Lack
- University of Central Oklahoma, Edmond, Oklahoma, USA
| | - Page Anderson
- Georgia State University, Department of Psychology, Atlanta, Georgia, USA
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Kiro LS, Chernyshov OV, Zak MY, Iakovenko NO, Ovechko AI, Dorovskykh AV. THE EFFECT OF COGNITIVE-BEHAVIORAL THERAPY ON INDICATORS OF LIPID AND CARBOHYDRATE METABOLISM IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE ON THE BACKGROUND OF ABDOMINAL OBESITY. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:1913-1921. [PMID: 37898925 DOI: 10.36740/wlek202309103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
OBJECTIVE The aim: Analyse the impact and effectiveness of cognitive-behavioural therapy in patients with NAFLD on the background of AO on indicators of lipid and carbohydrate metabolism. PATIENTS AND METHODS Materials and methods: 85 patients with NAFLD and obesity of the 1st degree (42 women, 43 men) were examined. All patients were divided into two clinical groups: 1st group (research) - 48 people, who underwent a course of CBT for 6 months; the control group - 37 people, who followed only diet therapy, recommended physical activity, without involvement in CBT. The general clinical examination of patients consisted of the measurement of anthropometric and physiological indicators, the study of lipid and carbohydrate profile indicators. RESULTS Results: After a 6-month course of CBT, a decrease in the atherogenic coefficient (AC) was recorded in the patients of the 1st group in 2.29 times (p=0.037<0.05), the number of patients with hypertension of the 1st degree decreased in 1.8 times (p=0.0047<0.05) in comparison with the initial indicators (on the 1st day) and amount of patients with normal blood pressure of the 1st group increased by 2.4 times (p=0.0115<0.05) compared to the control group. CONCLUSION Conclusions: The course of CBT should be an integral component in the program for the management of obese patients to optimize not only the psycho-emo¬tional condition, but also to correct lipid and carbohydrate metabolism indicators, reduce the risk of developing cardiovascular and neurological complications.
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Affiliation(s)
- Liudmyla S Kiro
- INSTITUTE OF MEDICINE OF BLACK SEA NATIONAL UNIVERSITY, MYKOLAIV, UKRAINE
| | - Oleh V Chernyshov
- INSTITUTE OF MEDICINE OF BLACK SEA NATIONAL UNIVERSITY, MYKOLAIV, UKRAINE
| | - Maksym Yu Zak
- INSTITUTE OF MEDICINE OF BLACK SEA NATIONAL UNIVERSITY, MYKOLAIV, UKRAINE
| | | | - Anna I Ovechko
- INSTITUTE OF MEDICINE OF BLACK SEA NATIONAL UNIVERSITY, MYKOLAIV, UKRAINE
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Abstract
Importance Anxiety disorders have a lifetime prevalence of approximately 34% in the US, are often chronic, and significantly impair quality of life and functioning. Observations Anxiety disorders are characterized by symptoms that include worry, social and performance fears, unexpected and/or triggered panic attacks, anticipatory anxiety, and avoidance behaviors. Generalized anxiety disorder (6.2% lifetime prevalence), social anxiety disorder (13% lifetime prevalence), and panic disorder (5.2% lifetime prevalence) with or without agoraphobia are common anxiety disorders seen in primary care. Anxiety disorders are associated with physical symptoms, such as palpitations, shortness of breath, and dizziness. Brief screening measures applied in primary care, such as the Generalized Anxiety Disorder-7, can aid in diagnosis of anxiety disorders (sensitivity, 57.6% to 93.9%; specificity, 61% to 97%). Providing information about symptoms, diagnosis, and evidence-based treatments is a first step in helping patients with anxiety. First-line treatments include pharmacotherapy and psychotherapy. Selective serotonin reuptake inhibitors (SSRIs, eg, sertraline) and serotonin-norepinephrine reuptake inhibitors (SNRIs, eg, venlafaxine extended release) remain first-line pharmacotherapy for generalized anxiety disorder, social anxiety disorder, and panic disorder. Meta-analyses suggest that SSRIs and SNRIs are associated with small to medium effect sizes compared with placebo (eg, generalized anxiety disorder: standardized mean difference [SMD], -0.55 [95% CI, -0.64 to -0.46]; social anxiety disorder: SMD, -0.67 [95% CI, -0.76 to -0.58]; panic disorder: SMD, -0.30 [95% CI, -0.37 to -0.23]). Cognitive behavioral therapy is the psychotherapy with the most evidence of efficacy for anxiety disorders compared with psychological or pill placebo (eg, generalized anxiety disorder: Hedges g = 1.01 [large effect size] [95% CI, 0.44 to 1.57]; social anxiety disorder: Hedges g = 0.41 [small to medium effect] [95% CI, 0.25 to 0.57]; panic disorder: Hedges g = 0.39 [small to medium effect[ [95% CI, 0.12 to 0.65]), including in primary care. When selecting treatment, clinicians should consider patient preference, current and prior treatments, medical and psychiatric comorbid illnesses, age, sex, and reproductive planning, as well as cost and access to care. Conclusions and Relevance Anxiety disorders affect approximately 34% of adults during their lifetime in the US and are associated with significant distress and impairment. First-line treatments for anxiety disorders include cognitive behavioral therapy, SSRIs such as sertraline, and SNRIs such as venlafaxine extended release.
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Affiliation(s)
- Kristin L Szuhany
- Department of Psychiatry, New York University Grossman School of Medicine, New York
| | - Naomi M Simon
- Department of Psychiatry, New York University Grossman School of Medicine, New York
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Anvari MS, Hampton T, Tong MP, Kahn G, Triemstra JD, Magidson JF, Felton JW. Behavioral Activation Disseminated by Non-Mental Health Professionals, Paraprofessionals, and Peers: A Systematic Review. Behav Ther 2022; 54:524-538. [PMID: 37088508 DOI: 10.1016/j.beth.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
There is a striking disparity between the number of individuals with significant mental health concerns and those who are able to access care globally. One promising solution to expanding the mental health taskforce is task-sharing, or employing nonspecialists in the delivery of evidence-based interventions. Behavioral activation (BA), a brief intervention that focuses on scheduling rewarding activities into one's daily life, may have promise for delivery using task-sharing approaches due to its straightforward, flexible nature. The aim of this systematic review was to examine the current state of the literature on non-specialist-delivered BA and evaluate the evidence base of this approach. Three databases (Pubmed, PsycInfo, and Cochrane) were searched, and all articles were screened for inclusion criteria by two research assistants, included the review of titles, abstracts, and full-text. The final dataset consisted of 13 research studies, represented through 15 articles. A meta-analysis was conducted to examine the overall pooled effects of peer-delivered BA on depressive symptoms (the most widely examined clinical outcome). Studies reported on effectiveness and implementation outcomes of non-specialist-delivered BA for depression, substance use, loneliness, trauma survivors, and individuals with comorbid physical health conditions. Results provide initial support for the effectiveness of BA utilizing a task-sharing approach, and highlight the feasibility and acceptability of using nonspecialists to deliver BA in a variety of contexts, including low-resource settings.
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Affiliation(s)
| | - Tessa Hampton
- Center for Health Policy & Health Services Research, Henry Ford Health
| | | | - Geoffrey Kahn
- Center for Health Policy & Health Services Research, Henry Ford Health
| | - Justin D Triemstra
- Spectrum Health, Helen DeVos Children's Hospital; College of Medicine, Michigan State University
| | | | - Julia W Felton
- Center for Health Policy & Health Services Research, Henry Ford Health, Detroit
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10
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Bertuzzi V, Semonella M, Andersson G, Manzoni GM, Castelnuovo G, Molinari E, Pietrabissa G. Study protocol for a randomized controlled trial evaluating the effectiveness of an internet-based self-help intervention to cope with psychological distress due to COVID-19 in the Italian general population: the RinasciMENTE project. Trials 2022; 23:801. [PMID: 36153586 PMCID: PMC9509606 DOI: 10.1186/s13063-022-06714-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 09/04/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND This study aims to evaluate the feasibility and effectiveness of the RinasciMENTE program, an Internet-based self-help intervention based on cognitive behavioral therapy (CBT) principles and techniques in supporting individuals experiencing psychological impairments during the COVID-19 pandemic. A randomized controlled trial (RCT) design with random allocation at the level of individual will be conducted to compare the impact of the RinasciMENTE program with a waiting list control in improving the psychological functioning of the general population during the COVID-19 pandemic. METHODS A minimum sample of 128 participants experiencing mild/subthreshold levels of psychological symptoms during the COVID-19 pandemic will be recruited. After the initial screening, participants will be randomly assigned to either the experimental group or the control condition. The program will last 2 months, during which participants will receive 8 weekly CBT treatment modules. The impact of the RinasciMENTE program on selected primary and secondary psychological outcomes will be tested at the end of the intervention (2 months) and 6- and 12-month follow-ups. DISCUSSION We expect people to show an increased level of psychological functioning and to acquire the skills and self-confidence necessary to deal with the psychological consequences of the COVID-19 outbreak and its related social isolation during and following the pandemic. TRIAL REGISTRATION ClinicalTrials.gov NCT0497903 Registered on 28 May 2021.
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Affiliation(s)
- Vanessa Bertuzzi
- Department of Psychology, Catholic University of Milan, 20123, Milan, Italy
| | | | - Gerhard Andersson
- Department of Behavioural Science and Learning, Linköping, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Solna, Sweden
| | - Gian Mauro Manzoni
- Department of Psychology, Faculty of Psychology, eCampus University, 22100, Como, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, 20123, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Enrico Molinari
- Department of Psychology, Catholic University of Milan, 20123, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of Milan, 20123, Milan, Italy. .,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy.
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11
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Agin-Liebes G, Davis AK. Psilocybin for the Treatment of Depression: A Promising New Pharmacotherapy Approach. Curr Top Behav Neurosci 2022; 56:125-140. [PMID: 34811715 PMCID: PMC10072288 DOI: 10.1007/7854_2021_282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Depression is highly prevalent and represents the leading cause of global disability and primary contributor to overall global burden of disease. Several lines of evidence from early-phase experimental trials suggest that serotonergic psychedelics, particularly psilocybin, with therapeutic support show great promise in the treatment of depression with large effect sizes. Neuroimaging data have also revealed the dynamic effects of psilocybin on functional activity within and between neural regions. This chapter reviews the methods and findings from three small human laboratory clinical trials examining the effects of psilocybin therapy for patients with major depressive disorder and treatment-resistant depression. Insights from functional magnetic resonance imaging and qualitative analyses are also presented, as well as a discussion of study limitations and future directions for the research.
