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Mor S, Botella C, Campos D, Carlbring P, Tur C, Quero S. An internet-based treatment for flying phobia using 360° images: A feasibility pilot study. Internet Interv 2022; 28:100510. [PMID: 35242593 PMCID: PMC8866141 DOI: 10.1016/j.invent.2022.100510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/10/2022] [Accepted: 02/13/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND More research is needed in the field of Internet-delivered Cognitive Behavioral Treatments (ICBTs) for specific phobia in order to understand which characteristics are important in online exposure scenarios. The aim of the present work was to conduct a feasibility pilot study to explore participants' opinions, preferences, and acceptability ratings of two types of images (still images vs 360° navigable images) in an ICBT for Flying Phobia (FP). A secondary aim was to test the potential effectiveness of the two active treatment arms compared to a waiting list control group. An exploratory aim was to compare the role of navigable images vs. still images in the level of sense of presence and reality judgment and explore their possible mediation in treatment effectiveness. METHODS Participants were randomly allocated to three conditions: NO-FEAR Airlines with still images (n = 26), NO-FEAR Airlines with still and navigable images (n = 26), and a waiting list group (n = 26). Primary outcome measures were participants' opinions, preferences, satisfaction, and acceptance regarding the images used in the exposure scenarios. Secondary outcome measures included FP symptomatology outcomes and measures of sense of presence and reality judgment. RESULTS Participants in the study preferred navigable images over still images before and after treatment (over 84%), and they considered them more effective and logical for the treatment of their problem. However, adherence in the experimental conditions was low (42.3% dropout rate), and more participants withdrew from the group that included navigable images compared to the group that only included still images (14 vs. 8), with no statistical differences in attrition between the two conditions. NO-FEAR Airlines proved to be effective in reducing FP symptomatology compared to the control group, with large between-group effect sizes on all FP measures (ranging from 0.76 to 2.79). No significant mediation effect was found for sense of presence or reality judgment in treatment effectiveness. DISCUSSION The results of the current study suggest that participants prefer more immersive images in exposure scenarios, providing data that can help to design useful exposure scenarios to treat specific phobias in the future. They also provide evidence supporting the effectiveness of an ICBT for FP. TRIAL REGISTRATION Registered at Clinicaltrials.gov (NCT03900559) on April 9, 2019. Retrospectively registered.
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Affiliation(s)
- Sonia Mor
- Universitat Jaume I, Castellón, Spain
| | - Cristina Botella
- Universitat Jaume I, Castellón, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| | - Daniel Campos
- Department of Psychology and Sociology, University of Zaragoza, Huesca, Spain
- Instituto de Investigación Sanitaria Aragón (IISAragon), Zaragoza, Spain
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | | | - Soledad Quero
- Universitat Jaume I, Castellón, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
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Client's Experiences Using a Location-Based Technology ICT System during Gambling Treatments' Crucial Components: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073769. [PMID: 35409450 PMCID: PMC8997771 DOI: 10.3390/ijerph19073769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 12/18/2022]
Abstract
Cognitive Behavioral Therapy is the treatment of choice for Gambling Disorder (GD), with stimulus control (SC) and exposure with response prevention (ERP) being its two core components. Despite their efficacy, SC and ERP are not easy to deliver, so it is important to explore new ways to enhance patient compliance regarding SC and ERP. The aim of this study is to describe and assess the opinion of two patients diagnosed with problem gambling and GD that used the Symptoms app, a location-based ICT system, during SC and ERP. A consensual qualitative research study was conducted. We used a semi-structured interview, developed ad-hoc based on the Expectation and Satisfaction Scale and System Usability Scale. A total of 20 categories were identified within six domains: usefulness, improvements, recommendation to other people, safety, usability, and opinion regarding the use of the app after completing the intervention. The patients considered the app to be useful during the SC and ERP components and emphasized that feeling observed and supported at any given time helped them avoid lapses. This work can offer a starting point that opens up new research paths regarding psychological interventions for gambling disorder, such as assessing whether location-based ICT tools enhance commitment rates.
