1
|
King AM, Plateau CR, Turner MJ, Young P, Barker JB. A systematic review of the nature and efficacy of Rational Emotive Behaviour Therapy interventions. PLoS One 2024; 19:e0306835. [PMID: 38980891 PMCID: PMC11232995 DOI: 10.1371/journal.pone.0306835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 06/23/2024] [Indexed: 07/11/2024] Open
Abstract
In the absence of a single comprehensive systematic review of Rational Emotive Behaviour Therapy interventions across all settings, we reviewed the methodological quality, effectiveness and efficacy of Rational Emotive Behaviour Therapy interventions on irrational/rational beliefs. We explored the impact of Rational Emotive Behaviour Therapy on wider outcomes (e.g., mental health) and identified the characteristics of successful interventions. PsycARTICLES, PsycINFO, Scopus, SPORTDiscus, and PubMed were systematically searched up to December 2023 with 162 Rational Emotive Behaviour Therapy intervention studies identified which included a validated measure of irrational/rational beliefs. Where possible, effect size for irrational/rational belief change was reported and data was analysed through a qualitative approach. Using the Mixed Methods Appraisal tool, methodological quality within the Sport and Exercise domain was assessed as good, whilst all other domains were considered low in quality, with insufficient detail provided on intervention characteristics and delivery. Most studies were conducted in the United States, within the Education domain, and assessed irrational beliefs in non-clinical adult samples. Overall, studies reported significant reductions in irrational beliefs, increases in rational beliefs and improvements in mental health outcomes (e.g., depression). More successful interventions were delivered by trained Rational Emotive Behaviour Therapy practitioners, adopted the ABC framework and were longer in duration. We highlight the importance of designing and conducting rigorous future Rational Emotive Behaviour Therapy research to generate clearer insights as to its impact on irrational/rational beliefs and mental health outcomes.
Collapse
Affiliation(s)
- Ailish M. King
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, United Kingdom
| | - Carolyn R. Plateau
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, United Kingdom
| | - Martin J. Turner
- Department of Psychology, Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
| | - Paul Young
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, United Kingdom
| | - Jamie B. Barker
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, United Kingdom
| |
Collapse
|
2
|
Chukwuorji JC, Ezeonu NA, Ude N, Itanyi IU, Eboreime E, Kung JY, Dennett L, Olawepo JO, Iheanacho T, Ogidi AG, Rositch AF, Nonyane BAS, Bass J, Ojo TM, Ikpeazu A, Ezeanolue EE. Addressing the unmet mental health needs of people living with HIV: a scoping review of interventions in sub-Saharan Africa. AIDS Care 2023; 35:1677-1690. [PMID: 36803172 DOI: 10.1080/09540121.2023.2176428] [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: 08/12/2022] [Accepted: 01/24/2023] [Indexed: 02/22/2023]
Abstract
Some mental health interventions have addressed mental health among people living with HIV (PLWH) using a variety of approaches, but little is known about the details of such interventions in sub-Saharan Africa (SSA), a region that bears the largest burden of HIV in the world. The present study describes mental health interventions for PLWH in SSA regardless of the date and language of publication. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) reporting guidelines, we identified 54 peer-reviewed articles on interventions addressing adverse mental health conditions among PLWH in SSA. The studies were conducted in 11 different countries, with the highest number of studies in South Africa (33.3%), Uganda (18.5%), Kenya (9.26%), and Nigeria (7.41%). While only one study was conducted before the year 2000, there was a gradual increase in the number of studies in the subsequent years. The studies were mostly conducted in hospital settings (55.5%), were non-pharmacologic (88.9%), and interventions were mostly cognitive behavioural therapy (CBT) and counselling. Task shifting was the primary implementation strategy used in four studies. Interventions addressing the mental health needs of PLWH that incorporates the unique challenges and opportunities in SSA is highly recommended.
Collapse
Affiliation(s)
- JohnBosco Chika Chukwuorji
- Department of Psychology, University of Nigeria, Nsukka, Enugu, Nigeria
- Center for Translation and Implementation Research (CTAIR), College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Nwamaka Alexandra Ezeonu
- Center for Translation and Implementation Research (CTAIR), College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Nnamdi Ude
- Center for Translation and Implementation Research (CTAIR), College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Ijeoma Uchenna Itanyi
- Center for Translation and Implementation Research (CTAIR), College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
- Department of Community Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Ejemai Eboreime
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Janice Y Kung
- J. W. Scott Library, University of Alberta, Edmonton, Canada
| | - Liz Dennett
- J. W. Scott Library, University of Alberta, Edmonton, Canada
| | | | - Theddeus Iheanacho
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Amaka G Ogidi
- Center for Translation and Implementation Research (CTAIR), College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Anne F Rositch
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bareng Aletta Sanny Nonyane
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Judy Bass
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Tunde Masseyferguson Ojo
- Department of Psychiatry, University of Abuja, Abuja, Nigeria
- Department of Mental Health, University of Abuja Teaching Hospital, FCT Abuja, Nigeria
- National Mental Health Programme, Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
| | - Akudo Ikpeazu
- National AIDS, Viral Hepatitis and STIs Control Programme (NASCP), Abuja, Nigeria
| | - Echezona E Ezeanolue
- Center for Translation and Implementation Research (CTAIR), College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
- Healthy Sunrise Foundation, Las Vegas, Nevada, USA
| |
Collapse
|
3
|