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Affiliation(s)
- Gabrielle Agin-Liebes
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA. .,Neuroscape, Sandler Neurosciences Center, San Francisco, CA, USA.
| | - Alan K Davis
- Department of Psychiatry, College of Social Work, The Ohio State University, Columbus, OH, USA.,Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, MD, USA
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12
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Benjet C, Kessler RC, Kazdin AE, Cuijpers P, Albor Y, Carrasco Tapias N, Contreras-Ibáñez CC, Durán González MS, Gildea SM, González N, Guerrero López JB, Luedtke A, Medina-Mora ME, Palacios J, Richards D, Salamanca-Sanabria A, Sampson NA. Study protocol for pragmatic trials of Internet-delivered guided and unguided cognitive behavior therapy for treating depression and anxiety in university students of two Latin American countries: the Yo Puedo Sentirme Bien study. Trials 2022; 23:450. [PMID: 35658942 PMCID: PMC9164185 DOI: 10.1186/s13063-022-06255-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 03/29/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are highly prevalent among university students and predict impaired college performance and later life role functioning. Yet most students do not receive treatment, especially in low-middle-income countries (LMICs). We aim to evaluate the effects of expanding treatment using scalable and inexpensive Internet-delivered transdiagnostic cognitive behavioral therapy (iCBT) among college students with symptoms of MDD and/or GAD in two LMICs in Latin America (Colombia and Mexico) and to investigate the feasibility of creating a precision treatment rule (PTR) to predict for whom iCBT is most effective. METHODS We will first carry out a multi-site randomized pragmatic clinical trial (N = 1500) of students seeking treatment at student mental health clinics in participating universities or responding to an email offering services. Students on wait lists for clinic services will be randomized to unguided iCBT (33%), guided iCBT (33%), and treatment as usual (TAU) (33%). iCBT will be provided immediately whereas TAU will be whenever a clinic appointment is available. Short-term aggregate effects will be assessed at 90 days and longer-term effects 12 months after randomization. We will use ensemble machine learning to predict heterogeneity of treatment effects of unguided versus guided iCBT versus TAU and develop a precision treatment rule (PTR) to optimize individual student outcome. We will then conduct a second and third trial with separate samples (n = 500 per arm), but with unequal allocation across two arms: 25% will be assigned to the treatment determined to yield optimal outcomes based on the PTR developed in the first trial (PTR for optimal short-term outcomes for Trial 2 and 12-month outcomes for Trial 3), whereas the remaining 75% will be assigned with equal allocation across all three treatment arms. DISCUSSION By collecting comprehensive baseline characteristics to evaluate heterogeneity of treatment effects, we will provide valuable and innovative information to optimize treatment effects and guide university mental health treatment planning. Such an effort could have enormous public-health implications for the region by increasing the reach of treatment, decreasing unmet need and clinic wait times, and serving as a model of evidence-based intervention planning and implementation. TRIAL STATUS IRB Approval of Protocol Version 1.0; June 3, 2020. Recruitment began on March 1, 2021. Recruitment is tentatively scheduled to be completed on May 30, 2024. TRIAL REGISTRATION ClinicalTrials.gov NCT04780542 . First submission date: February 28, 2021.
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Affiliation(s)
- Corina Benjet
- Center for Global Mental Health, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.
| | - Ronald C Kessler
- Department of Health care Policy, Harvard Medical School, Boston, MA, USA
| | | | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Yesica Albor
- Center for Global Mental Health, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | | | | | | | - Sarah M Gildea
- Department of Health care Policy, Harvard Medical School, Boston, MA, USA
| | - Noé González
- Center for Global Mental Health, National Institute of Psychiatry Ramón de la Fuente Muñiz and School of Psychology, UNAM, Mexico City, Mexico
| | | | - Alex Luedtke
- Department of Statistics, University of Washington, Seattle, WA, USA
| | - Maria Elena Medina-Mora
- Center for Global Mental Health, National Institute of Psychiatry Ramón de la Fuente Muñiz and School of Psychology, UNAM, Mexico City, Mexico
| | - Jorge Palacios
- SilverCloud Health, Dublin, Ireland
- E-mental Health Group, School of Psychology, University of Dublin, Trinity College Dublin, Dublin, Ireland
| | - Derek Richards
- SilverCloud Health, Dublin, Ireland
- E-mental Health Group, School of Psychology, University of Dublin, Trinity College Dublin, Dublin, Ireland
| | - Alicia Salamanca-Sanabria
- Future Health Technologies Programme, Campus for Research Excellence and Technological Enterprise, Singapore-ETH Centre, Singapore, Singapore
| | - Nancy A Sampson
- Department of Health care Policy, Harvard Medical School, Boston, MA, USA
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13
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Liu Z, Li M, Jia Y, Wang S, Zheng L, Wang C, Chen L. A randomized clinical trial of guided self-help intervention based on mindfulness for patients with hepatocellular carcinoma: effects and mechanisms. Jpn J Clin Oncol 2022; 52:227-236. [PMID: 35088079 DOI: 10.1093/jjco/hyab198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/26/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Compared with face-to-face mindfulness-based interventions (MBIs), online mindfulness interventions may be more convenient for patients with limited resources and can provide self-help mindfulness methods to improve the quality of life of cancer patients. This study investigated the effects of guided self-help mindfulness-based interventions (GSH-MBIs) on psychological distress, quality of life and sleep quality in patients with hepatocellular carcinoma and explored the underlying mechanisms. METHODS A total of 122 patients with hepatocellular carcinoma were randomly divided into the intervention group or the conventional treatment group. Psychological distress, quality of life, sleep quality, psychological flexibility and perceived stress were evaluated in the groups before the intervention at baseline, after the intervention, at 1-month follow-up and 3-month follow-up. The intervention's effects over time and the potential mediating effects were analysed using generalized estimating equations (GEE). RESULTS GEE results indicated significant time-group interaction effects on psychological distress (P < 0.001) and sleep quality (P < 0.001). The intervention significantly improved psychological flexibility (β, -2.066; 95% CI, -3.631, -0.500) and reduced perceived stress (β, -2.639; 95% CI, -4.110, -1.169). Psychological flexibility and perceived stress played a mediating role in the observed results. CONCLUSION GSH-MBIs can improve psychological distress and sleep quality via changing the psychological flexibility and perceived stress in hepatocellular carcinoma patients.
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Affiliation(s)
- Zengxia Liu
- School of Nursing, Jilin University, Changchun
- School of Nursing, Changchun University of Chinese Medicine, Changchun
| | - Min Li
- Invasive Technology Department, The First Hospital of Jilin University, Changchun, China
| | - Yong Jia
- School of Nursing, Jilin University, Changchun
| | - Shuo Wang
- School of Nursing, Jilin University, Changchun
| | | | - Cong Wang
- School of Nursing, Jilin University, Changchun
| | - Li Chen
- School of Nursing, Jilin University, Changchun
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14
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Mabrouk A, Mbithi G, Chongwo E, Too E, Sarki A, Namuguzi M, Atukwatse J, Ssewanyana D, Abubakar A. Mental health interventions for adolescents in sub-Saharan Africa: A scoping review. Front Psychiatry 2022; 13:937723. [PMID: 36061286 PMCID: PMC9429610 DOI: 10.3389/fpsyt.2022.937723] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/11/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Globally, adolescents are vulnerable to mental health problems, particularly those from sub-Saharan Africa (SSA) due to impoverished living conditions and a higher prevalence of chronic conditions such as HIV/AIDS in the region. The COVID-19 pandemic has further exacerbated this risk. This calls for an urgent need for evidence-based adolescent mental health interventions to reduce the risk and burden of mental health problems in SSA. The review aims to identify and characterize existing adolescent mental health interventions in SSA, as well as to evaluate their implementation strategies and effectiveness. METHODS We systematically searched PubMed, African Index Medicus, PsycINFO, Web of Science, and CINAHL databases for relevant articles. Furthermore, we searched gray literature databases, including Think Tank search, open gray, NGO search engine, and IGO search engine for additional relevant articles. The scoping review was conducted to identify original research articles on mental health interventions among adolescents in sub-Saharan Africa published from database inception to 31 December 2021. We carried out a narrative synthesis to report our findings. RESULTS Our literature search generated 4,750 studies, of which 1,141 were duplicates, 3,545 were excluded after screening, and 64 articles met the inclusion criteria. The 64 studies describe a total of 57 unique mental health interventions comprising 40,072 adolescents. The nature of these interventions was diverse, encompassing various implementation strategies such as economic-based, family strengthening, psychoeducation, interpersonal psychotherapy, Cognitive Behavioral Therapy, and resilience training, among others. Most of the interventions were selective interventions that targeted adolescents at high risk of developing mental health problems including adolescents living with HIV, war-affected adolescents, orphans, adolescents from poorer backgrounds, and survivors of sexual violence. Half of the interventions were delivered by lay persons. Sixty-two of the eligible studies examined the effectiveness of the mental health interventions, of which 55 of them reported a positive significant impact on various mental health outcomes. CONCLUSIONS The review findings show that there exist several diverse interventions that promote mental health among adolescents in sub-Saharan Africa. These interventions can be implemented in diverse settings including schools, communities, health facilities, and camps, and can be delivered by lay persons.
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Affiliation(s)
- Adam Mabrouk
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Gideon Mbithi
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Esther Chongwo
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Ezra Too
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Ahmed Sarki
- School of Nursing and Midwifery, Aga Khan University, Kampala, Uganda.,Family and Youth Health Initiative (FAYOHI), Dutse, Jigawa State, Nigeria
| | - Mary Namuguzi
- School of Nursing and Midwifery, Aga Khan University, Kampala, Uganda
| | - Joseph Atukwatse
- School of Nursing and Midwifery, Aga Khan University, Kampala, Uganda
| | - Derrick Ssewanyana
- Alliance for Human Development, Lunenfeld Tanenbaum Research Institute, Toronto, ON, Canada
| | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi, Kenya.,Neurosciences Group, KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya
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15
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Chang S, Sambasivam R, Seow E, Tan GCY, Lu SH, Assudani H, Chong SA, Subramaniam M, Vaingankar JA. "We Are All Trying to Find a Way to Help Ourselves": A Look at Self-Help Strategies Among Psychotherapy Clients. Front Psychol 2021; 12:621085. [PMID: 34690850 PMCID: PMC8529116 DOI: 10.3389/fpsyg.2021.621085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 09/09/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: This study examined self-help strategies engaged by psychotherapy clients and explored their views on such self-help approach. Methods: Secondary analysis of data from a qualitative research study was conducted. A total of 15 psychotherapy clients were recruited, and data were collected via semi-structured interviews. Thematic analysis of data was conducted using inductive approach to examine the content. Results: Three main themes revolving around self-help strategies were identified: (1) types of self-help strategies, (2) reasons for engaging in self-help activities, and (3) effectiveness of self-help strategies. Conclusion: The self-help approach to manage distress is common among psychotherapy clients. This study provided insights into understanding how and why clients use self-help strategies in their daily lives.