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Gao L, Dahmen A, Keller FM, Becker P, Lippke S. The Mediation Effect of Phobic Anxiety on the Treatment Outcome of Activity and Participation across Age: Comparison between Online and Face-to-Face Rehabilitation Aftercare of an RCT. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10919. [PMID: 34682655 PMCID: PMC8536151 DOI: 10.3390/ijerph182010919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 11/24/2022]
Abstract
The efficacy of internet and mobile-based interventions (IMIs) has been demonstrated with different mental health disorders, but little is known about the mediating effect of phobic anxiety on activity and participation and the differential effect of age. The current study tested a moderated mediation model with short-term change in phobic anxiety mediating between treatment (IMI vs. face-to-face, F2F) and long-term change in activity and participation, and age of patients moderating this mediation. Participants (N = 142) were recruited from psychosomatic rehabilitation clinics and randomized into the IMI psychosomatic aftercare or F2F psychosomatic aftercare. Moderated mediation analyses were conducted using R software. Results showed that the long-term treatment effects of activity and participation (βc = -0.18, p = 0.034; βc' = -0.13, p = 0.145) were improved through the successful decrease of phobic anxiety (βa = -0.18, p = 0.047; βb = 0.37, p = 0.010). Older patients benefited equally from both IMI and F2F interventions regarding short-term treatment change in phobic anxiety, while younger participants benefited more from IMI (βAge*Treatment = 0.20, p = 0.004). IMIs targeting mental disorders can improve activity and participation along with phobic anxiety, especially in younger individuals. The needs of older patients should be considered with the development and improvement of IMIs.
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Affiliation(s)
- Lingling Gao
- Department of Psychology & Methods, Jacobs University Bremen, 28759 Bremen, Germany; (L.G.); (A.D.); (F.M.K.)
| | - Alina Dahmen
- Department of Psychology & Methods, Jacobs University Bremen, 28759 Bremen, Germany; (L.G.); (A.D.); (F.M.K.)
- Dr. Becker Klinikgruppe, 50968 Cologne, Germany;
- Klinikum Wolfsburg, 38440 Wolfsburg, Germany
| | - Franziska Maria Keller
- Department of Psychology & Methods, Jacobs University Bremen, 28759 Bremen, Germany; (L.G.); (A.D.); (F.M.K.)
| | - Petra Becker
- Dr. Becker Klinikgruppe, 50968 Cologne, Germany;
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen, 28759 Bremen, Germany; (L.G.); (A.D.); (F.M.K.)
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Diaz-Sanahuja L, Campos D, Mira A, Castilla D, García-Palacios A, Bretón-López JM. Efficacy of an internet-based psychological intervention for problem gambling and gambling disorder: Study protocol for a randomized controlled trial. Internet Interv 2021; 26:100466. [PMID: 34646753 PMCID: PMC8501496 DOI: 10.1016/j.invent.2021.100466] [Citation(s) in RCA: 2] [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: 07/21/2021] [Revised: 09/15/2021] [Accepted: 09/29/2021] [Indexed: 01/06/2023] Open
Abstract
UNLABELLED Gambling Disorder is a prevalent non-substance use disorder, which contrasts with the low number of people requesting treatment. Information and Communication Technologies (ICT) could help to enhance the dissemination of evidence-based treatments and considerably reduce the costs. The current study seeks to assess the efficacy of an online psychological intervention for people suffering from gambling problems in Spain. The proposed study will be a two-arm, parallel-group, randomized controlled trial. A total of 134 participants (problem and pathological gamblers) will be randomly allocated to a waiting list control group (N = 67) or an intervention group (N = 67). The intervention program includes 8 modules, and it is based on motivational interviewing, cognitive-behavioral therapy (CBT), and extensions and innovations of CBT. It includes several complementary tools that are present throughout the entire intervention. Therapeutic support will be provided once a week through a phone call with a maximum length of 10 min. The primary outcome measure will be gambling severity and gambling-related cognitions, and secondary outcome measures will be readiness to change, and gambling self-efficacy. Other variables that will be considered are depression and anxiety symptoms, positive and negative affect, difficulties in emotion regulation strategies, impulsivity, and quality of life. Individuals will be assessed at baseline, post-treatment, and 3-, 6-, and 12-month follow-ups. During the treatment, participants will also respond to a daily Ecological Momentary Intervention (EMI) in order to evaluate urges to gamble, self-efficacy to cope with gambling urges, gambling urge frequency, and whether gambling behaviour occurs. The EMI includes immediate automatic feedback depending on the participant's responses. Treatment acceptance and satisfaction will also be assessed. The data will be analysed both per protocol and by Intention-to-treat. As far as we know, this is the first randomized controlled trial of an online psychological intervention for gambling disorder in Spain. It will expand our knowledge about treatments delivered via the Internet and contribute to improving treatment dissemination, reaching people suffering from this problem who otherwise would not receive help. TRIAL REGISTRATION Clinicaltrials.gov as NCT04074681. Registered 22 July 2019.