Greene MC, Kane J, Alto M, Giusto A, Lovero K, Stockton M, McClendon J, Nicholson T, Wainberg ML, Johnson RM, Tol WA. Psychosocial and pharmacologic interventions to reduce harmful alcohol use in low- and middle-income countries. Cochrane Database Syst Rev 2023; 5:CD013350. [PMID: 37158538 PMCID: PMC10167787 DOI: 10.1002/14651858.cd013350.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Harmful alcohol use is defined as unhealthy alcohol use that results in adverse physical, psychological, social, or societal consequences and is among the leading risk factors for disease, disability and premature mortality globally. The burden of harmful alcohol use is increasing in low- and middle-income countries (LMICs) and there remains a large unmet need for indicated prevention and treatment interventions to reduce harmful alcohol use in these settings. Evidence regarding which interventions are effective and feasible for addressing harmful and other patterns of unhealthy alcohol use in LMICs is limited, which contributes to this gap in services. OBJECTIVES To assess the efficacy and safety of psychosocial and pharmacologic treatment and indicated prevention interventions compared with control conditions (wait list, placebo, no treatment, standard care, or active control condition) aimed at reducing harmful alcohol use in LMICs. SEARCH METHODS We searched for randomized controlled trials (RCTs) indexed in the Cochrane Drugs and Alcohol Group (CDAG) Specialized Register, the Cochrane Clinical Register of Controlled Trials (CENTRAL) in the Cochrane Library, PubMed, Embase, PsycINFO, CINAHL, and the Latin American and Caribbean Health Sciences Literature (LILACS) through 12 December 2021. We searched clinicaltrials.gov, the World Health Organization International Clinical Trials Registry Platform, Web of Science, and Opengrey database to identify unpublished or ongoing studies. We searched the reference lists of included studies and relevant review articles for eligible studies. SELECTION CRITERIA All RCTs comparing an indicated prevention or treatment intervention (pharmacologic or psychosocial) versus a control condition for people with harmful alcohol use in LMICs were included. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We included 66 RCTs with 17,626 participants. Sixty-two of these trials contributed to the meta-analysis. Sixty-three studies were conducted in middle-income countries (MICs), and the remaining three studies were conducted in low-income countries (LICs). Twenty-five trials exclusively enrolled participants with alcohol use disorder. The remaining 51 trials enrolled participants with harmful alcohol use, some of which included both cases of alcohol use disorder and people reporting hazardous alcohol use patterns that did not meet criteria for disorder. Fifty-two RCTs assessed the efficacy of psychosocial interventions; 27 were brief interventions primarily based on motivational interviewing and were compared to brief advice, information, or assessment only. We are uncertain whether a reduction in harmful alcohol use is attributable to brief interventions given the high levels of heterogeneity among included studies (Studies reporting continuous outcomes: Tau² = 0.15, Q =139.64, df =16, P<.001, I² = 89%, 3913 participants, 17 trials, very low certainty; Studies reporting dichotomous outcomes: Tau²=0.18, Q=58.26, df=3, P<.001, I² =95%, 1349 participants, 4 trials, very low certainty). The other types of psychosocial interventions included a range of therapeutic approaches such as behavioral risk reduction, cognitive-behavioral therapy, contingency management, rational emotive therapy, and relapse prevention. These interventions were most commonly compared to usual care involving varying combinations of psychoeducation, counseling, and pharmacotherapy. We are uncertain whether a reduction in harmful alcohol use is attributable to psychosocial treatments due to high levels of heterogeneity among included studies (Heterogeneity: Tau² = 1.15; Q = 444.32, df = 11, P<.001; I²=98%, 2106 participants, 12 trials, very low certainty). Eight trials compared combined pharmacologic and psychosocial interventions with placebo, psychosocial intervention alone, or another pharmacologic treatment. The active pharmacologic study conditions included disulfiram, naltrexone, ondansetron, or topiramate. The psychosocial components of these interventions included counseling, encouragement to attend Alcoholics Anonymous, motivational interviewing, brief cognitive-behavioral therapy, or other psychotherapy (not specified). Analysis of studies comparing a combined pharmacologic and psychosocial intervention to psychosocial intervention alone found that the combined approach may be associated with a greater reduction in harmful alcohol use (standardized mean difference (standardized mean difference (SMD))=-0.43, 95% confidence interval (CI): -0.61 to -0.24; 475 participants; 4 trials; low certainty). Four trials compared pharmacologic intervention alone with placebo and three with another pharmacotherapy. Drugs assessed were: acamprosate, amitriptyline, baclofen disulfiram, gabapentin, mirtazapine, and naltrexone. None of these trials evaluated the primary clinical outcome of interest, harmful alcohol use. Thirty-one trials reported rates of retention in the intervention. Meta-analyses revealed that rates of retention between study conditions did not differ in any of the comparisons (pharmacologic risk ratio (RR) = 1.13, 95% CI: 0.89 to 1.44, 247 participants, 3 trials, low certainty; pharmacologic in addition to psychosocial intervention: RR = 1.15, 95% CI: 0.95 to 1.40, 363 participants, 3 trials, moderate certainty). Due to high levels of heterogeneity, we did not calculate pooled estimates comparing retention in brief (Heterogeneity: Tau² = 0.00; Q = 172.59, df = 11, P<.001; I2 = 94%; 5380 participants; 12 trials, very low certainty) or other psychosocial interventions (Heterogeneity: Tau² = 0.01; Q = 34.07, df = 8, P<.001; I2 = 77%; 1664 participants; 9 trials, very low certainty). Two pharmacologic trials and three combined pharmacologic and psychosocial trials reported on side effects. These studies found more side effects attributable to amitriptyline relative to mirtazapine, naltrexone and topiramate relative to placebo, yet no differences in side effects between placebo and either acamprosate or ondansetron. Across all intervention types there was substantial risk of bias. Primary threats to validity included lack of blinding and differential/high rates of attrition. AUTHORS' CONCLUSIONS In LMICs there is low-certainty evidence supporting the efficacy of combined psychosocial and pharmacologic interventions on reducing harmful alcohol use relative to psychosocial interventions alone. There is insufficient evidence to determine the efficacy of pharmacologic or psychosocial interventions on reducing harmful alcohol use largely due to the substantial heterogeneity in outcomes, comparisons, and interventions that precluded pooling of these data in meta-analyses. The majority of studies are brief interventions, primarily among men, and using measures that have not been validated in the target population. Confidence in these results is reduced by the risk of bias and significant heterogeneity among studies as well as the heterogeneity of results on different outcome measures within studies. More evidence on the efficacy of pharmacologic interventions, specific types of psychosocial interventions are needed to increase the certainty of these results.