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Affiliation(s)
- Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Esmond Seow
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Sharon Huixian Lu
- Department of Psychology, Institute of Mental Health, Singapore, Singapore
| | - Hanita Assudani
- Department of Psychology, Institute of Mental Health, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
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16
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Woodford J, Farrand P, Hagström J, Hedenmalm L, von Essen L. Internet-Administered Cognitive Behavioral Therapy for Common Mental Health Difficulties in Parents of Children Treated for Cancer: Intervention Development and Description Study. JMIR Form Res 2021; 5:e22709. [PMID: 34142662 PMCID: PMC8367173 DOI: 10.2196/22709] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/08/2021] [Accepted: 06/17/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Following the end of a child's treatment for cancer, parents may report psychological distress. However, there is a lack of evidence-based interventions that are tailored to the population, and psychological support needs are commonly unmet. An internet-administered low-intensity cognitive behavioral therapy (LICBT)-based intervention (EJDeR [internetbaserad självhjälp för föräldrar till barn som avslutat en behandling mot cancer]) may provide a solution. OBJECTIVE The first objective is to provide an overview of a multimethod approach that was used to inform the development of the EJDeR intervention. The second objective is to provide a detailed description of the EJDeR intervention in accordance with the Template for Intervention Description and Replication (TIDieR) checklist. METHODS EJDeR was developed through a multimethod approach, which included the use of existing evidence, the conceptualization of distress, participatory action research, a cross-sectional survey, and professional and public involvement. Depending on the main presenting difficulty identified during assessment, LICBT behavioral activation or worry management treatment protocols are adopted for the treatment of depression or generalized anxiety disorder when experienced individually or when comorbid. EJDeR is delivered via the Uppsala University Psychosocial Care Programme (U-CARE) portal, a web-based platform that is designed to deliver internet-administered LICBT interventions and includes secure videoconferencing. To guide parents in the use of EJDeR, weekly written messages via the portal are provided by e-therapists comprising final year psychology program students with training in cognitive behavioral therapy. RESULTS An overview of the development process and a description of EJDeR, which was informed by the TIDieR checklist, are presented. Adaptations that were made in response to public involvement are highlighted. CONCLUSIONS EJDeR represents a novel, guided, internet-administered LICBT intervention for supporting parents of children treated for cancer. Adopting the TIDieR checklist offers the potential to enhance fidelity to the intervention protocol and facilitate later implementation. The intervention is currently being tested in a feasibility study (the ENGAGE study). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2018-023708.
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Affiliation(s)
- Joanne Woodford
- Uppsala University, Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala, Sweden
| | - Paul Farrand
- Clinical Education, Development, and Research (CEDAR), Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Josefin Hagström
- Uppsala University, Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala, Sweden
| | - Li Hedenmalm
- Uppsala University, Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala, Sweden
| | - Louise von Essen
- Uppsala University, Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala, Sweden
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17
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Finazzi E, MacBeth A. Service users experience of psychological interventions in primary care settings: A qualitative meta-synthesis. Clin Psychol Psychother 2021; 29:400-423. [PMID: 34260121 DOI: 10.1002/cpp.2650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/25/2021] [Accepted: 06/27/2021] [Indexed: 11/07/2022]
Abstract
Primary care mental health services play a crucial role in public mental health by providing local and accessible psychological interventions that meet individuals' needs. Despite growing research investigating service users' perspectives of psychological interventions, a qualitative systematic review in this context is not available. The present meta-synthesis collates the existing articles and gives a thematic synthesis of qualitative studies on service users' experience of psychological interventions in primary care. Multiple databases (CINAHL, EMBASE, PsychINFO, MEDLINE, and Cochrane Library) were searched for published qualitative studies of service users' experiences of psychological interventions delivered in primary care. Articles were included if they met inclusion criteria. Study quality was assessed using the Critical Appraisal Skills Programme tool. All types of psychological interventions were considered across model and delivery format (e.g., face-to-face, computerised programmes, and group). NVIVO was used to code the dataset and themes were extracted following thematic synthesis. Twenty-two studies were included. Four analytical themes and 10 subthemes emerged. The identified themes were as follows: (1) 'Access and Acceptability: facilitators and barriers', (2) 'Structural aspects'; (3) 'Therapeutic process' and (4) 'Outcomes'. A model of interrelationships between themes is proposed. Findings suggest several 'essential ingredients' across psychological interventions and modalities. The crucial role of relational factors, the importance of assessing service users' perceptions of treatment features (e.g., remote delivery) and of tailoring the intervention to their needs were emphasised. Results also suggest involving service users more in discussions and decisions about psychological interventions offered might enhance access, acceptability, and engagement. Recommendations for practice and research are provided.
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Affiliation(s)
- Emilia Finazzi
- School of Health and Social Sciences, University of Edinburgh, Edinburgh, UK.,Department of Clinical and Counselling Psychology, NHS Grampian, Aberdeen, UK
| | - Angus MacBeth
- School of Health and Social Sciences, University of Edinburgh, Edinburgh, UK
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18
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Effects of two different emotion-inducing methods on the emotional memory of non-clinically depressed individuals. PLoS One 2021; 16:e0249863. [PMID: 34048448 PMCID: PMC8162709 DOI: 10.1371/journal.pone.0249863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/26/2021] [Indexed: 11/19/2022] Open
Abstract
In the study of emotional memory bias in depressed individuals, most previous studies have used emotional materials, but there were significant differences in the effects of different emotion-inducing methods on face memory. In the present study, two experiments were conducted to explore the effects of different emotion-inducing methods on memory between healthy participants and non-clinically depressed participants. The results from experiment 1 showed that when feedback was used as induction, the memory performance of the non-clinical depression group was significantly higher than that of the healthy group under the condition of negative feedback. Under positive and neutral feedback, there were no significant differences between the two groups. In experiment 2, when emotional materials were used as a mode of induction, no significantly difference in each emotional condition between the healthy and depressed groups was found. The results of the present study show that different methods of emotional induction have different effects on depressed participants. Compared with the emotion induced by the emotional material, the non-clinical depressed participants had a better memory effect induced by negative emotional events.
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19
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Bantjes J, Kazdin AE, Cuijpers P, Breet E, Dunn-Coetzee M, Davids C, Stein DJ, Kessler RC. A Web-Based Group Cognitive Behavioral Therapy Intervention for Symptoms of Anxiety and Depression Among University Students: Open-Label, Pragmatic Trial. JMIR Ment Health 2021; 8:e27400. [PMID: 34042598 PMCID: PMC8193479 DOI: 10.2196/27400] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/02/2021] [Accepted: 03/15/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Anxiety and depression are common among university students, and university counseling centers are under pressure to develop effective, novel, and sustainable interventions that engage and retain students. Group interventions delivered via the internet could be a novel and effective way to promote student mental health. OBJECTIVE We conducted a pragmatic open trial to investigate the uptake, retention, treatment response, and level of satisfaction with a remote group cognitive behavioral therapy intervention designed to reduce symptoms of anxiety and depression delivered on the web to university students during the COVID-19 pandemic. METHODS Preintervention and postintervention self-reported data on anxiety and depression were collected using the Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9. Satisfaction was assessed postintervention using the Client Satisfaction with Treatment Questionnaire. RESULTS A total of 175 students were enrolled, 158 (90.3%) of whom initiated treatment. Among those initiating treatment, 86.1% (135/158) identified as female, and the mean age was 22.4 (SD 4.9) years. The mean number of sessions attended was 6.4 (SD 2.8) out of 10. Among participants with clinically significant symptoms at baseline, mean symptom scores decreased significantly for anxiety (t56=11.6; P<.001), depression (t61=7.8; P<.001), and composite anxiety and depression (t60=10.7; P<.001), with large effect sizes (d=1-1.5). Remission rates among participants with clinically significant baseline symptoms were 67.7%-78.9% and were not associated with baseline symptom severity. High overall levels of satisfaction with treatment were reported. CONCLUSIONS The results of this study serve as a proof of concept for the use of web-based group cognitive behavioral therapy to promote the mental health of university students.
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Affiliation(s)
- Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Alan E Kazdin
- Department of Psychology, Yale University, New Haven, CT, United States
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands
| | - Elsie Breet
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Munita Dunn-Coetzee
- Centre for Student Counselling and Development, Student Affairs, Stellenbosch University, Stellenbosch, South Africa
| | - Charl Davids
- Centre for Student Counselling and Development, Student Affairs, Stellenbosch University, Stellenbosch, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
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20
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Dowling NA, Merkouris SS, Rodda SN, Smith D, Aarsman S, Lavis T, Lubman DI, Austin DW, Cunningham JA, Battersby MW, O SC. GamblingLess: A Randomised Trial Comparing Guided and Unguided Internet-Based Gambling Interventions. J Clin Med 2021; 10:2224. [PMID: 34063826 PMCID: PMC8196610 DOI: 10.3390/jcm10112224] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/10/2021] [Accepted: 05/13/2021] [Indexed: 12/11/2022] Open
Abstract
There is little evidence relating to the effects of adding guidance to internet-based gambling interventions. The primary aim was to compare the effectiveness of an online self-directed cognitive-behavioural gambling program (GamblingLess) with and without therapist-delivered guidance. It was hypothesised that, compared to the unguided intervention, the guided intervention would result in superior improvements in gambling symptom severity, urges, frequency, expenditure, psychological distress, quality of life and help-seeking. A two-arm, parallel-group, randomised trial with pragmatic features and three post-baseline evaluations (8 weeks, 12 weeks, 24 months) was conducted with 206 gamblers (106 unguided; 101 guided). Participants in both conditions reported significant improvements in gambling symptom severity, urges, frequency, expenditure, and psychological distress across the evaluation period, even after using intention-to-treat analyses and controlling for other low- and high-intensity help-seeking, as well as clinically significant changes in gambling symptom severity (69% recovered/improved). The guided intervention resulted in additional improvements to urges and frequency, within-group change in quality of life, and somewhat higher rates of clinically significant change (77% cf. 61%). These findings, which support the delivery of this intervention, suggest that guidance may offer some advantages but further research is required to establish when and for whom human support adds value.
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Affiliation(s)
- Nicki A. Dowling
- School of Psychology, Deakin University, Geelong, VIC 3220, Australia; (S.S.M.); (S.A.); (D.W.A.)
- Melbourne Graduate School of Education, University of Melbourne, Parkville, VIC 3010, Australia
| | - Stephanie S. Merkouris
- School of Psychology, Deakin University, Geelong, VIC 3220, Australia; (S.S.M.); (S.A.); (D.W.A.)
| | - Simone N. Rodda
- School of Psychology, Deakin University, Geelong, VIC 3220, Australia; (S.S.M.); (S.A.); (D.W.A.)
- School of Population Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand;
- Turning Point, Eastern Health, 110 Church St, Richmond, VIC 3121, Australia
| | - David Smith
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia; (D.S.); (M.W.B.)
| | - Stephanie Aarsman
- School of Psychology, Deakin University, Geelong, VIC 3220, Australia; (S.S.M.); (S.A.); (D.W.A.)
| | - Tiffany Lavis
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5000, Australia;
| | - Dan I. Lubman
- Turning Point, Eastern Health and Monash Addiction Research Centre, Eastern Health Clinical School, Richmond, VIC 3121, Australia;
| | - David W. Austin
- School of Psychology, Deakin University, Geelong, VIC 3220, Australia; (S.S.M.); (S.A.); (D.W.A.)
| | - John A. Cunningham
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK;
- Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Malcolm W. Battersby
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia; (D.S.); (M.W.B.)
| | - Seung Chul O
- Faculty of Health, Deakin University, Geelong, VIC 3220, Australia;
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Hook JN, Kim Penberthy J, Davis DE, Van Tongeren DR. Inquiry-based stress reduction: A systematic review of the empirical literature. J Clin Psychol 2021; 77:1280-1295. [PMID: 33538339 DOI: 10.1002/jclp.23120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/11/2020] [Accepted: 01/20/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This paper reviewed the empirical research on inquiry-based stress reduction (IBSR; also called "The Work"), which has similarities to third-wave cognitive behavioral approaches such as Acceptance and Commitment Therapy (ACT). Widely used as a self-help intervention, IBSR has only recently been subjected to empirical research. METHOD We reviewed empirical studies (published and unpublished) that examined IBSR. RESULTS We found 17 empirical studies (15 independent samples) that examined IBSR. Several studies reported positive changes on variables such as stress, anxiety, and well-being. However, only three studies evaluated IBSR using randomized clinical trials (RCTs). Concerns related to treatment feasibility and cost-effectiveness of IBSR are noted. CONCLUSIONS There are some promising initial findings on IBSR. However, additional research employing high-quality research designs is necessary to explore the efficacy and effectiveness of IBSR in various contexts.