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Key Words
- A, Action
- C, Contemplation
- CBT
- CBT, Cognitive Behavioral Therapy
- CIDI, Composite International Diagnostic Interview
- CONSORT-EHEALTH, Consolidated Standards of Reporting Trials of Electronic and Mobile Health Applications and Online Telehealth
- DERS, Difficulties in Emotion Regulation Scale
- DGOJ, Directorate General for the Regulation of Gambling
- DSM-5, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
- DSM-III-R, Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition Revised
- DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition
- EDBs, Emotion Driven Behaviours
- EMA, Ecological Momentary Assessment
- EMI, Ecological Momentary Intervention
- Efficacy
- Emotion regulation
- G-SAS, The Gambling Symptom Assessment Scale
- GD, Gambling Disorder
- GE, Gambling Expectancies
- GI, Gambling history interview and current gambling situation and related variables assessment
- GRCS-S, Gambling-Related Cognitions Scale
- GSEQ, Gambling Self-Efficacy Questionnaire
- Gambling
- HADS, Hospital Anxiety Depression Scale
- IB, Interpretative Bias
- IC, Illusion of Control
- ICD-10, International Statistical Classification of Diseases and Related Health Problems 10th Revision
- ISG, Perceived Inability to Stop Gambling
- Internet
- M, Maintenance
- MFS, Monitoring, Feedback and Support
- MI, Motivational Interviewing
- MINI, Mini International Neuropsychiatric Interview
- NA, Negative Affect
- NODS, NORC DSM-IV Screen for Gambling Problems
- OASIS, The Overall Anxiety Severity and Impairment Scale
- ODSIS, The Overall Depression Severity and Impairment Scale
- P, Precontemplation
- PA, Positive Affect
- PANAS, The Positive and Negative Affect Schedule
- PC, Predictive Control
- PFIs, Personal Feedback Interventions
- QLI, Quality Life Index
- RCT, Randomized Controlled Trial
- SCID-P, The Structured Clinical Interview
- SPIRIT, Standard Protocol Items Recommendations for Interventional Trials
- SUS, System Usability Scale
- UPPS-P, The Short UPPS-P Impulsivity Scale
- URICA, The University of Rhode Island Change Assessment Scale
- WL, Waiting List
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Affiliation(s)
- Laura Diaz-Sanahuja
- Universitat Jaume I, Castellón, Spain
- Corresponding author at: Department of Basic Psychology, Clinical and Psychobiology, Universitat Jaume I, Avenida de Vicent Sos Baynat, s/n, 12071 Castellón, (Spain).
| | - Daniel Campos
- Universidad de Zaragoza, Huesca, Spain
- Instituto de Investigación Sanitaria Aragón (IISAragon), Zaragoza, Spain
| | | | - Diana Castilla
- Universidad de Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Azucena García-Palacios
- Universitat Jaume I, Castellón, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Juana María Bretón-López
- Universitat Jaume I, Castellón, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
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Tur C, Campos D, Herrero R, Mor S, López-Montoyo A, Castilla D, Quero S. Internet-delivered Cognitive-Behavioral Therapy (iCBT) for Adults with Prolonged Grief Disorder (PGD): A Study Protocol for a Randomized Feasibility Trial. BMJ Open 2021; 11:e046477. [PMID: 34230018 PMCID: PMC8261880 DOI: 10.1136/bmjopen-2020-046477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 06/11/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Grief is an emotional reaction to the loss of a loved one with a natural recovery. Approximately 10% of people who lose a loved one develop prolonged grief disorder (PGD). Internet-based and computer-based interventions (ie, internet-delivered cognitive-behavioural therapy, iCBT) are a cost-effective alternative that makes it possible to reach more people with PGD. The main aim of this study is to assess the feasibility of a new iCBT-called GROw-for PGD. As a secondary objective, the potential effectiveness of GROw will be explored. METHODS AND ANALYSIS This study is a two-arm feasibility randomised trial. A total of 48 adults with PGD who meet the eligibility criteria will be randomised to the experimental group (iCBT: GROw) or the active control group (face-to-face CBT treatment). The treatment is organised sequentially in eight modules in the iCBT format and 8-10 sessions in the face-to-face format, and both formats have the same therapeutic components. There will be five assessment points with qualitative and quantitative evaluations: screening, baseline, after the intervention, 3-month follow-up and 12-month follow-up. Consistent with the objectives, the measures are related to the feasibility outcomes for the main aim of the study (participant adherence, expectations and satisfaction with the treatment, preferences, alliance and utility) and psychological and mental health outcomes for secondary analyses (symptoms of grief, symptoms of depression, symptoms of anxiety, affectivity, quality of life, work and social adaptation, post-traumatic growth, purpose in life, mindfulness and compassion). ETHICS AND DISSEMINATION The Ethics Committee of the Universitat Jaume I (Castellón, Spain) granted approval for the study (CD/002/2019). Dissemination will include publications and presentations at national and international conferences. TRIAL REGISTRATION NUMBER NCT04462146.
