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Hadjistavropoulos HD, Hill TG, Philipp-Muller AE, Dear B, Titov N. Perceptions of client stories in internet-delivered cognitive behaviour therapy: A mixed-methods evaluation. Internet Interv 2023; 34:100692. [PMID: 38099092 PMCID: PMC10719527 DOI: 10.1016/j.invent.2023.100692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 12/17/2023] Open
Abstract
Internet-delivered Cognitive-Behavioural Therapy (ICBT) aims to support people with mental health concerns using online treatment materials. Client stories (either real or a composite based on many clients) are often used in ICBT to facilitate learning. However, these stories remain understudied in terms of how they are perceived by clients, as well as their relationship to ICBT engagement, satisfaction, and outcomes. Among a sample of 324 clients enrolled in transdiagnostic ICBT targeting symptoms of depression and anxiety, we examined client perceptions of stories through mixed-method qualitative (open-ended) and quantitative (closed-ended) data collection. Specifically, 234 (72.22 %) clients responded to questions about stories at 4 weeks and 221 (68.21 %) responded to questions at 8 weeks. Most clients who responded to questions endorsed reviewing at least some stories (79.06 % at 4 weeks, 71.95 % at 8 weeks). Moreover, they rated stories positively in terms of being relatable, making clients feel less alone, increasing knowledge, providing ideas for how to use skills, and motivating clients to use skills. These perceptions of stories remained stable over the course of treatment. Stories were perceived more positively among those with lower symptom severity at 8 weeks as well as those who were more satisfied with ICBT at 8 weeks. Story perceptions at 4 weeks were predictive of decreased post-treatment anxiety symptom severity but not depression while controlling for baseline scores, age, and education. 26.49 % of clients at 4 weeks who reviewed stories and 33.33 % at 8 weeks provided suggestions about how to improve stories. In a qualitative analysis, we found 5 categories of suggestions including increasing the variety of issues and relatability of stories, ensuring the stories are realistic, refining the formatting, and making the stories shorter. Overall, this study provides insights into how client stories could be improved to play a more significant role in future ICBT programs.
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Affiliation(s)
- Heather D. Hadjistavropoulos
- Department of Psychology, University of Regina, Regina, Canada
- Online Therapy Unit, University of Regina, Regina, Canada
| | - Taylor G. Hill
- Department of Psychology, University of Regina, Regina, Canada
- Department of Psychology and Neuroscience, Dalhousie University, Canada
- Healthy Populations Institute, Dalhousie University, Canada
- Online Therapy Unit, University of Regina, Regina, Canada
| | - Aaron E. Philipp-Muller
- Department of Psychology, University of Regina, Regina, Canada
- Online Therapy Unit, University of Regina, Regina, Canada
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de Grosbois J, Canthiya L, Philipp-Muller AE, Hickey NK, Hodzic-Santor B, Heleno MC, Jokel R, Meltzer JA. Asynchronous, online spaced-repetition training alleviates word-finding difficulties in aphasia. Neuropsychol Rehabil 2023; 33:1672-1696. [PMID: 36378584 DOI: 10.1080/09602011.2022.2143822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 10/28/2022] [Indexed: 11/17/2022]
Abstract
Word-finding difficulties for naming everyday objects are often prevalent in aphasia. Traditionally, treating these difficulties has involved repeated drilling of troublesome items with a therapist. Spaced repetition schedules can improve the efficiency of such training. However, spaced repetition in a therapy environment can be both difficult to implement and time-consuming. The current study evaluated the potential utility of automated, asynchronous, online spaced repetition training for the treatment of word-finding difficulties in individuals with aphasia. Twenty-one participants completed a two-week training study, completing approximately 60 minutes per day of asynchronous online drilling. The training items were identified using a pretest, and word-finding difficulties were evaluated both at the end of training (i.e., a post-test) and four weeks later (i.e., a retention test). The trained items were separated into three different spaced-repetition schedules: (1) Short-spacing; (2) Long-spacing; and (3) Adaptive-spacing. At the retention-test, all trained items outperformed non-trained items in terms of accuracy and reaction time. Further, preliminary evidence suggested a potential reaction time advantage for the adaptive-spacing condition. Overall, online, asynchronous spaced repetition training appears to be effective in treating word-finding difficulties in aphasia. Further research will be required to determine if different spaced repetition schedules can be leveraged to enhance this effect.
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Affiliation(s)
- John de Grosbois
- Baycrest Health Sciences, Rotman Research Institute, Toronto, Canada
| | - Lathushikka Canthiya
- Baycrest Health Sciences, Rotman Research Institute, Toronto, Canada
- University of Toronto, Toronto, Canada
| | - Aaron E Philipp-Muller
- Baycrest Health Sciences, Rotman Research Institute, Toronto, Canada
- University of Toronto, Toronto, Canada
| | - Natasha K Hickey
- Baycrest Health Sciences, Rotman Research Institute, Toronto, Canada
| | | | - Madeline C Heleno
- Baycrest Health Sciences, Rotman Research Institute, Toronto, Canada
| | - Regina Jokel
- Baycrest Health Sciences, Rotman Research Institute, Toronto, Canada
| | - Jed A Meltzer
- Baycrest Health Sciences, Rotman Research Institute, Toronto, Canada
- University of Toronto, Toronto, Canada
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Philipp-Muller AE, Stephenson CJ, Moghimi E, Shirazi AH, Milev R, Vazquez G, Reshetukha T, Alavi N. Combining Ketamine and Psychotherapy for the Treatment of Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis. J Clin Psychiatry 2023; 84. [PMID: 36752752 DOI: 10.4088/jcp.22br14564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Aaron E Philipp-Muller
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada.,Corresponding author: Aaron E. Philipp-Muller, BScH, Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada, Hotel Dieu Hospital - 166 Brock St, Kingston, Ontario, Canada K7L 5G2
| | - Callum J Stephenson
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Elnaz Moghimi
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Amir H Shirazi
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Roumen Milev
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada.,Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Gustavo Vazquez
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada.,Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Taras Reshetukha
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada.,Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Nazanin Alavi
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada.,Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
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