Collapse
Affiliation(s)
- M Claire Greene
- Program on Forced Migration and Health, Columbia University Mailman School of Public Health, New York, New York, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jeremy Kane
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Michelle Alto
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Ali Giusto
- Department of Psychiatry, Columbia University/NYSPI, New York, New York, USA
| | - Kathryn Lovero
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Melissa Stockton
- Department of Psychiatry, Columbia University/NYSPI, New York, New York, USA
| | - Jasmine McClendon
- Department of Psychiatry, UC Davis Medical Center, Sacramento, CALIFORNIA, USA
| | - Terriann Nicholson
- Department of Psychiatry, Columbia University/NYSPI, New York, New York, USA
| | - Milton L Wainberg
- Department of Psychiatry, Columbia University/NYSPI, New York, New York, USA
| | - Renee M Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Wietse Anton Tol
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Peter C. Alderman Program for Global Mental Health, HealthRight International, New York, USA
| |
Collapse
|
4
|
Ugwuanyi LT, Egbe CI, Nnamani AP, Ubah JC, Adaka TA, Adama GN, Ejide AB, Uloh-Bethels AC, Emelogu NU, Ossai RC, Okoyeukwu NG, Agbo PA, Otu MS. Rational emotive health therapy for the management of depressive symptoms among parents of children with intellectual and reading disabilities in English language. Medicine (Baltimore) 2022; 101:e30039. [PMID: 35960096 PMCID: PMC9371501 DOI: 10.1097/md.0000000000030039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND There is little data in developing countries such as Nigeria with regard to the impact of caring for their children with intellectual and reading disability (IRD) on the quality of life of the parents and the risk of psychopathology. OBJECTIVE The main objective of the study was to assess the level of psychopathology, i.e., depression among parents of children with intellectual and reading disabilities. METHODS This was pretest/posttest control group design with 198 parents (99 fathers/99 mothers) of 100 children with the diagnosis of IRD. The measures used in this study for data collection was Beck Depression Inventory (BDI). Repeated measures analysis of variance (ANOVA) was employed for data analysis. RESULTS Result obtained showed a significant high proportion of depressive symptoms among parents of children with intellectual and reading disabilities at initial assessment. Furthermore, the REHT intervention resulted in a significant reduction in depression of parents in treatment group as compared to those in the control group. CONCLUSION The presence of a child with intellectual and reading disabilities does not cause parents to become depressed but irrational beliefs about their children's mental and reading deficiencies may contribute to unhealthy thinking and feelings about the future of their children. REHT is very effective in assisting depressed parents of children with intellectual and reading disabilities to think rationally about their children and work towards overcoming disability-related as well as behavior-related irrational beliefs. The mental health providers, therapists and counselors should apply the REHT in managing people with psychological distress especially parents of children with intellectual and reading disabilities who may have psychological diagnosis of depression.
Collapse
Affiliation(s)
| | - Cajetan Ikechukwu Egbe
- Department of Arts Education, University of Nigeria, Nsukka
- *Correspondence: Cajetan Ikechukwu Egbe, Department of Arts Education, University of Nigeria, Nsukka
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Wechsberg WM, van der Drift I, Howard BN, Myers B, Browne FA, Bonner CP, Carney T, Ndirangu J, Washio Y. Gender and Context Matter: Behavioral and Structural Interventions for People Who Use Alcohol and Other Drugs in Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8661. [PMID: 35886515 PMCID: PMC9316816 DOI: 10.3390/ijerph19148661] [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] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/30/2022] [Accepted: 07/05/2022] [Indexed: 12/04/2022]
Abstract
Heavy alcohol consumption and other drug use are prominent across Africa and increase the risk of exposure to violence, HIV acquisition, and other life-threatening injuries. This review synthesizes evidence on alcohol and other drug (AOD) interventions in Africa; evaluates the differences between interventions that do and do not specifically target populations that use AODs; and highlights the impact of comprehensive vs. brief interventions and those that address syndemic issues from a gender and contextualized lens. Literature searches were conducted to identify research outcomes of randomized interventions published between January 2010 and May 2022 that address AOD use in Africa. Thirty-five full-text articles were included in this review. Most of the identified research studies were concentrated in a few countries. Most studies were conducted in South Africa. Many of the studies comprised brief interventions. However, the most comprehensive interventions were the most effective for AOD outcomes. Several studies indicated the importance of addressing AOD use alongside gender-based violence, mental health needs, gender roles, and other social determinants that affect health outcomes. Intervening on AOD use and addressing social determinants from a gender and contextually relevant perspective is essential to ensuring the long-term health and well-being of people in Africa.