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Affiliation(s)
- Joshua N Hook
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Jennifer Kim Penberthy
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Don E Davis
- Department of Counseling and Psychological Services, Georgia State University, Atlanta, Georgia, USA
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Shao D, Zhang H, Cui N, Sun J, Li J, Cao F. The efficacy and mechanisms of a guided self-help intervention based on mindfulness in patients with breast cancer: A randomized controlled trial. Cancer 2020; 127:1377-1386. [PMID: 33332582 DOI: 10.1002/cncr.33381] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 10/13/2020] [Accepted: 11/25/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Mindfulness-based interventions (MBIs) can alleviate psychological distress in patients with cancer. However, face-to-face MBIs may be inconvenient for patients. Therefore, guided self-help interventions may be more accessible. The authors investigated the effects of a guided self-help MBI for depression, anxiety, and sleep disorder symptoms in patients with breast cancer and explored the potential underlying mechanisms. METHODS One hundred forty-four postoperative patients with breast cancer were randomly assigned to an intervention group (6-week guided self-help MBI; n = 72) or a wait-list control group (routine treatment; n = 72). Self-reported depression, anxiety, sleep disorder symptoms, and rumination and worry as potential mediators were assessed at baseline and postintervention. Outcomes were then assessed at 1-month and 3-month follow-up. The intervention's effects over time and the potential mediating effect were analyzed using generalized estimating equations. The trial was registered at the Chinese Clinical Registry (ChiCTR-IOR-16008073). RESULTS Significant improvements in depression and sleep disorder symptoms occurred in the intervention group compared with wait-list controls, and the improvements were maintained at 1-month and 3-month follow-up. Changes in rumination and worry mediated the intervention's effects on changes in depression and sleep disorder symptoms. CONCLUSIONS A guided self-help MBI reduced depressive and sleep disorder symptoms by mitigating rumination and worry in patients with breast cancer. These findings support benefits of this accessible psychological intervention in oncology and provide insight into possible mechanisms of action. The current research contributes to discovering effective and widely accessible means for people with physical health conditions and may remove barriers that otherwise would have precluded participation in face-to-face psychological interventions.
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Affiliation(s)
- Di Shao
- Center for Health Management and Policy, School of Public Health, National Health Commission Key Laboratory of Health Economics and Policy, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Huihui Zhang
- Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Naixue Cui
- School of Nursing, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jiwei Sun
- School of Nursing, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jie Li
- Center for Health Management and Policy, School of Public Health, National Health Commission Key Laboratory of Health Economics and Policy, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fenglin Cao
- School of Nursing, Cheeloo College of Medicine, Shandong University, Jinan, China
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23
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Fonagy P, Lemma A, Target M, O'Keeffe S, Constantinou MP, Ventura Wurman T, Luyten P, Allison E, Roth A, Cape J, Pilling S. Dynamic interpersonal therapy for moderate to severe depression: a pilot randomized controlled and feasibility trial. Psychol Med 2020; 50:1010-1019. [PMID: 31084635 DOI: 10.1017/s0033291719000928] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Improving Access to Psychological Therapies (IAPT) services treat most patients in England who present to primary care with major depression. Psychodynamic psychotherapy is one of the psychotherapies offered. Dynamic Interpersonal Therapy (DIT) is a psychodynamic and mentalization-based treatment for depression. 16 sessions are delivered over approximately 5 months. Neither DIT's effectiveness relative to low-intensity treatment (LIT), nor the feasibility of randomizing patients to psychodynamic or cognitive-behavioural treatments (CBT) in an IAPT setting has been demonstrated. METHODS 147 patients were randomized in a 3:2:1 ratio to DIT (n = 73), LIT (control intervention; n = 54) or CBT (n = 20) in four IAPT treatment services in a combined superiority and feasibility design. Patients meeting criteria for major depressive disorder were assessed at baseline, mid-treatment (3 months) and post-treatment (6 months) using the Hamilton Rating Scale for Depression (HRSD-17), Beck Depression Inventory-II (BDI-II) and other self-rated questionnaire measures. Patients receiving DIT were also followed up 6 months post-completion. RESULTS The DIT arm showed significantly lower HRSD-17 scores at the 6-month primary end-point compared with LIT (d = 0.70). Significantly more DIT patients (51%) showed clinically significant change on the HRSD-17 compared with LIT (9%). The DIT and CBT arms showed equivalence on most outcomes. Results were similar with the BDI-II. DIT showed benefit across a range of secondary outcomes. CONCLUSIONS DIT delivered in a primary care setting is superior to LIT and can be appropriately compared with CBT in future RCTs.
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Affiliation(s)
- Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Alessandra Lemma
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Mary Target
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Sally O'Keeffe
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Matthew P Constantinou
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Tamara Ventura Wurman
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Patrick Luyten
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
| | - Elizabeth Allison
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Anthony Roth
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - John Cape
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Stephen Pilling
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Delgadillo J, Branson A, Kellett S, Myles-Hooton P, Hardy GE, Shafran R. Therapist personality traits as predictors of psychological treatment outcomes. Psychother Res 2020; 30:857-870. [PMID: 32089100 DOI: 10.1080/10503307.2020.1731927] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Aim: To investigate if therapists' personality influences their patients' treatment outcomes. Methods: N = 4,052 patients were treated by 69 therapists, including 36 Psychological Wellbeing Practitioners (PWPs) and 33 Cognitive Behavioural Therapists (CBTs). Therapists completed the NEO-PI-R personality inventory, they reported years of clinical experience, and expert assessors rated their clinical competence and reflective abilities. Their patients completed pre and post-treatment measures of depression (PHQ-9) and anxiety (GAD-7). Associations between therapist personality traits and patient treatment outcomes were examined using multilevel modelling, controlling for therapist demographics, clinical experience, technical competence and reflective ability. Results: Relative to other sources of variability, therapists accounted for 1% to 3% of overall variability in treatment outcomes. However, the magnitude of systematic heterogeneity in performance between therapists was around 6%, such that the best-performing therapists outperformed average therapists by a margin of moderate to large effects (g = .57-1.10). Clinical experience, technical competence and reflective ability were unrelated to treatment outcomes. Patients treated by PWPs with above-average agreeableness scores and CBTs with above-average openness to experience scores had poorer treatment outcomes. Conclusions: Therapist effects may be partly explained by the influence of their personality on their work with anxious and depressed patients.
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Affiliation(s)
- Jaime Delgadillo
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Amanda Branson
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Stephen Kellett
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Pamela Myles-Hooton
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Gillian E Hardy
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, London, UK
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Trevillion K, Ryan EG, Pickles A, Heslin M, Byford S, Nath S, Bick D, Milgrom J, Mycroft R, Domoney J, Pariante C, Hunter MS, Howard LM. An exploratory parallel-group randomised controlled trial of antenatal Guided Self-Help (plus usual care) versus usual care alone for pregnant women with depression: DAWN trial. J Affect Disord 2020; 261:187-197. [PMID: 31634678 DOI: 10.1016/j.jad.2019.10.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/30/2019] [Accepted: 10/09/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Depression is a common antenatal mental disorder associated with significant maternal morbidity and adverse fetal outcomes. However, there is a lack of research on the effectiveness or cost-effectiveness of psychological interventions for antenatal depression. METHODS A parallel-group, exploratory randomised controlled trial across five hospitals. The trial compared Guided Self-Help, modified for pregnancy, plus usual care with usual care alone for pregnant women meeting DSM-IV criteria for mild-moderate depression. The trial objectives were to establish recruitment/follow-up rates, compliance and acceptability, and to provide preliminary evidence of intervention efficacy and cost-effectiveness. The primary outcome of depressive symptoms was assessed by blinded researchers using the Edinburgh Postnatal Depression Scale at 14-weeks post-randomisation. RESULTS 620 women were screened, 114 women were eligible and 53 (46.5%) were randomised. 26 women received Guided Self-Help - 18 (69%) attending ≥4 sessions - and 27 usual care; n = 3 women were lost to follow-up (follow-up rate for primary outcome 92%). Women receiving Guided Self-Help reported fewer depressive symptoms at follow-up than women receiving usual care (adjusted effect size -0.64 (95%CI: -1.30, 0.06) p = 0.07). There were no trial-related adverse events. The cost-effectiveness acceptability curve showed the probability of Guided Self-Help being cost-effective compared with usual care ranged from 10 to 50% with a willingness-to-pay range from £0 to £50,000. CONCLUSIONS AND LIMITATIONS Despite intense efforts we did not meet our anticipated recruitment target. However, high levels of acceptability, a lack of adverse events and a trend towards improvements in symptoms of depression post-treatment indicates this intervention is suitable for talking therapy services.
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Affiliation(s)
- K Trevillion
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, United Kingdom.
| | - E G Ryan
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, United Kingdom; Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, United Kingdom
| | - A Pickles
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, United Kingdom
| | - M Heslin
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, United Kingdom
| | - S Byford
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, United Kingdom
| | - S Nath
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, United Kingdom
| | - D Bick
- Departmentof Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - J Milgrom
- University of Melbourne and Parent-Infant Research Institute, Melbourne, Australia
| | - R Mycroft
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, United Kingdom
| | - J Domoney
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, United Kingdom
| | - C Pariante
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, United Kingdom
| | - M S Hunter
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, United Kingdom
| | - L M Howard
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, United Kingdom
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Davis AK, Barrett FS, Griffiths RR. Psychological flexibility mediates the relations between acute psychedelic effects and subjective decreases in depression and anxiety. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020; 15:39-45. [PMID: 32864325 PMCID: PMC7451132 DOI: 10.1016/j.jcbs.2019.11.004] [Citation(s) in RCA: 141] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Prior research has shown that acute subjective psychedelic effects are associated with both spontaneous and intended changes in depression and anxiety. Psychedelics are also theorized to produce increases in psychological flexibility, which could explain decreases in depression and anxiety following a psychedelic experience. Therefore, the present cross-sectional survey study sought to examine whether psychological flexibility mediated the relationship between acute psychedelic experiences and spontaneous or intended changes in depression and anxiety among a large international sample of people who reported having used a psychedelic (n=985; male=71.6%; Caucasian/white=84.1%; M age=32.2, SD=12.6). A regression analysis showed that acute effects (i.e., mystical and insightful effects) were significantly associated with decreases in depression/anxiety following a psychedelic experience. A path analysis revealed that, while controlling for age and sex, increases in psychological flexibility fully mediated the effect of mystical and insightful experiences on decreases in depression and anxiety following a psychedelic experience. This suggests that psychological flexibility may be an important mediator of the therapeutic effects of psychedelic drugs. Future prospective experimental studies should examine the effect of psychedelic drug administration on psychological flexibility in order to gain a better understanding of the psychological processes that predict therapeutic effects of psychedelics.