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Affiliation(s)
- Cintia Tur
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
| | - Daniel Campos
- Department of Psychology and Sociology, University of Zaragoza, Huesca, Spain
| | - Rocio Herrero
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain
| | - Sonia Mor
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
| | - Alba López-Montoyo
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
| | - Diana Castilla
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain
| | - Soledad Quero
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
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Mor S, Botella C, Campos D, Tur C, Castilla D, Soler C, Quero S. An Internet-based treatment for Flying Phobia using 360° images: Study protocol for a feasibility pilot study. Internet Interv 2021; 24:100387. [PMID: 33936953 PMCID: PMC8076687 DOI: 10.1016/j.invent.2021.100387] [Citation(s) in RCA: 2] [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: 07/24/2020] [Revised: 03/15/2021] [Accepted: 03/24/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Flying Phobia (FP) is a prevalent disorder that can cause serious interference in a person's life. ICBT interventions have already shown their efficacy in several studies, but studies in the field of specific phobias are still scarce. Moreover, few studies have investigated the feasibility of using different types of images in exposure scenarios in ICBTs and no studies have been carried out on the role of sense of presence and reality judgement. The aim of the present study is to explore the feasibility of an ICBT for FP (NO-FEAR Airlines) using two types of images with different levels of immersion (still and navigable images). A secondary aim is to explore the potential effectiveness of the two experimental conditions using two types of images compared to a waiting list control group. Finally, the role of navigable images compared to the still images in the level of anxiety, sense of presence, and reality judgement will also be explored. This paper presents the study protocol. METHODS This study is a three-armed feasibility pilot study with the following conditions: NO-FEAR Airlines with navigable images, NO-FEAR Airlines with still images, and a waiting list group. A minimum of 60 participants will be recruited. The intervention will have a maximum duration of 6 weeks. Measurements will be taken at four different moments: baseline, post-intervention, and two follow-ups (3- and 12-month). Participants' opinions, preference, satisfaction and acceptance regarding the images used in the exposure scenarios will be assessed. FP symptomatology outcomes will also be considered for secondary analyses. The anxiety, sense of presence, and reality judgement in the exposure scenarios will also be analysed. DISCUSSION This study will conduct a pilot study on the feasibility of an ICBT for FP and it is the first one to explore the evaluation of patients of the two type of images (still and navigable) and the role of presence and reality judgement in exposure scenarios delivered through the Internet. Research in this field can have an impact on the way these scenarios are designed and developed, as well as helping to explore whether they have any effect on adherence. TRIAL REGISTRATION NCT03900559. Trial Registration date 3 April 2019, retrospectively registered.