Collapse
Affiliation(s)
- Wendee M. Wechsberg
- Substance Use, Gender and Applied Research Program, RTI International, Research Triangle Park, NC 27709, USA; (I.v.d.D.); (B.N.H.); (F.A.B.); (C.P.B.); (J.N.); (Y.W.)
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Psychology, North Carolina State University, Raleigh, NC 27695, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27708, USA
| | - Isa van der Drift
- Substance Use, Gender and Applied Research Program, RTI International, Research Triangle Park, NC 27709, USA; (I.v.d.D.); (B.N.H.); (F.A.B.); (C.P.B.); (J.N.); (Y.W.)
| | - Brittni N. Howard
- Substance Use, Gender and Applied Research Program, RTI International, Research Triangle Park, NC 27709, USA; (I.v.d.D.); (B.N.H.); (F.A.B.); (C.P.B.); (J.N.); (Y.W.)
| | - Bronwyn Myers
- Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town 7580, South Africa; (B.M.); (T.C.)
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town 7701, South Africa
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth 6102, Australia
| | - Felicia A. Browne
- Substance Use, Gender and Applied Research Program, RTI International, Research Triangle Park, NC 27709, USA; (I.v.d.D.); (B.N.H.); (F.A.B.); (C.P.B.); (J.N.); (Y.W.)
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Courtney Peasant Bonner
- Substance Use, Gender and Applied Research Program, RTI International, Research Triangle Park, NC 27709, USA; (I.v.d.D.); (B.N.H.); (F.A.B.); (C.P.B.); (J.N.); (Y.W.)
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Tara Carney
- Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town 7580, South Africa; (B.M.); (T.C.)
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town 7701, South Africa
| | - Jacqueline Ndirangu
- Substance Use, Gender and Applied Research Program, RTI International, Research Triangle Park, NC 27709, USA; (I.v.d.D.); (B.N.H.); (F.A.B.); (C.P.B.); (J.N.); (Y.W.)
| | - Yukiko Washio
- Substance Use, Gender and Applied Research Program, RTI International, Research Triangle Park, NC 27709, USA; (I.v.d.D.); (B.N.H.); (F.A.B.); (C.P.B.); (J.N.); (Y.W.)
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19122, USA
| |
Collapse
|
6
|
Effect of Rational Emotive Behaviour Therapy on Depressive Symptoms in a Sample of Parents of Children with Intellectual Disability. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2022. [DOI: 10.1007/s10942-022-00454-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
7
|
Lorenz HS, Stuebing MD, Nambeye C, Lungu G, Littlefield LM. Substance Use Treatment Using Cultural Arts and 12 Steps: Curriculum Training and Community-led Implementation in Zambia. Addict Behav Rep 2022; 15:100424. [PMID: 35541027 PMCID: PMC9079769 DOI: 10.1016/j.abrep.2022.100424] [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: 12/01/2021] [Revised: 03/05/2022] [Accepted: 03/23/2022] [Indexed: 11/30/2022] Open
Abstract
Evaluating training in 12 Step group therapy curriculum utilizing Zambian art forms. Zambian-led implementation of curriculum brings addiction treatment into communities. Training professionals changes perspectives on value of treating substance users. This curriculum-based treatment decreases client substance use frequency. This curriculum-based treatment increases client participation and motivation.
Introduction Substance use in Zambia is stigmatized and treatment access is limited. Over 30,000 people are homeless in Lusaka, where one-quarter of homeless youth report use. Zambia's Ministry of Health recently developed policies targeting alcohol, suggesting Chainama, the only mental health hospital, offer treatment. Together, they endorsed training in the curriculum studied in this paper. We hypothesized training Zambian professionals would improve their perceptions of substance users and treatment. We then explored if treatment using the curriculum, as delivered to clients by training participants, would encourage client motivation to change, participation in groups, and reduce substance use frequency. Methods Part 1: One-hundred professionals were trained in a curriculum-based, literacy-free intervention employing cognitive behavioral and rational emotive behavior therapy techniques to explore 12 Steps of addiction recovery through Zambian art forms. Pre/post questionnaires captured perspectives around substance users and treatment. Part 2: Trained organizations delivered the curriculum in their communities. Twenty-five organizations rated feasibility and benefit of the curriculum. Data for 200 clients recorded pre/post motivation to change, open-sharing/participation, and frequency of substance use. Results While training significantly modified professionals’ perspectives regarding the value of offering treatment, their views of substance users did not change. Clients endorsed increases in “motivation to change” and “participation/open-sharing.” Frequency of alcohol, marijuana, inhalant, and cigarette use significantly decreased. Conclusion Training in the curriculum helped address a public health need, playing a role in increased motivational variables and decreased substance use. Research addressing this study’s limitations is encouraged. Video abstract For a video summary of this paper, please visit https://youtu.be/uDZTVxtzF1Y.