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Affiliation(s)
- Alan K. Davis
- College of Social Work, The Ohio State University, Columbus, OH 43210
- Center for Psychedelic and Consciousness Research, Department of Psychiatry, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224 USA
| | - Frederick S. Barrett
- Center for Psychedelic and Consciousness Research, Department of Psychiatry, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224 USA
| | - Roland R. Griffiths
- Center for Psychedelic and Consciousness Research, Department of Psychiatry, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224 USA
- Department of Neuroscience, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224 USA
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McDevitt-Petrovic O, Shevlin M, Kirby K. Modelling changes in anxiety and depression during low-intensity cognitive behavioural therapy: An application of growth mixture models. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2019; 59:169-185. [PMID: 31696972 DOI: 10.1111/bjc.12237] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 10/05/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Research largely supports the clinical effectiveness of low-intensity cognitive behavioural therapy (LICBT) for mild-to-moderate anxiety and depression, delivered by psychological well-being practitioners (PWPs). Knowledge regarding the predictors of treatment response, however, is relatively limited. The primary aim of this study was to model the heterogeneity in longitudinal changes in anxiety and depression throughout LICBT provided by PWPs in Northern Ireland (NI), and to explore associations between pre-treatment variables and differences in treatment response. METHODS Growth mixture modelling (GMM) techniques were employed to examine changes in psychological status in clients (N = 253) over the first six sessions of treatment, to identify divergent early response trajectories. A series of pre-treatment variables were used to predict class membership using chi-square tests and binary logistic regression models. RESULTS There was one class representing improvement and one representing no improvement for both anxiety and depression. Class membership was predictive of treatment outcome. Pre-treatment variables associated with less improvement included unemployment, risk of suicide, neglect of self or others, using medication, receiving previous or concurrent treatments, a longer duration of difficulties, and comorbidities. CONCLUSIONS Findings indicate most of the sample populated an 'improvers' class for both depression and anxiety. Pre-treatment variables identified as predictive of poor treatment response may need to be considered by practitioners in potential triage referral decision policies, supporting cost-effective and efficient services. Further research around predictors of clinical outcome is recommended. PRACTITIONER POINTS Most of the sample belonged to an 'improvers' class. Several pre-treatment variables predicted poor treatment response (unemployment, suicide risk, neglect, medication, previous or concurrent treatments, longer duration of difficulties, and comorbidities). Few studies have utilized GMM to determine predictors of outcome following LICBT Regarding pre-treatment variables, the possibility of self-report bias cannot be excluded. The time period was relatively short, although represented the optimum number of sessions recommended for LICBT. The lack of a control group and random allocation were the main limitations.
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Internet-Based Cognitive Behavior Therapy for Stress and Anxiety among Young Japanese Adults: A Preliminary Study. PSYCH 2019. [DOI: 10.3390/psych1010025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In the present study, we examined the effect of an internet cognitive behavior therapy (ICBT) program on anxiety, stress, and depressive symptoms in university students. Data were analyzed for 17 participants undergoing ICBT and 11 control group participants. An ANOVA of intention-to-treat analysis and per protocol (PP) analysis indicated that the interaction between group and measurement time was significant for the state–trait anxiety inventory (STAI) scores and that idiosyncratic anxiety was significantly improved. Through the results of PP, a moderate effect size for changes in STAI scores in the intervention group was observed (d = 0.62) based on Cohen’s (1988) classifications. A large effect was also observed for improvements in idiosyncratic anxiety (d = 0.91). Based on the results of the analyses, a significant interaction was observed for the STAI scores. In the intervention group, STAI scores and individual anxiety were significantly reduced after implementing the ICBT program. It was suggested that the ICBT program may positively influence thinking about anxiety and stress from an objective viewpoint.
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Kaldo V, Bothelius K, Blom K, Lindhe M, Larsson M, Karimi K, Melder S, Bondestam V, Ulfsparre C, Sternbrink K, Jernelöv S. An open‐ended primary‐care group intervention for insomnia based on a self‐help book – A randomized controlled trial and 4‐year follow‐up. J Sleep Res 2019; 29:e12881. [DOI: 10.1111/jsr.12881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/01/2019] [Accepted: 05/08/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Viktor Kaldo
- Centre for Psychiatry Research Department of Clinical Neuroscience Karolinska Institutet, & Stockholm Health Care Services Stockholm County Council, M58 Karolinska University Hospital Huddinge Stockholm Sweden
- Department of Psychology Faculty of Health and Life Sciences Linnaeus University Växjö Sweden
| | | | - Kerstin Blom
- Centre for Psychiatry Research Department of Clinical Neuroscience Karolinska Institutet, & Stockholm Health Care Services Stockholm County Council, M58 Karolinska University Hospital Huddinge Stockholm Sweden
- Division of Psychiatry Haukeland University Hospital Bergen Norway
| | - Maria Lindhe
- Department of Psychology Stockholm University Stockholm Sweden
- Gustavsbergs Primary Care Centre Stockholm Health Care Services Stockholm County Council Stockholm Sweden
| | - Matilda Larsson
- Department of Psychology Stockholm University Stockholm Sweden
- Gustavsbergs Primary Care Centre Stockholm Health Care Services Stockholm County Council Stockholm Sweden
| | - Kobra Karimi
- Department of Psychology Stockholm University Stockholm Sweden
| | - Susanne Melder
- Department of Psychology Stockholm University Stockholm Sweden
| | | | | | - Klara Sternbrink
- Gustavsbergs Primary Care Centre Stockholm Health Care Services Stockholm County Council Stockholm Sweden
| | - Susanna Jernelöv
- Centre for Psychiatry Research Department of Clinical Neuroscience Karolinska Institutet, & Stockholm Health Care Services Stockholm County Council, M58 Karolinska University Hospital Huddinge Stockholm Sweden
- Division of Psychology Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
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A systematic review of mindfulness based interventions for children and young people with ADHD and their parents. ACTA ACUST UNITED AC 2019. [DOI: 10.2478/gp-2019-0007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Abstract
Objective
Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent disorders in childhood, which may pose risks in later life such as academic underachievement and anti-social behaviour. It has been suggested that mindfulness-based interventions (MBI) may contribute to positive outcomes with child and adult populations. In this article, we aim to systematically review the literature regarding the effectiveness of MBI on both children with ADHD and their parents.
Method
Seven databases were searched using the PRISMA criteria and included peer-reviewed journals and grey literature.
Results
Ten studies met the inclusion criteria. Findings suggested that MBI had positive results in addressing attention deficits in children with ADHD, but in terms of hyperactivity, the evidence was conflicting. MBI interventions also appear to effectively address parental stress and family functioning. However, the rating from the quality assessment showed several methodological limitations.
Discussion
The current evidence on the impact of MBI on ADHD symptoms is non-conclusive. However, promising data indicated the potential for MBI in addressing parental stress and family functioning. Further research is recommended to overcome the current methodological limitations.
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Abstract
Depression is a common and heterogeneous condition with a chronic and recurrent natural course that is frequently seen in the primary care setting. Primary care providers play a central role in managing depression and concurrent physical comorbidities, and they face challenges in diagnosing and treating the condition. In this two part series, we review the evidence available to help to guide primary care providers and practices to recognize and manage depression. The first review outlined an approach to screening and diagnosing depression in primary care. This second review presents an evidence based approach to the treatment of depression in primary care, detailing the recommended lifestyle, drug, and psychological interventions at the individual level. It also highlights strategies that are being adopted at an organizational level to manage depression more effectively in primary care.
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Affiliation(s)
- Parashar Ramanuj
- Center for Family and Community Medicine, Columbia University Medical Center, New York, NY, USA
- Royal National Orthopaedic Hospital
| | | | - Harold Alan Pincus
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA
- Irving Institute for Clinical and Translational Research, Columbia University, New York, NY, USA
- RAND Corporation, Pittsburgh, PA, USA
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Davis AK, So S, Lancelotta R, Barsuglia JP, Griffiths RR. 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) used in a naturalistic group setting is associated with unintended improvements in depression and anxiety. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:161-169. [PMID: 30822141 DOI: 10.1080/00952990.2018.1545024] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND A recent epidemiological study suggested that 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) used for spiritual and recreational reasons is associated with subjective improvement in depression and anxiety. Further exploration of the potential psychotherapeutic effects of 5-MeO-DMT could inform future clinical trials. OBJECTIVES We examined self-reported improvement in depression and anxiety among people who use 5-MeO-DMT in a group setting with structured procedures guiding dose and administration of 5-MeO-DMT. Such procedures also include activities for the preparation of, and support during/following sessions, which are similar to procedures used in clinical trials of hallucinogen administration. Next, we examined whether depression or anxiety were improved following use, and whether the acute subjective effects (mystical/challenging) or beliefs about the 5-MeO-DMT experience were associated with improvements in these conditions. METHODS Respondents (n = 362; Mage = 47.7; Male = 55%; White/Caucasian = 84%) completed an anonymous web-based survey. RESULTS Of those reporting having been diagnosed with depression (41%) or anxiety (48%), most reported these conditions were improved (depression = 80%; anxiety = 79%) following 5-MeO-DMT use, and fewer reported they were unchanged (depression = 17%; anxiety = 19%) or worsened (depression = 3%; anxiety = 2%). Improvement in depression/anxiety conditions were associated with greater intensity of mystical experiences and higher ratings of the spiritual significance and personal meaning of the 5-MeO-DMT experience. There were no associations between depression or anxiety improvement and the intensity of acute challenging physical/psychological effects during the 5-MeO-DMT experience. CONCLUSIONS Future prospective controlled clinical pharmacology studies should examine the safety and efficacy of 5-MeO-DMT administration for relieving depression and anxiety.
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Affiliation(s)
- Alan K Davis
- a Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences , Johns Hopkins School of Medicine , Baltimore , MD USA
| | - Sara So
- b Bloomberg School of Public Health, Department of Mental Health , Johns Hopkins University , Baltimore , MD , USA
| | - Rafael Lancelotta
- c School of Counseling, Leadership, Advocacy, and Design , University of Wyoming , Laramie , WY USA
| | | | - Roland R Griffiths
- a Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences , Johns Hopkins School of Medicine , Baltimore , MD USA.,e Department of Neuroscience , Johns Hopkins School of Medicine , Baltimore , MD USA
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Zhang A, Franklin C, Jing S, Bornheimer LA, Hai AH, Himle JA, Kong D, Ji Q. The effectiveness of four empirically supported psychotherapies for primary care depression and anxiety: A systematic review and meta-analysis. J Affect Disord 2019; 245:1168-1186. [PMID: 30699860 DOI: 10.1016/j.jad.2018.12.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/14/2018] [Accepted: 12/08/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Depressive and anxiety disorders are highly prevalent and detrimental in primary care settings. However, there are gaps in the literature concerning effectiveness and generalizability of empirically supported interventions and treatment of both depression and anxiety in primary care settings. The aim of this review is to systematically assess and meta-analyze the effectiveness of brief empirically-supported psychotherapies for treating depression and/or anxiety in primary care. METHODS Seven electronic databases, five professional websites and manual search of reference lists were searched through April 2017 for randomized controlled trials (RCTs) of four psychotherapies treating primary care depression and anxiety: cognitive-behavior therapy (CBT), problem-solving therapy (PST), motivational interviewing (MI), and solution-focused brief therapy (SFBT). RESULTS From an initial pool of 1140 articles, 179 articles were eligible for full-text review and 65 articles were included for final analysis. Sixty-five articles containing 198 effect sizes reported an overall treatment effect size of d = 0.462, p < 0.001. Single-predictor meta-regression indicated that marital status, treatment modality (individual versus group), and treatment composition were significant moderators. Multiple-predictor meta-regression discovered treatment setting (inside versus outside primary care) significantly moderated treatment effect, b = -0.863, p = 0.039 after controlling for other intervention characteristics. CONCLUSION Treatment effects were found for CBT and PST, both for depressive and anxiety disorders. Interventions delivered outside primary care settings were more effective than those within, individual treatment had greater treatment effects compared to group treatment, and both technology-assisted and in-person treatments were found to be effective.