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Affiliation(s)
- Sonia Mor
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Cristina Botella
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| | - Daniel Campos
- Department of Psychology and Sociology, University of Zaragoza, Huesca, Spain
- Instituto de Investigación Sanitaria Aragón (IISAragon), Zaragoza, Spain
| | - Cintia Tur
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | | | | | - Soledad Quero
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
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Díaz-García A, González-Robles A, García-Palacios A, Fernández-Felipe I, Tur C, Castilla D, Botella C. Blended transdiagnostic group CBT for emotional disorders: A feasibility trial protocol. Internet Interv 2021; 23:100363. [PMID: 33520670 PMCID: PMC7820549 DOI: 10.1016/j.invent.2021.100363] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 12/21/2020] [Accepted: 12/29/2020] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Emotional disorders (anxiety and depressive disorders) are a relevant public health concern associated with high prevalence, high costs, and important disability. Therefore, research priorities include designing and testing cost-effective interventions to reach everyone in need. Internet-delivered interventions for emotional disorders are effective and can help to disseminate and implement evidence-based treatments. However, although these treatments are generally effective, not all patients benefit from this treatment format equally. Blended treatments are a new form of intervention that combines the strengths of face-to-face and Internet approaches. Nevertheless, research on blended interventions has focused primarily on individual therapy, and less attention has been paid to the potential of using this format in group psychotherapy. This study aims to analyze the feasibility of blended transdiagnostic group CBT for emotional disorders. The current article describes the study protocol for this trial. METHOD AND ANALYSIS A one-armed pilot trial will be conducted. Participants will be 30 adults suffering from DSM-5 anxiety and/or depressive disorders. The treatment consists of a blended transdiagnostic group intervention delivered during a period of 24 weeks. Groups of 6 to 10 patients will attend a total of eight 2-hour, face-to-face sessions, alternated with the use of an online platform where they will find the contents of the treatment protocol. The intervention has four core components: present-focused awareness, cognitive flexibility, identification and modification of behavioral and cognitive patterns of emotional avoidance, and interoceptive and situational exposure. These components are delivered in 16 modules. Assessments will be performed at baseline, during the treatment, at post-treatment, and at 3-month follow-up. Clinical and treatment acceptability outcomes will be included. Quantitative and qualitative data (participants' views about blended group psychotherapy) will be analyzed. ETHICS AND DISSEMINATION The trial has received ethical approval from the Ethics Committee of Universitat Jaume I (September 2019) and will be conducted in accordance with the study protocol, the Declaration of Helsinki, and good clinical practice. The results of this study will be disseminated by presentation at conferences and will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04008576. Registered 05 July 2019, https://clinicaltrials.gov/ct2/show/NCT04008576.
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Affiliation(s)
- Amanda Díaz-García
- Department of Psychology and Sociology, Universidad de Zaragoza (Campus de Teruel), Teruel, Spain
| | - Alberto González-Robles
- Department of Psychology and Sociology, Universidad de Zaragoza (Campus de Teruel), Teruel, Spain
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellon, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Isabel Fernández-Felipe
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellon, Spain
| | - Cintia Tur
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellon, Spain
| | - Diana Castilla
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain
| | - Cristina Botella
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellon, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
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Lan T, Zhao F, Xiong B. The Acceptability and Influencing Factors of an Internet-Based Tinnitus Multivariate Integrated Sound Therapy for Patients With Tinnitus. EAR, NOSE & THROAT JOURNAL 2020; 101:680-689. [PMID: 33258696 DOI: 10.1177/0145561320973768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To explore the acceptability and influencing factors of an Internet-based Tinnitus Multivariate Integrated Sound Therapy (iT-MIST). The individually tailored sound therapy used narrowband noise centered on the patient's tinnitus frequency in combination with natural sounds and relaxing music. DESIGN Patients with tinnitus were given a 1-week trial of iT-MIST. Semistructured interviews were then carried out and a thematic analysis used to analyze, identify, organize, and report factors discovered in the data. STUDY SAMPLE Semistructured interviews were carried out with 11 participants, 2 women and 9 men, mean age 39.82 years. RESULTS The first theme identified from patient interview analysis was their motivation to undertake and expectations of iT-MIST. Nearly half of the participants indicated that advice from the physician was considered very important and professional. Benefits acknowledged by most participants from their iT-MIST experience were accessibility, convenience, time- and cost-effectiveness, and emotional benefit. However, a few participants with poor understanding of tinnitus and iT-MIST showed a negative acceptability with doubtful thoughts and complaints about technical issues such as being easily interrupted by messages and phone calls. CONCLUSION Patients with tinnitus in this study were not universally accepting of the iT-MIST therapy. Concerns about their tinnitus and ability to comply with doctor's recommendations were the main influencing factors. Attitude or willingness to explore new therapies facilitated its use. Emotional benefits, for example, relaxation and comfort, were seen to sustain motivation, while doubtful thoughts and technical problems negatively affected acceptability.