Collapse
Affiliation(s)
- Hjördis S. Lorenz
- Oxford Centre for Anxiety Disorders and Trauma, University of Oxford, The Old Rectory, Paradise Square, OX1 1TW Oxford, United Kingdom
| | - Melissa Davis Stuebing
- CoLaborers International, 104 Spring Ave #959, Chestertown, MD 21620, USA
- Corresponding author at: 5809 Maywood Blvd Virginia Beach, VA 23455, USA.
| | - Chipego Nambeye
- CoLaborers Zambia, Plot Number 1449, Ibex Hill Meanwood, Off Kaleb Saili Drive, Lusaka, Zambia
- New Day Orphanage, PO Box 630260, Choma 10101, Zambia
| | - Gabriel Lungu
- The Republic of Zambia Ministry of Health, Chainama Hills Hospital, Off Great E, Lusaka 10101, Zambia
| | - Lauren M. Littlefield
- Department of Psychology, Washington College, 300 Washington Ave, Chestertown, MD 21620, USA
| |
Collapse
|
8
|
Nakimuli‐Mpungu E, Musisi S, Smith CM, Von Isenburg M, Akimana B, Shakarishvili A, Nachega JB, Mills EJ, Chibanda D, Ribeiro M, V Williams A, Joska JA. Mental health interventions for persons living with HIV in low- and middle-income countries: a systematic review. J Int AIDS Soc 2021; 24 Suppl 2:e25722. [PMID: 34164926 PMCID: PMC8222847 DOI: 10.1002/jia2.25722] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Addressing the intersection between mental health and HIV is critical for the wellbeing of persons living with HIV (PLWH). This systematic review synthesized the literature on mental health interventions for PLWH in low- and middle-income countries (LMICs) to determine intervention components and explore their relationship with intervention effectiveness. METHODS We included only controlled clinical trials of interventions aiming to improve the mental health of PLWH. We conducted a search in the following databases: PubMed, CINAHL, PsycINFO and EMBASE for eligible studies describing the evaluation of interventions for mental health problems among PLWH in LMICs published through August 2020. Two reviewers independently screened references in two successive stages of title/abstract screening and then full-text screening for references meeting title/abstract criteria. RESULTS We identified a total of 30 eligible articles representing 6477 PLWH who were assigned to either the intervention arm (n = 3182) or control arm (n = 3346). The mental health interventions evaluated were psychological (n = 17, 56.67%), pharmacological (n = 6, 20.00%), combined psychological and pharmacological (n = 1, 3.33%) and complementary/alternative treatments (n = 6, 20.00%). The mental health problems targeted were depression (n = 22, 73.33 %), multiple psychological symptoms (n = 1, 3.33%), alcohol and substance use problems (n = 4, 13.33%), post-traumatic stress disorder (n = 1, 3.33%) and HIV-related neuro-cognitive impairment (n = 2, 6.67%). Studies of interventions with significant effects had significantly a higher number of active ingredients than those without significant effects [3.41 (2.24) vs. 1.84 (1.46) Mean (SD)] [Mean difference = -1.56, 95% CI = -3.03 to -0.09, p = 0.037]. CONCLUSIONS There continue to be advances in mental health interventions for PLWH with mental illness in LMICs. However, more research is needed to elucidate how intervention components lead to intervention effectiveness. We recommend scale up of culturally appropriate interventions that have been successfully evaluated in low- and middle-income countries.
Collapse
Affiliation(s)
| | - Seggane Musisi
- Department of PsychiatryCollege of Health SciencesMakerere UniversityKampalaUganda
| | - Colin M Smith
- Department of Psychiatry and Behavioral SciencesDuke University Medical CenterDurhamNCUSA
- Department of MedicineDuke University Medical CenterDurhamNCUSA
| | - Megan Von Isenburg
- Duke University Medical Center LibraryDuke University Medical CenterDurhamNCUSA
| | - Benedict Akimana
- The Butabika National Referral HospitalMinistry of HealthKampalaUganda
| | | | - Jean B Nachega
- Department of International Health, Bloomberg's School of Public HealthJohns Hopkins UniversityBaltimoreMDUSA
- Department of EpidemiologyPittsburgh Graduate School of Public HealthUniversity of PittsburghPittsburghPAUSA
- Stellenbosch Center for Infectious DiseaseDepartment of MedicineStellenbosch UniversityStellenboschSouth Africa
| | - Edward J Mills
- Department of Clinical Epidemiology & BiostatisticsMcMaster UniversityHamiltonONCanada
| | - Dixon Chibanda
- Zimbabwe AIDS Prevention ProjectDepartment of Community MedicineUniversity of ZimbabweHarareZimbabwe
| | - Marcelo Ribeiro
- Reference Center for Alcohol, Tobacco and Other Drugs (CRATOD)São Paulo State Secretary of HealthSão PauloBrazil
| | - Anna V Williams
- National Addiction CentreInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonUK
| | - John A Joska
- HIV Mental Health Research UnitDepartment of PsychiatryNeuroscience InstituteUniversity of Cape TownCape TownSouth Africa
| |
Collapse
|
9
|
Ugwuozor FO, Otu MS, Mbaji IN. Critical thinking intervention for stress reduction among undergraduates in the Nigerian Universities. Medicine (Baltimore) 2021; 100:e25030. [PMID: 33725978 PMCID: PMC7982192 DOI: 10.1097/md.0000000000025030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 02/06/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The stress level of undergraduates is increasing at an alarming rate. This study's objective was to determine the effect of critical thinking intervention (CTI) for stress reduction among undergraduates in Nigerian Universities. METHODS This research used a pretest-posttest design. Participants were 103 undergraduates who had experienced a high level of stress. The Academic Stress Questionnaire (ASQ) and the Educational Stress Scale (ESSS) were the measures used for data collection in the study, while repeated measures analysis of variance was used for data analysis. RESULTS Before the intervention, assessment results showed that the stress level of participants was high, with no difference between those undergraduates in the treatment group and those in the no-treatment control group. After the intervention, the assessment results indicated a significant reduction in the undergraduates' stress level in the treatment group compared to those in the no-treatment control group. Further significant reduction was observed in the undergraduates' stress level in the treatment group compared to those in the no-treatment control group after follow-up assessment. CONCLUSION The authors concluded that CTI intervention was significantly effective for stress reduction among undergraduates in Nigerian Universities. Therefore, counselors are called upon to adopt the principle of CTI intervention to help patients under stress reduce their stress levels.