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Affiliation(s)
- Anao Zhang
- University of Michigan, School of Social Work, United States; Shanghai Children's Medical Center, China.
| | - Cynthia Franklin
- The University of Texas at Austin, Steve Hicks School of Social Work, United States
| | - Shijie Jing
- East China University of Political Science and Law, School of Social Development, China
| | | | - Audrey Hang Hai
- The University of Texas at Austin, Steve Hicks School of Social Work, United States
| | - Joseph A Himle
- University of Michigan, School of Social Work, United States; University of Michigan, Department of Psychiatry
| | - Dexia Kong
- Rutgers, The State University of New Jersey, Institute for Health, Health Care Policy and Aging Research, United States
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An evaluation of the transition from BAME community mental health worker to IAPT low intensity psychological wellbeing practitioner. COGNITIVE BEHAVIOUR THERAPIST 2019. [DOI: 10.1017/s1754470x18000296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractThe Improving Access to Psychological Therapies (IAPT) programme started in 2008, but it contained little provision for specifically meeting the needs of Black, Asian and minority ethnic (BAME) groups. The purpose of this evaluation was to describe the experience of transition from BAME community mental health worker (CMHW) to IAPT low-intensity psychological wellbeing practitioner (PWP) in order to identify possible gains and losses for the former communities served, and the factors that might contribute to successful training of people with BAME expertise. Four former CMHWs who had transitioned into working as PWPs were interviewed. Semi-structured interviews were used. The data were analysed using thematic analysis. Six major themes were identified with the benefits of training emerging as an important factor for the participants in enhancing their role. Three of the themes interconnected and focused on the impact for BAME communities in terms of access to service and barriers. Evident in the interviews were descriptions of adaptations that were made as a result of CMHW having access to both new and old skills. Finally, two themes focused on the participant recommendations as to how IAPT services might become more culturally responsive. The findings suggest that there can be significant benefits for services to provide IAPT training to people already providing culturally specific services. The participants reported that low-intensity cognitive behavioural therapy (LICBT) was effective, but only when cultural sensitive adaptations were made. The evaluation has some clear recommendations as to how IAPT services might seek to offer culturally responsive CBT. Suggestions for carrying out further practice-based evaluations are made.
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Moore BA, Buono FD, Lloyd DP, Printz DMB, Fiellin DA, Barry DT. A randomized clinical trial of the Recovery Line among methadone treatment patients with ongoing illicit drug use. J Subst Abuse Treat 2018; 97:68-74. [PMID: 30577901 DOI: 10.1016/j.jsat.2018.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 11/12/2018] [Accepted: 11/23/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Relapse, drug use, and treatment dropout are common challenges facing patients receiving methadone. Though effective, multiple barriers to face-to-face counseling exist. The Recovery Line (RL), an automated, self-management system based on Cognitive Behavioral Therapy, is a phone-based adjunctive treatment that provides low cost, consistent delivery and immediate therapeutic availability 24 h a day. METHODS The current study was a 12-week randomized clinical efficacy trial of treatment-as-usual (TAU) only or RL + TAU for methadone treatment patients with continued illicit drug use (N = 82). Previous small trial phases evaluated methods to increase participant engagement and use of the RL and were incorporated into the current RL version. Primary outcomes were days of self-reported illicit drug abstinence and urine screens negative for illicit drugs. RESULTS Days of self-reported illicit drug abstinence improved for patients in RL + TAU but not in TAU. Percent of urine screens negative for illicit drugs, coping skills efficacy, and retention in methadone treatment did not differ by condition. Patients in RL + TAU attended more substance use disorder treatment and self-help group sessions during treatment than those in TAU. RL system use was generally low and more system use was correlated with abstinence outcomes. CONCLUSIONS Although the RL did not impact urine screen outcomes, it increases self-reported abstinence. Additional methods to increase patient engagement with automated, self-management systems for substance use disorder are needed.
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Affiliation(s)
- Brent A Moore
- Department of Psychiatry, Yale School of Medicine, New Haven, 06511, CT, USA; VA Connecticut Healthcare System, West Haven, 06516, CT, USA; APT Foundation, New Haven, 06511, CT, USA.
| | - Frank D Buono
- Department of Psychiatry, Yale School of Medicine, New Haven, 06511, CT, USA; VA Connecticut Healthcare System, West Haven, 06516, CT, USA; APT Foundation, New Haven, 06511, CT, USA
| | - Daniel P Lloyd
- Department of Psychiatry, Yale School of Medicine, New Haven, 06511, CT, USA; APT Foundation, New Haven, 06511, CT, USA
| | - Destiny M B Printz
- Department of Psychiatry, Yale School of Medicine, New Haven, 06511, CT, USA; VA Connecticut Healthcare System, West Haven, 06516, CT, USA; APT Foundation, New Haven, 06511, CT, USA
| | - David A Fiellin
- Department of Internal Medicine, Yale University School of Medicine, New Haven, 06510, CT, USA
| | - Declan T Barry
- Department of Psychiatry, Yale School of Medicine, New Haven, 06511, CT, USA; APT Foundation, New Haven, 06511, CT, USA
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Ma Y, She Z, Siu AFY, Zeng X, Liu X. Effectiveness of Online Mindfulness-Based Interventions on Psychological Distress and the Mediating Role of Emotion Regulation. Front Psychol 2018; 9:2090. [PMID: 30429816 PMCID: PMC6220599 DOI: 10.3389/fpsyg.2018.02090] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 10/10/2018] [Indexed: 11/13/2022] Open
Abstract
Online mindfulness-based intervention as a feasible and acceptable approach has received mounting attention in recent years, yet more evidence is needed to demonstrate its effectiveness. The primary objective of this study was to examine the effects of online mindfulness-based programs on psychological distress (depression and anxiety). The randomized controlled intervention design consisted of four conditions: group mindfulness-based intervention (GMBI), self-direct mindfulness-based intervention (SDMBI), discussion group (DG) and blank control group (BCG). The program lasted 8 weeks and a total of 76 participants completed the pre- and post-test. Results showed that participants in GMBI and SDMBI had significant pre- and post-test differences on mindfulness, emotion regulation difficulties, and psychological distress, with medium to large effect sizes. In addition, ANCOVA results indicated significant effects of group membership on post-test scores of mindfulness, depression and anxiety when controlling the pretest scores, with medium to large effect sizes. The GMBI appeared to exert the greatest effects on outcome variables in comparison with other groups. In addition, changes in emotion regulation difficulties across groups could mediate the relationship between changes in mindfulness dimensions (Observing and Describing) and changes in psychological distress across groups. These results provided encouraging evidence for the effectiveness of online mindfulness-based interventions in reducing psychological distress, and the possible mediating role of emotion regulation, while also underlining the importance of group discussion in online mindfulness-based interventions.
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Affiliation(s)
- Ying Ma
- School of Education, Shaanxi Normal University, Xi’an, China
| | - Zhaozhuo She
- Beijing Key Laboratory of Learning and Cognition, Capital Normal University, Beijing, China
| | | | - Xianglong Zeng
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xinghua Liu
- Beijing Key Laboratory of Learning and Cognition, Capital Normal University, Beijing, China
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China
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Lin PZ, Xue JM, Yang B, Li M, Cao FL. Effectiveness of self-help psychological interventions for treating and preventing postpartum depression: a meta-analysis. Arch Womens Ment Health 2018; 21:491-503. [PMID: 29616334 DOI: 10.1007/s00737-018-0835-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 03/21/2018] [Indexed: 10/17/2022]
Abstract
Previous studies have reported different effect sizes for self-help interventions designed to reduce postpartum depression symptoms; therefore, a comprehensive quantitative review of the research was required. A meta-analysis was conducted to examine the effectiveness of self-help interventions designed to treat and prevent postpartum depression, and identified nine relevant randomized controlled trials. Differences in depressive symptoms between self-help interventions and control conditions, changes in depressive symptoms following self-help interventions, and differences in postintervention recovery and improvement rates between self-help interventions and control conditions were assessed in separate analyses. In treatment trials, depression scores continued to decrease from baseline to posttreatment and follow-up assessment in treatment subgroups. Changes in treatment subgroups' depression scores from baseline to postintervention assessment were greater relative to those observed in prevention subgroups. Self-help interventions produced larger overall effects on postpartum depression, relative to those observed in control conditions, in posttreatment (Hedges' g = 0.51) and follow-up (Hedges' g = 0.32) assessments; and self-help interventions were significantly more effective, relative to control conditions, in promoting recovery from postpartum depression. Effectiveness in preventing depression did not differ significantly between self-help interventions and control conditions.The findings suggested that self-help interventions designed to treat postpartum depression reduced levels of depressive symptoms effectively and decreased the risk of postpartum depression.
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Affiliation(s)
- Ping-Zhen Lin
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, 250012, Shandong, People's Republic of China
| | - Jiao-Mei Xue
- Society and Law School, Shandong Women's University, Jinan, Shandong, People's Republic of China
| | - Bei Yang
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, 250012, Shandong, People's Republic of China
| | - Meng Li
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, 250012, Shandong, People's Republic of China
| | - Feng-Lin Cao
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, 250012, Shandong, People's Republic of China.
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Abstract
Cognitive-behavioural therapy self-help offers an accessible and efficient way to treat common mental disorders. The evidence-based self-help movement has an important foothold in the healthcare arena. This article surveys the emergence of self-help at a particular social and historical junction, and summarises key lessons from experimental and practice-based studies. Declaration of interest None.