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Affiliation(s)
- Tianxiang Lan
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, 11352Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Fei Zhao
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, 11352Cardiff Metropolitan University, Cardiff, United Kingdom.,Department of Hearing and Speech Science, 11352Xinhua College, Sun Yat-Sen University, Guangzhou, China
| | - Binbin Xiong
- Department of Otolaryngology, 558113Shenzhen University General Hospital, Shenzhen, Guangdong, China
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Burgoyne N, Cohn AS. Lessons from the Transition to Relational Teletherapy During COVID-19. FAMILY PROCESS 2020; 59:974-988. [PMID: 32692867 PMCID: PMC7404738 DOI: 10.1111/famp.12589] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
When the World Health Organization declared the coronavirus outbreak a pandemic, clinicians were challenged to maintain continuity of care. Teletherapy became the primary means of service delivery for many who had never or only sparingly used it. The Family Institute at Northwestern University, in response to encouraging findings with respect to the effectiveness of teletherapy and recognizing advantages with respect to access to care, launched our teletherapy services in 2018. As a relationship-based organization, we were keen to exploit the opportunity that teletherapy provides to integrate additional members of the client system into the treatment. Over these two plus years, we have learned a great deal. Our learning was greatly accelerated by our transition to a 100% teletherapy practice in the wake of the pandemic. Teletherapy is a different context. Intentionally managing the context's constraints and exploiting its strengths is key to providing high-quality couple and family therapy. This step is often overlooked or resisted when teletherapy is an occasional add-on to a face-to-face practice.
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Affiliation(s)
- Nancy Burgoyne
- The Family Institute at Northwestern UniversityEvanstonILUSA
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Campos D, Navarro-Gil M, Herrera-Mercadal P, Martínez-García L, Cebolla A, Borao L, López-Del-Hoyo Y, Castilla D, Del Río E, García-Campayo J, Quero S. Feasibility of the Internet Attachment-Based Compassion Therapy in the General Population: Protocol for an Open-Label Uncontrolled Pilot Trial. JMIR Res Protoc 2020; 9:e16717. [PMID: 32384051 PMCID: PMC7455878 DOI: 10.2196/16717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/27/2020] [Accepted: 01/27/2020] [Indexed: 12/28/2022] Open
Abstract
Background Compassion-based interventions delivered over the internet are showing promising results for the promotion of psychological health and well-being. Several studies have highlighted their feasibility, acceptance, and preliminary efficacy. However, this is an incipient field of research, and to the best of our knowledge, there are no data available from Spanish-speaking countries. Objective The aim of this study is to investigate the feasibility, acceptance, and preliminary efficacy of the Internet Attachment–Based Compassion Therapy (iABCT), a web-based version of the Attachment-Based Compassion Therapy, in Spanish speakers from the general population. Methods This feasibility study features a single-arm, uncontrolled, within-group design with an embedded qualitative and quantitative process evaluation at baseline, immediately after the intervention and at the 3-month follow-up. A minimum of 35 participants from the general population will be allocated to iABCT. Feasibility measures will include attrition rate, patterns of use of the web-based system, and participants’ acceptability, usability, and opinion. The primary outcome was measured using the Pemberton Happiness Index. Secondary outcomes were measured using the Compassion Scale, Self-Compassion Scale, Forms of Self-Criticizing/Attacking and Self-Reassuring Scale-Short form, Five Facets of Mindfulness Questionnaire, Relationships Questionnaire, General Health Questionnaire, Non-Attachment Scale, International Positive and Negative Affect Schedule Short Form, Purpose-In-Life Test, and difficulties regarding the practice of compassion (Compassion Practice Quality Questionnaire). Mixed models will be used to evaluate primary and secondary outcome measures. A qualitative content analysis of the participants’ qualitative responses will also be performed. Results Enrollment started in February 2020 and will be finished in April 2020. Data analysis will start in October 2020. Conclusions To our knowledge, this study will, for the first time, show data on the feasibility, acceptability, and preliminary efficacy of web-based compassion (and self-compassion) training—that is, the adapted iABCT—in Spanish speakers from the general population. Further aspects of their implementation (ie, facilitators, barriers, and unwanted effects) and mechanisms of change will be investigated. This study will allow the revision and fine-tuning of the developed intervention, study design, and planning procedures, as well as the initiation of a future randomized controlled trial. Trial Registration Clinicaltrials.gov: NCT03918746. Registered on April 17, 2019. Protocol version 1, 6 March 2019. International Registered Report Identifier (IRRID) PRR1-10.2196/16717