Collapse
|
10
|
The Effect of Rational Emotive Career Coaching on Dysfunctional Career Beliefs in Recent University Graduates. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2021. [DOI: 10.1007/s10942-020-00383-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
11
|
Madhombiro M, Kidd M, Dube B, Dube M, Mutsvuke W, Muronzie T, Zhou DT, Derveeuw S, Chibanda D, Chingono A, Rusakaniko S, Hutson A, Morse GD, Abas MA, Seedat S. Effectiveness of a psychological intervention delivered by general nurses for alcohol use disorders in people living with HIV in Zimbabwe: a cluster randomized controlled trial. J Int AIDS Soc 2020; 23:e25641. [PMID: 33314786 PMCID: PMC7733606 DOI: 10.1002/jia2.25641] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 10/12/2020] [Accepted: 10/22/2020] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION There have been very few randomized clinical trials of interventions for alcohol use disorders (AUD) in people living with HIV (PLWH) in African countries. This is despite the fact that alcohol use is one of the modifiable risk factors for poor virological control in PLWH on antiretroviral therapy. METHODS Sixteen clinic clusters in Zimbabwe were selected through stratified randomization and randomized 1: 1 to Intervention and Control arms. Inclusion criteria for individual participants were being adult, living with HIV and a probable alcohol use disorder as defined by a score of 6 (women) or 7 (men) on the Alcohol Use Disorders Identification Test (AUDIT). In the Intervention clusters, participants received 8 to 10 sessions of Motivational Interviewing blended with brief Cognitive Behavioural Therapy (MI-CBT). In the control clusters, participants received four Enhanced Usual Care (EUC) sessions based on the alcohol treatment module from the World Health Organisation mhGAP intervention guide. General Nurses from the clinics were trained to deliver both treatments. The primary outcome was a change in AUDIT score at six-month post-randomization. Viral load, functioning and quality of life were secondary outcomes. A random-effects analysis-of-covariance model was used to account for the cluster design. RESULTS Two hundred and thirty-four participants (n = 108 intervention and n = 126 control) were enrolled across 16 clinics. Participants were recruited from November 2016 to November 2017 and followed through to May 2018. Their mean age was 43.3 years (SD = 9.1) and 78.6% (n = 184) were male. At six months, the mean AUDIT score fell by -6.15 (95% CI -6.32; -6.00) in the MI-CBT arm, compared to a fall of - 3.09 95 % CI - 3.21; -2.93) in the EUC arm (mean difference -3.09 (95% CI -4.53 to -1.23) (p = 0.05). Viral load reduced and quality of life and functioning improved in both arms but the difference between arms was non-significant. CONCLUSIONS Interventions for hazardous drinking and AUD comprising brief, multiple alcohol treatment sessions delivered by nurses in public HIV facilities in low-income African countries can reduce problematic drinking among PLWH. Such interventions should be integrated into the primary care management of AUD and HIV and delivered by non-specialist providers. Research is needed on cost-effectiveness and implementation of such interventions, and on validation of cut-points for alcohol use scales in low resource settings, in partnership with those with lived experience of HIV and AUD.
Collapse
Affiliation(s)
- Munyaradzi Madhombiro
- Department of PsychiatryUniversity of ZimbabweHarareZimbabwe
- SUNY University at BuffaloBuffaloNYUSA
| | - Martin Kidd
- Centre for Statistical ConsultationStellenbosch UniversityStellenboschSouth Africa
| | - Bazondlile Dube
- Department of PsychiatryUniversity of ZimbabweHarareZimbabwe
| | - Michelle Dube
- Department of PsychiatryUniversity of ZimbabweHarareZimbabwe
| | - Wilson Mutsvuke
- Department of PsychiatryUniversity of ZimbabweHarareZimbabwe
| | | | - Danai Tavonga Zhou
- Department of PsychiatryUniversity of ZimbabweHarareZimbabwe
- Department of Medical Laboratory SciencesUniversity of ZimbabweHarareZimbabwe
| | - Sarah Derveeuw
- Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUnited Kingdom
| | - Dixon Chibanda
- Department of PsychiatryUniversity of ZimbabweHarareZimbabwe
| | - Alfred Chingono
- Department of PsychiatryUniversity of ZimbabweHarareZimbabwe
| | | | - Alan Hutson
- Department of Biostatistics and BioinformaticsRoswell Park Comprehensive Cancer CenterBuffaloNYUSA
| | | | - Melanie A Abas
- Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUnited Kingdom
- Lewisham HospitalSouth London and MaudsleyNHS Foundation TrustLondonUnited Kingdom
| | - Soraya Seedat
- Faculty of Medicine and Health SciencesStellenbosch UniversityStellenboschSouth Africa
| |
Collapse
|
12
|