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Affiliation(s)
- Jaime Delgadillo
- Clinical Psychology Unit,Department of Psychology,University of Sheffield,Sheffield,UK
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What is the evidence for the efficacy of self-help acceptance and commitment therapy? A systematic review and meta-analysis. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2017. [DOI: 10.1016/j.jcbs.2017.08.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Pateraki E, Morris PG. Effectiveness of cognitive behavioural therapy in reducing anxiety in adults and children with asthma: A systematic review. J Asthma 2017; 55:532-554. [PMID: 28759284 DOI: 10.1080/02770903.2017.1350967] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Asthma and anxiety are known to interact, leading to exacerbations for both conditions. This systematic review summarised evidence regarding the effectiveness of cognitive behavioural therapy (CBT) in reducing anxiety in individuals with asthma, with results presented separately for adults and children. DATA SOURCES PRISMA and CRD guidance were followed to conduct and report the current review. Three major electronic databases (Ovid Medline, PsycINFO, and EMBASE) and manual searches were used to find relevant published and unpublished research. STUDY SELECTIONS Sixteen trials (12 adult- and four child-focused) met inclusion criteria, and were evaluated with adapted quality criteria. Both controlled trials and repeated-measures designs were eligible. All CBT intervention formats were eligible (group, individual, computerised, and self-help). Nine studies (eight adult and one child) focused upon participants with either an anxiety diagnosis or with above-threshold anxiety scores on a validated measure at baseline. RESULTS The review provides tentative preliminary support for the use of CBT for anxiety in adults with asthma, with the evidence base for interventions with children appearing promising, but under-developed. Studies were more likely to indicate beneficial effects where anxiety-focused (rather than illness-focused) intervention protocols were utilised, asthma-related education was provided and where the trials focused on individuals with likely clinical levels of anxiety at baseline. CONCLUSION Whilst further high-quality research is needed, available evidence is supportive of anxiety-focused CBT interventions tailored to target the particular mechanisms thought to maintain this comorbidity in asthma.
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Affiliation(s)
- Eleni Pateraki
- a Paediatric Psychology, Wishaw General Hospital , NHS Lanarkshire , Wishaw , UK
| | - Paul Graham Morris
- b Clinical and Health Psychology , University of Edinburgh , Edinburgh , UK
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Shirotsuki K, Nonaka Y, Abe K, Adachi SI, Adachi S, Kuboki T, Nakao M. The effect for Japanese workers of a self-help computerized cognitive behaviour therapy program with a supplement soft drink. Biopsychosoc Med 2017; 11:23. [PMID: 28932258 PMCID: PMC5604512 DOI: 10.1186/s13030-017-0109-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 07/28/2017] [Indexed: 11/16/2022] Open
Abstract
Background Computerized cognitive behaviour therapy (CCBT) programs can provide a useful self-help approach to the treatment of psychological problems. Previous studies have shown that CCBT has moderate effects on depression, insomnia, and anxiety. The present study investigated whether a supplement drink that includes L-carnosine enhances the effect of CCBT on psychological well-being. Methods Eighty-seven participants were randomly allocated to a control group, CCBT, or CCBT with supplement drink. The CCBT and CCBT with supplement drink groups received six weekly self-help CCBT program instalments, which consisted of psycho-education about stress management and coping, behaviour activation, and cognitive restructuring. The CCBT group consumed a bottle of the supplement soft drink every morning through the 6 weeks. This program was delivered by an e-learning system on demand and also included a self-help guidebook. Seventy-two participants completed the program or were assess at the end of the study. Results ANOVA revealed that there were significant interactions (times × groups) for POMS tension-anxiety and fatigue. The CCBT group showed significantly improved tension-anxiety scores, whereas the CCBT with drink group showed significant improvements on fatigue. Conclusion The self-help CCBT program reduced the subjective experience of tension-anxiety in this group of workers. The addition of a supplement drink enhanced the effect of CCBT on fatigue, providing one possible approach to enhancement of such programs. Trial registration This study was registered on September 2, 2016 at UMIN. The registration number is UMIN000023903.
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Affiliation(s)
- Kentaro Shirotsuki
- Faculty of Human Sciences, Musashino University, 3-3-3, Ariake, Koto-ku, Tokyo, 135-8181 Japan
| | - Yuji Nonaka
- Innovation Development Department, Suntory Global Innovation Center Limited, Osaka, Japan
| | - Keiichi Abe
- Innovation Development Department, Suntory Global Innovation Center Limited, Osaka, Japan
| | | | - Shohei Adachi
- Medical corporation So-bun-kai, Clinic Adachi, Gifu, Japan
| | | | - Mutsuhiro Nakao
- Department of Psychosomatic Medicine, Teikyo University Hospital, Tokyo, Japan
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Shirotsuki K, Nonaka Y, Takano J, Abe K, Adachi SI, Adachi S, Nakao M. Brief internet-based cognitive behavior therapy program with a supplement drink improved anxiety and somatic symptoms in Japanese workers. Biopsychosoc Med 2017; 11:25. [PMID: 28874913 PMCID: PMC5579873 DOI: 10.1186/s13030-017-0111-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 08/14/2017] [Indexed: 12/05/2022] Open
Abstract
Background Self-help cognitive behavior therapy (CBT) is a useful approach for the treatment of psychological problems. Recent research on the effectiveness of self-help internet-based CBT (ICBT) indicates that the paradigm moderately improves psychological problems. Furthermore, previous studies have shown that food and drinks containing supplements improve various health conditions. We investigated the effect of a brief self-help ICBT administered with a supplement drink on psychological well-being and somatic symptoms. Methods In total, 101 healthy workers were enrolled in the 4-week ICBT program, which consisted of psychoeducation on stress management, behavior activation, and cognitive restructuring. The supplement soft drink was taken every day during the program. The participants were instructed to watch on-demand video clips and read the self-help guidebook and supporting comic strip weekly on the Internet or smartphone. The Japanese version of the Profile of Mood States (POMS) was administered before and after completion of the program. Scores on the POMS tension-anxiety (POMS-TA), depression (POMS-D), and fatigue (POMS-F) subscales were used to assess the effect of the program. Somatic symptoms were assessed using the Brief Job Stress Questionnaire. Results In total, 75 participants continued the program for 4 weeks; however, of those, 27 failed to complete all weekly tasks or meet the post-assessment deadlines. Therefore, the data of 48 participants were included in the analysis. Pre-post intervention comparisons using paired t-tests revealed significant improvement on the POMS-TA, but not the POMS-D or POMS-F subscales. Moreover, participants reported a significant reduction in the severity of low back pain. Conclusion Our brief intervention moderately improved anxiety levels and the symptom of low back pain. These findings suggest that the brief ICBT program is effective in non-patient populations. Future directions for brief ICBT are discussed. Trial registration This study was registered on February 10, 2016 at UMIN. The registration number is UMIN000020962.
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Affiliation(s)
- Kentaro Shirotsuki
- Faculty of Human Sciences, Faculty of Human Relations, Musashino University, 3-3-3, Ariake, Koto-ku, Tokyo, 135-8181 Japan
| | - Yuji Nonaka
- Suntory Global Innovation Center Research Institute, Kyoto, Japan
| | - Jiro Takano
- Suntory Global Innovation Center Research Institute, Kyoto, Japan
| | - Keiichi Abe
- Suntory Global Innovation Center Research Institute, Kyoto, Japan
| | | | - Shohei Adachi
- Medical Corporation So-bun-kai, Clinic Adachi, Gifu, Japan
| | - Mutsuhiro Nakao
- Department of Psychosomatic Medicine, Teikyo University Hospital, Tokyo, Japan
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Ali S, Rhodes L, Moreea O, McMillan D, Gilbody S, Leach C, Lucock M, Lutz W, Delgadillo J. How durable is the effect of low intensity CBT for depression and anxiety? Remission and relapse in a longitudinal cohort study. Behav Res Ther 2017; 94:1-8. [PMID: 28437680 DOI: 10.1016/j.brat.2017.04.006] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 04/11/2017] [Accepted: 04/17/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Depression and anxiety disorders are relapse-prone conditions, even after successful treatment with pharmacotherapy or psychotherapy. Cognitive behavioural therapy (CBT) is known to prevent relapse, but there is little evidence of the durability of remission after low intensity forms of CBT (LiCBT). METHOD This study aimed to examine relapse rates 12 months after completing routinely-delivered LiCBT. A cohort of 439 LiCBT completers with remission of symptoms provided monthly depression (PHQ-9) and anxiety (GAD-7) measures during 12 months after treatment. Survival analysis was conducted to model time-to-relapse while controlling for patient characteristics. RESULTS Overall, 53% of cases relapsed within 1 year. Of these relapse events, the majority (79%) occurred within the first 6 months post-treatment. Cases reporting residual depression symptoms (PHQ-9 = 5 to 9) at the end of treatment had significantly higher risk of relapse (hazard ratio = 1.90, p < 0.001). CONCLUSIONS The high rate of relapse after LiCBT highlights the need for relapse prevention, particularly for those with residual depression symptoms.
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Affiliation(s)
- Shehzad Ali
- Department of Health Sciences and Centre for Health Economics, University of York, York, UK
| | | | - Omar Moreea
- Centre for Clinical Practice, National Institute for Health and Care Excellence, Manchester, UK
| | - Dean McMillan
- Hull York Medical School and Department of Health Sciences, University of York, York, United Kingdom
| | - Simon Gilbody
- Hull York Medical School and Department of Health Sciences, University of York, York, United Kingdom
| | - Chris Leach
- South West Yorkshire Partnership NHS Foundation Trust and University of Huddersfield, Huddersfield, UK
| | - Mike Lucock
- South West Yorkshire Partnership NHS Foundation Trust and University of Huddersfield, Huddersfield, UK
| | - Wolfgang Lutz
- Department of Psychology, University of Trier, Trier, Germany
| | - Jaime Delgadillo
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK.
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Strand M, Gammon D, Ruland CM. Transitions from biomedical to recovery-oriented practices in mental health: a scoping review to explore the role of Internet-based interventions. BMC Health Serv Res 2017; 17:257. [PMID: 28388907 PMCID: PMC5385090 DOI: 10.1186/s12913-017-2176-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 03/18/2017] [Indexed: 01/21/2023] Open
Abstract
Background The Internet is transforming mental health care services by increasing access to, and potentially improving the quality of, care. Internet-based interventions in mental health can potentially play a role in transitions from biomedical to recovery-oriented research and practices, but an overview of what this may entail, current work, and issues that need addressing, is lacking. The objective of this study is to describe Internet-based recovery-oriented interventions (referred to as e-recovery) and current research, and to identify gaps and issues relevant to advancing recovery research and practices through opportunities provided by the Internet. Methods Five iterative stages of a scoping review framework were followed in searching and analyzing the literature. A recovery framework with four domains and 16 themes was used to deductively code intervention characteristics according to their support for recovery-oriented practices. Only Internet-based interventions used in conjunction with ongoing care were included. Results Twenty studies describing six e-recovery interventions were identified and originated in Australia, Finland, the Netherlands, Norway and USA. The domain supporting personal recovery was most clearly reflected in interventions, whereas the last three domains, i.e., promoting citizenship, organizational commitment and working relationship were less evident. Support for the formulation and follow-up of personal goals and preferences, and in accessing peer-support, were the characteristics shared by most interventions. Three of the six studies that employed a comparison group used randomization, and none presented definitive findings. None used recovery-oriented frameworks or specific recovery outcome measures. Four of the interventions were specific to a diagnosis. Conclusion Research about how technologies might aid in illuminating and shaping recovery processes is in its formative stages. We recommend that future e-recovery research and innovation attend to four dimensions: evidence-supported interventions, new knowledge about personal recovery, values-based approaches and Internet as a facilitator for organizational transformation. The incremental changes facilitated by e-recovery may help propel a shift in mental health care toward recovery-oriented practices.