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Affiliation(s)
- Daniel Campos
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón de la plana, Spain.,Instituto de Investigación Sanitaria Aragón (IISAragon), Zaragoza, Spain
| | - Mayte Navarro-Gil
- Instituto de Investigación Sanitaria Aragón (IISAragon), Zaragoza, Spain.,Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Paola Herrera-Mercadal
- Instituto de Investigación Sanitaria Aragón (IISAragon), Zaragoza, Spain.,Department of Psychology and Sociology, University of Zaragoza, Huesca, Spain
| | | | - Ausiàs Cebolla
- Department of Personality, Evaluation and Psychological Treatment, Universitat de València, Valencia, Spain.,CIBER of Physiopathology of Obesity and Nutrition CIBERobn, Madrid, Spain
| | - Luis Borao
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Yolanda López-Del-Hoyo
- Instituto de Investigación Sanitaria Aragón (IISAragon), Zaragoza, Spain.,Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | - Diana Castilla
- Department of Personality, Evaluation and Psychological Treatment, Universitat de València, Valencia, Spain.,CIBER of Physiopathology of Obesity and Nutrition CIBERobn, Madrid, Spain
| | - Eva Del Río
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón de la plana, Spain
| | - Javier García-Campayo
- Instituto de Investigación Sanitaria Aragón (IISAragon), Zaragoza, Spain.,Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain.,Department of Psychiatry, Miguel Servet Hospital, Zaragoza, Spain
| | - Soledad Quero
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón de la plana, Spain.,CIBER of Physiopathology of Obesity and Nutrition CIBERobn, Madrid, Spain
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11
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González-Robles A, Díaz-García A, García-Palacios A, Roca P, Ramos-Quiroga JA, Botella C. Effectiveness of a Transdiagnostic Guided Internet-Delivered Protocol for Emotional Disorders Versus Treatment as Usual in Specialized Care: Randomized Controlled Trial. J Med Internet Res 2020; 22:e18220. [PMID: 32673226 PMCID: PMC7381075 DOI: 10.2196/18220] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/08/2020] [Accepted: 04/08/2020] [Indexed: 12/20/2022] Open
Abstract
Background Anxiety disorders and depression (emotional disorders) are highly prevalent mental disorders. Extensive empirical evidence supports the efficacy of cognitive behavioral therapy (CBT) for the treatment of these disorders. However, there are still some barriers related to their dissemination and implementation, which make it difficult for patients to receive these treatments, especially in public health care settings where resources are limited. Recent advances in improving CBT dissemination encompass different perspectives. One is the transdiagnostic approach, which offers treatment protocols that can be used for a range of emotional disorders. Another approach is the use of the internet to reach a larger number of people who could benefit from CBT. Objective This study aimed to analyze the effectiveness and acceptability of a transdiagnostic internet-delivered protocol (EmotionRegulation) with human and automated guidance in patients from public specialized mental health care settings. Methods A 2-armed randomized controlled trial (RCT) was conducted to compare the effectiveness of EmotionRegulation with treatment as usual (TAU) in specialized mental health care. In all, 214 participants were randomly assigned to receive either EmotionRegulation (n=106) or TAU (n=108). Measurement assessments were conducted at pre- and postintervention and at a 3-month follow-up. Results The results revealed the superiority of EmotionRegulation over TAU on measures of depression (d=0.41), anxiety (d=0.35), and health-related quality of life (d=−0.45) at posttreatment, and these gains were maintained at the 3-month follow-up. Furthermore, the results for expectations and opinions showed that EmotionRegulation was well accepted by participants. Conclusions EmotionRegulation was more effective than TAU for the treatment of emotional disorders in the Spanish public mental health system. The implications of this RCT, limitations, and suggestions for future research are discussed. Trial Registration ClinicalTrials.gov NCT02345668; https://clinicaltrials.gov/ct2/show/NCT02345668
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Affiliation(s)
- Alberto González-Robles
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
| | - Amanda Díaz-García
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, Madrid, Spain
| | - Pablo Roca
- Department of Personality, Assessment, and Clinical Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Botella
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, Madrid, Spain
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12