Preusse M, Neuner F, Ertl V. Effectiveness of Psychosocial Interventions Targeting Hazardous and Harmful Alcohol Use and Alcohol-Related Symptoms in Low- and Middle-Income Countries: A Systematic Review. Front Psychiatry 2020; 11:768. [PMID: 32903779 PMCID: PMC7438922 DOI: 10.3389/fpsyt.2020.00768] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 07/20/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In low- and middle-income countries (LMIC), the mismatch between the number of individuals needing and those receiving treatment for alcohol use disorders (AUD) is substantial. In order to provide suggestions for the scaling up of effective service provision we systematically reviewed the current evidence on the effectiveness of AUD-focused psychosocial interventions in LMIC. METHODS We used a systematic review methodology following the PRISMA guidelines. Twelve electronic databases listing published and grey literature were searched and only randomized-controlled trials (RCTs) were included. Where possible, effect sizes were calculated using Hedges' g indices. RESULTS Twenty-one RCTs conducted in 15 different LMIC between 1992 and 2018 fulfilled inclusion criteria. Most studies employed brief one-on-one interventions facilitated by trained primary care staff. Eighty-six percent of RCTs based their interventions on the principles of motivational interviewing (MI) with the majority supplementing MI-based interventions with alcohol-tailored elements of cognitive-behavioral therapy (CBT). The remaining RCTs employed CBT-components exclusively. Just over 40% of studies included in quantitative analyses (n=17) yielded an at least medium-sized effect (g≥.50) of the respective intervention compared to alcohol-related and unrelated control conditions or waiting list. Only half of the trials implementing the widely applied MI-based approaches (or MI-based approaches blended with CBT-elements) were superior to their respective control conditions. CONCLUSION To date, a relatively small number of RCTs investigating AUD-focused treatments has been conducted in LMIC. The majority of between condition effect size estimates were small and no type of intervention can clearly be recommended over another. No RCTs were conducted in conflict-affected areas in LMIC although they would merit particular attention since AUD is often linked to trauma-related mental health disorders. More RCTs in LMIC are required and alternatives to MI-based approaches should be investigated. This systematic review summarizes properties of effective interventions and provides implications for future research.
Collapse
Affiliation(s)
- Melissa Preusse
- Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Bielefeld, Germany
- vivo international, Konstanz, Germany
| | - Frank Neuner
- Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Bielefeld, Germany
- vivo international, Konstanz, Germany
| | - Verena Ertl
- vivo international, Konstanz, Germany
- Department of Clinical Psychology and Biopsychology, Catholic University Eichstätt-Ingolstadt, Eichstätt, Germany
| |
Collapse
|
13
|
Ofoegbu TO, Asogwa UD, Ogbonna CS, Aloh HE, Eseadi C, Eskay M, Nji GC, Ngwoke OR, Agboti CI, Nnachi RA, Nnachi OC, Otu MS. Effect of digital storytelling intervention on burnout thoughts of adolescent: Athletes with disabilities. Medicine (Baltimore) 2020; 99:e21164. [PMID: 32791690 PMCID: PMC7386998 DOI: 10.1097/md.0000000000021164] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND/OBJECTIVE Both athletes with and without disabilities can develop burnout symptoms. However, athletes with disabilities may face different or more challenges compared to their counterparts without disabilities. The present study aimed at ascertaining the effect of digital storytelling intervention on burnout thoughts of adolescent-athletes with disabilities. METHOD This study is a randomized controlled trial involving a total of 171 adolescent-athletes with disabilities who showed a high degree of burnout symptoms. These adolescent-athletes were randomly assigned to either an intervention group (n = 85) or a waitlisted control group (n = 86). The treatment intervention for the adolescent-athletes was digital stories which were created based on the framework of rational emotive behaviour therapy (REBT). The Athlete Burnout Questionnaire was used for gathering of data at three different times (baseline, post-test and follow up). Data were analyzed using repeated measure analysis of variance at a significant level of 0.05. RESULTS Results showed that the digital storytelling intervention based on REBT significantly reduced burnout thoughts among disabled adolescent-athletes in the intervention group compared to athletes in the waitlisted control group as measured by the Athlete Burnout Questionnaire. Additionally, at follow-up evaluation, it was observed that the decrease in burnout scores was maintained by those athletes in the digital storytelling intervention. CONCLUSION Digital storytelling intervention based on rational emotive behaviour therapy shows great potentials in addressing burnout among adolescent-athletes with disabilities.
