| 1. |
- Boettcher, Johanna, et al.
(författare)
-
Side effects in Internet-based interventions for social anxiety disorder
- 2014
-
Ingår i: Internet Interventions. - : Elsevier BV. - 2214-7829. ; 1:1, s. 3-11
-
Tidskriftsartikel (refereegranskat)abstract
- Internet-based interventions are effective in the treatment of various mental disorders and have already been integrated in routine health care in some countries. Empirical data on potential negative effects of these interventions is lacking. This study investigated side effects in an Internet-based treatment for Social Anxiety Disorder (SAD).A total of 133 individuals diagnosed with SAD took part in an 11-week guided treatment. Side effects were assessed as open formatted questions after week 2 and at post-treatment after week 11. Answers were independently rated by two coders. In addition, rates of deterioration and non-response were calculated for primary social anxiety and secondary outcome measures (depression and quality of life).In total, 19 participants (14%) described unwanted negative events that they related to treatment. The emergence of new symptoms was the most commonly experienced side effect, followed by the deterioration of social anxiety symptoms and negative well-being. The large majority of the described side effects had a temporary but no enduring negative effect on participants' well-being. At post-treatment, none of the participants reported deterioration on social anxiety measures and 0–7% deteriorated on secondary outcome measures. Non-response was frequent with 32–50% for social anxiety measures and 57–90% for secondary outcomes at post-assessment.Results suggest that a small proportion of participants in Internet-based interventions experiences negative effects during treatment. Information about potential side effects should be integrated in patient education in the practice of Internet-based treatments.
|
|
| 2. |
- Bystedt, Samuel, et al.
(författare)
-
Clinicians' perspectives on negative effects of psychological treatments
- 2014
-
Ingår i: Cognitive Behaviour Therapy. - : Informa UK Limited. - 1650-6073 .- 1651-2316. ; 43:4, s. 319-331
-
Tidskriftsartikel (refereegranskat)abstract
- Negative effects of psychological treatments is a fairly unexplored area of clinical research. Previous investigations have indicated that a portion of all patients experience negative effects in terms of deterioration and various adverse events. Meanwhile, evidence suggests that many clinicians are untrained in identifying negative effects and unaware of the current research findings. The objective of the current study is thus to investigate clinicians' own perspectives and experiences of possible negative effects of psychological treatments. An invitation to participate in an anonymous online survey consisting of 14 open-ended questions was distributed via three mailing lists used by clinicians that primarily identify themselves as cognitive behavior therapists. The responses were analyzed using a qualitative method based on thematic analysis. In total, 74 participants completed the survey. A majority agreed that negative effects of psychological treatments exist and pose a problem, and many reported having experienced both deterioration and adverse events among patients in their own practice. The thematic analysis resulted in three core themes: characteristics of negative effects, causal factors, as well as methods and criteria for evaluating negative effects. The clinicians recognize that negative effects exist, but many are unaware of the current research findings and are unfamiliar with methods and criteria for identifying and preventing deterioration and adverse events. The results provide evidence for further dissemination of the present knowledge regarding negative effects, particularly during basic clinical training, as well as the need for raising awareness of the available methods for identifying and preventing negative effects.
|
|
| 3. |
- Carlbring, Per, et al.
(författare)
-
Consensus statement on defining and measuring negative effects of Internet interventions
- 2014
-
Konferensbidrag (refereegranskat)abstract
- Background: Internet interventions have great potential for alleviating emotional distress, promoting mental health, and enhancing well-being. Numerous clinical trials have demonstrated their effectiveness for a number of psychiatric conditions, and interventions delivered via the Internet will likely become a common alternative to face-to-face treatment. Meanwhile, research has paid little attention to the negative effects associated with treatment, warranting further investigation of the possibility that some patients might deteriorate or encounter adverse events despite receiving best available care. Evidence from research of face-to-face treatment suggests that negative effects afflict 5-10% of all patients undergoing treatment in terms of deterioration.Objective: There is currently a lack of consensus on how to define and measure negative effects in psychotherapy research in general, leaving researchers without practical guidelines for monitoring and reporting negative effects in clinical trials. The current study therefore sought out to provide recommendations that could promote the study of negative effects in Internet interventions with the aim of increasing the knowledge of its occurrence and characteristics.Methods: Ten experts in the field of Internet interventions were invited to participate and share their perspective on how to explore negative effects, using the Delphi technique to facilitate a dialogue and reach an agreement. The authors discuss the importance of conducting research on negative effects in order to further the understanding of its incidence and different features.Results: Suggestions on how to classify and measure negative effects in Internet interventions are proposed, involving methods from both quantitative and qualitative research. Potential mechanisms underlying negative effects are also discussed, differentiating common factors shared with face-to-face treatments from those unique to treatments delivered via the Internet.Conclusions: We conclude that negative effects are to be expected and need to be acknowledged to a greater extent, advising researchers to systematically probe for negative effects whenever conducting clinical trials involving Internet interventions, as well as to share their findings in scientific journals.