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Apolinário-Hagen J, Drüge M, Fritsche L. Cognitive Behavioral Therapy, Mindfulness-Based Cognitive Therapy and Acceptance Commitment Therapy for Anxiety Disorders: Integrating Traditional with Digital Treatment Approaches. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:291-329. [DOI: 10.1007/978-981-32-9705-0_17] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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13
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Miralles I, Granell C, García-Palacios A, Castilla D, González-Pérez A, Casteleyn S, Bretón-López J. Enhancing In Vivo Exposure in the Treatment of Panic Disorder and Agoraphobia Using Location-Based Technologies: A Case Study. Clin Case Stud 2019. [DOI: 10.1177/1534650119892900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Panic disorder (PD) is quite prevalent and often appears along with agoraphobia (PD/A). The treatment of choice is cognitive behavioral therapy (CBT). Transdiagnostic intervention, an emotion-focused, cognitive behavioral intervention that has led to the Unified Protocol (UP), emphasizes the common underlying mechanisms that contribute to the development and maintenance of emotional disorders such as PD/A. A core feature of this treatment approach is in vivo exposure (IVE) to feared situations, which aims to prevent avoidance behaviors and encourages the patient to confront feared situations gradually. It is a difficult component for patients, especially when implementing the exposure on their own. Different feedback formats can be used to increase adequate IVE and reduce overt or subtle avoidance. The use of smartphones is a very useful option to initiate and sustain exposure behavior. The purpose of this study is to describe the use of location-based technologies (LBTs) during the IVE component of the UP treatment of a 47-year-old patient with PD/A. The acceptability and usability of the system were assessed. The Symptoms platform was employed during the exposure module, using LBT with a smartphone app. The patient reported positive expectations, high satisfaction scores, and an overall satisfactory experience. Enhancing key therapeutic components during treatment through the development of media-based tools is a very promising future research aim, and the possibility of using advanced smartphone features should be explored.
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Affiliation(s)
| | | | | | - Diana Castilla
- Universitat de València, Spain
- Instituto Salud Carlos III, Santiago de Compostela, Spain
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14
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Simon N, McGillivray L, Roberts NP, Barawi K, Lewis CE, Bisson JI. Acceptability of internet-based cognitive behavioural therapy (i-CBT) for post-traumatic stress disorder (PTSD): a systematic review. Eur J Psychotraumatol 2019; 10:1646092. [PMID: 31497259 PMCID: PMC6719262 DOI: 10.1080/20008198.2019.1646092] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/26/2019] [Accepted: 07/03/2019] [Indexed: 11/28/2022] Open
Abstract
Background: Internet-delivered Cognitive Behavioural Therapy (i-CBT) offers potential as an alternative, accessible, clinically and cost-effective treatment for post-traumatic stress disorder (PTSD), but little is known about its acceptability. Objective: To review the available evidence to understand the acceptability of i-CBT for PTSD. Method: We undertook a mixed-methods systematic review according to Cochrane Collaboration Guidelines, of randomised controlled trials (RCTs) of i-CBT for adults with PTSD. We examined included studies for measures of acceptability, and possible proxy indicators of acceptability, including dropout rates, which were meta-analysed as risk ratios (RRs). Results: Ten studies with 720 participants were included. We found i-CBT to be acceptable according to specific acceptability measures, and suggestions for acceptability according to some proxy measures of i-CBT programme usage. There was, however, evidence of greater dropout from i-CBT than waitlist (RR 1.39, CI 1.03-1.88; 8 studies; participants = 585) and no evidence of a difference in dropout between i-CBT and i-non-CBT (RR 2.14, CI 0.97-4.73; participants = 132; 2 studies). Conclusion: i-CBT appears a potentially acceptable intervention for adults with PTSD. We identified clinical and research questions, including the status of proxy indicators, and call for standardised, consistent treatment acceptability measurement.
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Affiliation(s)
- Natalie Simon
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Leah McGillivray
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Neil P. Roberts
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
- Psychology and Psychological Therapies Directorate, Cardiff and Vale University Health Board, Cardiff, UK
| | - Kali Barawi
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Catrin E. Lewis
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Jonathan I. Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
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