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Affiliation(s)
- Monica Strand
- Centre for Shared Decision Making and Collaborative Care Research, Oslo University Hospital, P.O. Box 4950, Nydalen, Oslo, 0424, Norway. .,Department of Psychiatry Blakstad, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Asker, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Deede Gammon
- Centre for Shared Decision Making and Collaborative Care Research, Oslo University Hospital, P.O. Box 4950, Nydalen, Oslo, 0424, Norway.,Norwegian Centre for Integrated Care and Telemedicine, University Hospital in North Norway, Tromsø, Norway
| | - Cornelia M Ruland
- Centre for Shared Decision Making and Collaborative Care Research, Oslo University Hospital, P.O. Box 4950, Nydalen, Oslo, 0424, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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Development and Evaluation of Cognitive Analytic Guided Self-Help (CAT-SH) for Use in IAPT Services. Behav Cogn Psychother 2017; 45:266-284. [PMID: 28325165 DOI: 10.1017/s1352465816000485] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is a lack of treatment plurality at step 2 of Improving Access to Psychological Therapies (IAPT) services. This project therefore sought to develop and pilot a cognitive analytic informed guided self-help treatment for mild-to-moderate anxiety for delivery by Psychological Wellbeing Practitioners (PWPs). METHOD Medical Research Council treatment development guidelines were used. Phase I included development of the six-session treatment manual using practice guidelines, small-scale modelling (n = 3) and indicated manual iterations. Phase II consisted of a mixed methods case series design (n = 11) to index feasibility, uptake and clinical outcomes. RESULTS Cognitive analytic guided self-help (CAT-SH) met established quality parameters for guided self-help. A high treatment completion rate was observed, with 10/11 patients who attended the first treatment session subsequently completing full treatment. Six out of ten patients completing full treatment met reliable recovery criteria at follow-up. Effect sizes and recovery rates equate with extant PWP outcome benchmarks. Practitioner feedback indicated that delivery of CAT-SH was feasible. CONCLUSION CAT-SH shows promise as a low-intensity treatment for anxiety, and so further, larger and more controlled evaluations are indicated.
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Merkouris SS, Rodda SN, Austin D, Lubman DI, Harvey P, Battersby M, Cunningham J, Lavis T, Smith D, Dowling NA. GAMBLINGLESS: FOR LIFE study protocol: a pragmatic randomised trial of an online cognitive-behavioural programme for disordered gambling. BMJ Open 2017; 7:e014226. [PMID: 28235970 PMCID: PMC5337748 DOI: 10.1136/bmjopen-2016-014226] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION The prevalence of disordered gambling worldwide has been estimated at 2.3%. Only a small minority of disordered gamblers seek specialist face-to-face treatment, and so a need for alternative treatment delivery models that capitalise on advances in communication technology, and use self-directed activity that can complement existing services has been identified. As such, the primary aim of this study is to evaluate an online self-directed cognitive-behavioural programme for disordered gambling (GamblingLess: For Life). METHODS AND ANALYSIS The study will be a 2-arm, parallel group, pragmatic randomised trial. Participants will be randomly allocated to a pure self-directed (PSD) or guided self-directed (GSD) intervention. Participants in both groups will be asked to work through the 4 modules of the GamblingLess programme over 8 weeks. Participants in the GSD intervention will also receive weekly emails of guidance and support from a gambling counsellor. A total of 200 participants will be recruited. Participants will be eligible if they reside in Australia, are aged 18 years and over, have access to the internet, have adequate knowledge of the English language, are seeking help for their own gambling problems and are willing to take part in the intervention and associated assessments. Assessments will be conducted at preintervention, and at 2, 3 and 12 months from preintervention. The primary outcome is gambling severity, assessed using the Gambling Symptom Assessment Scale. Secondary outcomes include gambling frequency, gambling expenditure, psychological distress, quality of life and additional help-seeking. Qualitative interviews will also be conducted with a subsample of participants and the Guides (counsellors). ETHICS AND DISSEMINATION The study has been approved by the Deakin University Human Research and Eastern Health Human Research Ethics Committees. Findings will be disseminated via report, peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER ACTRN12615000864527; results.
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Affiliation(s)
- S S Merkouris
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - S N Rodda
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Turning Point, Eastern Health, Fitzroy, Australia
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
- Auckland University of Technology, Auckland, New Zealand
| | - D Austin
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - D I Lubman
- Turning Point, Eastern Health, Fitzroy, Australia
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - P Harvey
- School of Medicine, Flinders University, Adelaide, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - M Battersby
- School of Medicine, Flinders University, Adelaide, Australia
| | - J Cunningham
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
- Research School of Population Health, Australian National University, Canberra, Australia
| | - T Lavis
- School of Medicine, Flinders University, Adelaide, Australia
| | - D Smith
- School of Medicine, Flinders University, Adelaide, Australia
| | - N A Dowling
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Melbourne Graduate School of Education, University of Melbourne, Parkville, Australia
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Delgadillo J, Kellett S, Ali S, McMillan D, Barkham M, Saxon D, Donohoe G, Stonebank H, Mullaney S, Eschoe P, Thwaites R, Lucock M. A multi-service practice research network study of large group psychoeducational cognitive behavioural therapy. Behav Res Ther 2016; 87:155-161. [DOI: 10.1016/j.brat.2016.09.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 06/23/2016] [Accepted: 09/19/2016] [Indexed: 01/08/2023]
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Trevillion K, Domoney J, Pickles A, Bick D, Byford S, Heslin M, Milgrom J, Mycroft R, Pariante C, Ryan E, Hunter M, Howard LM. Depression: an exploratory parallel-group randomised controlled trial of Antenatal guided self help for WomeN (DAWN): study protocol for a randomised controlled trial. Trials 2016; 17:503. [PMID: 27756349 PMCID: PMC5070149 DOI: 10.1186/s13063-016-1632-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 09/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is a common antenatal mental disorder and is associated with an increased risk of adverse effects on the fetus and significant morbidity for the mother; if untreated it can also continue into the post-natal period and affect mother-infant interactions. There has been little research evaluating the effectiveness or cost-effectiveness of antenatal psychological interventions for antenatal depression, particularly for mild to moderate disorders. International guidelines recommend a stepped care approach starting with Guided Self Help, and the aim of this exploratory trial is to investigate Guided Self Help modified for pregnancy. METHODS The DAWN trial is an exploratory randomised controlled trial of the effectiveness and cost-effectiveness of antenatal Guided Self Help, modified for pregnancy and delivered by National Health Service Psychological Wellbeing Practitioners. Antenatal Guided Self Help, in addition to usual care, is compared with usual care for pregnant women diagnosed with mild to moderate depression and mixed anxiety and depression, using the Structured Clinical Interview for DSM-IV Disorders. Modifications for pregnancy include perinatal mental health training, addressing pregnancy-specific worries and including sections on health issues in pregnancy and planning for parenthood. Women allocated to Guided Self Help will be seen for up to eight sessions by a Psychological Wellbeing Practitioner (including an initial assessment session); there will also be an appointment at 12 weeks after delivery. Research measures including the Edinburgh Postnatal Depression Scale (primary outcome) and other measures of depression, anxiety, quality of life and service use will be collected from women before random allocation, 14 weeks after random allocation and at 12 weeks after delivery. Potential psychological mechanisms of the intervention will be explored using the Pregnancy-Related Thoughts Questionnaire and the Metacognitive Awareness Questionnaire. DISCUSSION The DAWN trial is the first exploratory trial to investigate the efficacy of antenatal Guided Self Help for pregnant women with mild to moderate depression meeting DSM-IV diagnostic criteria. Recruitment started January 2015 and is expected to be completed by July 2016. TRIAL REGISTRATION ISRCTN registry: ISRCTN83768230 . Registered on 8 August 2014.
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Affiliation(s)
- Kylee Trevillion
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Jill Domoney
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Andrew Pickles
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Debra Bick
- Florence Nightingale Faculty of Nursing and Midwifery, Division of Women’s Health, King’s College London, London, UK
| | - Sarah Byford
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Margaret Heslin
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Jeannette Milgrom
- University of Melbourne and Parent-Infant Research Institute, Melbourne, Australia
| | - Rachel Mycroft
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Carmine Pariante
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Elizabeth Ryan
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Myra Hunter
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Louise Michele Howard
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Pearcy CP, Anderson RA, Egan SJ, Rees CS. A systematic review and meta-analysis of self-help therapeutic interventions for obsessive-compulsive disorder: Is therapeutic contact key to overall improvement? J Behav Ther Exp Psychiatry 2016; 51:74-83. [PMID: 26794856 DOI: 10.1016/j.jbtep.2015.12.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 11/27/2015] [Accepted: 12/27/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVES The presence of obsessive-compulsive disorder (OCD) can result in low quality of life, with significant impairments in social and occupational functioning. An increase in the dissemination of self-help programs has been observed in the treatment of OCD, and has provided improved accessibility to treatment. The present study examined the efficacy of self-help interventions for OCD in the context of therapeutic contact. METHODS Randomised controlled trials and quasi-experimental studies were identified through computerised database searches. Self-help format (bibliotherapy, internet-based, computerised), and therapeutic contact were examined for their effect on treatment outcomes. RESULTS Eighteen studies targeting self-help for OCD met inclusion criteria with 1570 participants. The average post-treatment effect size (Hedges' g) of self-help interventions on primary outcomes was .51 (95% CI: .41 to 0.61). Subgroup analysis revealed large effect sizes for minimal-contact self-help (g = 0.91, 95% CI: 0.66 to 1.17), moderate effect sizes for predominantly self-help (g = 0.68, 95% CI: 0.40 to 0.96), and small effect sizes for self-administered self-help (g = 0.33, 95% CI: .18 to 0.47). LIMITATIONS A large variation of treatment approaches, amount of therapeutic contact, and risk of bias within each study may account for the large magnitude in effect sizes across studies. Additionally, the long-term follow-up effects of treatment approaches were not examined. CONCLUSIONS A growing body of literature supporting to the use of self-help treatments for OCD is evident, however, further investigation through use of randomised controlled trials is required, particularly the use of stepped care and long-term effectiveness.
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Affiliation(s)
- Caitlin P Pearcy
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
| | - Rebecca A Anderson
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
| | - Sarah J Egan
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
| | - Clare S Rees
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
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Liegl G, Boeckle M, Leitner A, Pieh C. A meta-analytic review of brief guided self-help education for chronic pain. Eur J Pain 2016; 20:1551-1562. [DOI: 10.1002/ejp.881] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2016] [Indexed: 02/01/2023]
Affiliation(s)
- G. Liegl
- Department of Psychotherapy and Biopsychosocial Health; Danube University Krems; Austria
- Department of Psychosomatic Medicine; Center for Internal Medicine and Dermatology; Charité - Universitätsmedizin Berlin; Germany
| | - M. Boeckle
- Department of Psychotherapy and Biopsychosocial Health; Danube University Krems; Austria
| | - A. Leitner
- Department of Psychotherapy and Biopsychosocial Health; Danube University Krems; Austria
| | - C. Pieh
- Department of Psychotherapy and Biopsychosocial Health; Danube University Krems; Austria
- Karl Landsteiner University of Health Sciences; Krems Austria
- Department of Psychosomatic Medicine; University of Regensburg; Germany
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