Collapse
Affiliation(s)
- Theresa Onyema Ofoegbu
- Department of Arts Education, University of Nigeria, Nsukka, P.M.B. 410001, Enugu State, Nigeria
| | - Uche D. Asogwa
- Department of Arts Education, University of Nigeria, Nsukka, P.M.B. 410001, Enugu State, Nigeria
| | - Chimaobi Samuel Ogbonna
- Department of Arts Education, University of Nigeria, Nsukka, P.M.B. 410001, Enugu State, Nigeria
| | - Henry E. Aloh
- Health Economics, Management and Policy Research Unit, Department of Health Sciences, Alex-Ekwueme Federal University Ndufu-Alike Ikwo, Ebonyi State, Nigeria
| | - Chiedu Eseadi
- Department of Educational Foundations, University of Nigeria, Nsukka, P.M.B. 410001, Enugu State, Nigeria
| | - Michael Eskay
- Department of Educational Foundations, University of Nigeria, Nsukka, P.M.B. 410001, Enugu State, Nigeria
| | - Godfrey C. Nji
- Department Human Kinetics and Health Education, University of Nigeria, Nsukka, P.M.B. 410001, Enugu State, Nigeria
| | - Oliver Rotachukwu Ngwoke
- Department Human Kinetics and Health Education, University of Nigeria, Nsukka, P.M.B. 410001, Enugu State, Nigeria
| | - Christian Iheanacho Agboti
- Department of Sociology/Criminology & Security Studies, Alex-Ekwueme Federal University Ndufu Alike Ikwo, Ebonyi State, Nigeria
| | - Robert Azu Nnachi
- Department of Accountancy/Business Administration/Banking and Finance, Alex-Ekwueme Federal University Ndufu-Alike Ikwo, Ebonyi State, Nigeria
| | - Oluomachi Charity Nnachi
- Department of Haematology and Blood Transfusion, Alex-Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - Mkpoikanke S. Otu
- Department of Educational Foundations, University of Nigeria, Nsukka, P.M.B. 410001, Enugu State, Nigeria
| |
Collapse
|
14
|
Ofoegbu TO, Otu MS, Christopher I, Uche A, Nwabuko LO, Ebere I, Dike IC, Ngozi O, Chinedozie U, Muhammed A. Impact of an educational digital storytelling intervention on HIV risk perception among Nigerian adolescents. J Int Med Res 2019; 48:300060519854635. [PMID: 31208259 PMCID: PMC7140211 DOI: 10.1177/0300060519854635] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective The study objective was to investigate the impact of an educational digital
storytelling intervention (EDSI) on human immunodeficiency virus (HIV) risk
perception and knowledge among Nigerian adolescents. Methods Using a randomized controlled trial design procedure, we recruited 98
Nigerian adolescents who were college students. Data were collected using
the Perceived Risk of HIV Scale and the HIV Knowledge Questionnaire and were
analysed using repeated measures analysis of variance. Results The results showed that the EDSI was effective in increasing HIV risk
perception and knowledge among adolescents in the treatment group compared
with those in the no-treatment control group. Conclusion The EDSI is a useful tool to help adolescents to increase their HIV risk
perception and knowledge. Further research and policy changes are needed to
support the full implementation of the EDSI in different sectors of Nigerian
society and in other parts of the world.
Collapse
Affiliation(s)
| | | | | | - Asogwa Uche
- Department of Arts Education, University of Nigeria, Nsukka, Nigeria
| | - Linus Okechukwu Nwabuko
- Department of Adult Education and Extra Moral Studies, University of Nigeria, Nsukka, Nigeria
| | - Ibe Ebere
- Department of Science Education, University of Nigeria, Nsukka, Nigeria
| | - Ibiwari Caroline Dike
- Department of Educational Foundations (Childhood Education), University of Nigeria, Nsukka, Nigeria
| | - Obiyo Ngozi
- Department of Educational Foundations, University of Nigeria, Nsukka, Nigeria
| | - Uwakwe Chinedozie
- Department of Arts Education, University of Nigeria, Nsukka, Nigeria
| | | |
Collapse
|
15
|
Nnamani A, Akabogu J, Otu MS, Ukoha E, Uloh-Bethels AC, Omile JC, Obiezu MN, Dike AE, Ike CV, Iyekekpolor OM. Cognitive behaviour language therapy for speech anxiety among stuttering school adolescents. J Int Med Res 2019; 47:3109-3114. [PMID: 31154887 PMCID: PMC6683914 DOI: 10.1177/0300060519853387] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective To determine the effectiveness of a cognitive behaviour language therapy (CBLT) programme to reduce speech anxiety among stuttering school adolescents. Methods This was a group randomized clinical trial that enrolled stuttering school adolescents who had severe speech anxiety. The participants were randomized to either the treatment group or the control group. The Speech Anxiety Thoughts Inventory (SATI) score was recorded before and after a 12-week CBLT programme was delivered in 24 group sessions to the treatment group. The control group did not receive any therapy. Results A total of 92 stuttering school adolescents who met the inclusion criteria were randomized to the treatment group (n = 46; 22 males, 24 females; mean ± SD age, 16.36 ± 2.20 years) or the control group (n = 46; 28 males, 18 females; mean ± SD age, 15.45 ± 2.10 years). Results showed that the CBLT intervention significantly reduced speech anxiety among stuttering school adolescents compared with the control group (post-test SATI assessment, mean ± SD 26.52 ± 1.67 versus 89.92 ± 3.17, respectively). Conclusion These findings suggest that speech educators and therapists in educational institutions and hospitals should follow the principles of CBLT when treating speech anxiety.
Collapse
Affiliation(s)
- Amuche Nnamani
- 1 Department of Arts Education, University of Nigeria, Nsukka, Nigeria
| | - Josephine Akabogu
- 1 Department of Arts Education, University of Nigeria, Nsukka, Nigeria
| | | | - Evelyn Ukoha
- 1 Department of Arts Education, University of Nigeria, Nsukka, Nigeria
| | | | - Jacinta Chinwe Omile
- 3 Department of English and Literary Studies, Federal College of Education (Technical), Umunze, Nigeria
| | - Maureen Nnenna Obiezu
- 3 Department of English and Literary Studies, Federal College of Education (Technical), Umunze, Nigeria
| | - Anastasia E Dike
- 1 Department of Arts Education, University of Nigeria, Nsukka, Nigeria
| | - Chioma Vivian Ike
- 4 Department of English and Literary Studies, Federal College of Education, Eha-Amufu, Nigeria
| | | |
Collapse
|