|
|
| 4. |
- Carlbring, Per, et al.
(författare)
-
Practicing clinicians' understanding and experiences of negative effects in psychotherapy
- 2014
-
Konferensbidrag (refereegranskat)abstract
- Introduction: Research of psychotherapy has primarily focused on examining its efficacy and effectiveness for different psychiatric disorders. Hence, little is known about its potential for generating negative effects among patients undergoing treatment, even though some evidence suggest that 5-10% of all patients experience negative effects in terms of deterioration alone. Meanwhile, other types of adverse events might exist as well, e.g., social stigma, lower self-esteem, and less self-reliance. However, the knowledge of negative effects is currently scarce, and research has found that many practicing clinicians do not acknowledge that some patients might fare worse during treatment. Investigating practicing clinicians’ understanding and experiences of negative effects is therefore important in order to raise awareness of its occurrence and characteristics.Method: Participants were recruited through the Swedish Society for Behavior Therapy, the Section for Cognitive Behavior Therapy within the Swedish Psychological Association, and students attending the psychotherapist program at Stockholm University. Seventy four participants completed an online survey regarding negative effects of psychotherapy. The responses were analyzed using thematic analysis.Results: A majority of the participants believed that negative effects of psychotherapy exist, and some had personal experiences of patients encountering adverse events during treatment. Few received information about negative effects during their basic training in psychotherapy. Common negative effects were described as discomfort, lack of treatment effect, deterioration, dependency, and invasiveness. Possible causal factors were incompetence or inadequately applied methods, harmful treatment interventions, insufficient working alliance, among others. Only one participant was able to mention methods for monitoring negative effects during treatment.Conclusion: Practicing clinicians recognize that negative effects could pose a problem, but few were informed of its existence during their basic training in psychotherapy or know who to monitor it during treatment, warranting an increased awareness of negative effects among future clinicians.
|
|
| 5. |
- Carlbring, Per, et al.
(författare)
-
Side effects in Internet-based interventions for social anxiety disorder
- 2014
-
Konferensbidrag (refereegranskat)abstract
- Background: Internet-based interventions are effective in the treatment of various mental disorders and have already been integrated in routine health care in some countries. Empirical data on potential negative effects of these interventions is lacking.Objective: This study investigated side effects in an Internet-based treatment for Social Anxiety Disorder (SAD).Methods: A total of 133 individuals diagnosed with SAD took part in an 11-week guided treatment. Side effects were assessed as open formatted questions after week 2 and at post-treatment after week 11. Answers were independently rated by two coders. In addition, rates of deterioration and non-response were calculated for primary social anxiety and secondary outcome measures (depression and quality of life).Results: In total, 19 participants (14%) described unwanted negative events that they related to treatment. The emergence of new symptoms was the most commonly experienced side effect, followed by the deterioration of social anxiety symptoms and negative well-being. The large majority of the described side effects had a temporary but no enduring negative effect on participants’ well-being. At post-treatment, none of the participants reported deterioration on social anxiety measures and 0-7% deteriorated on secondary outcome measures. Non-response was frequent with 32-50% for social anxiety measures and 57-90% for secondary outcomes at post-assessment.Conclusions: Results suggest that a small proportion of participants in Internet-based interventions experiences negative effects during treatment. Information about potential side effects should be integrated in patient education in the practice of Internet-based treatments.
|
|
| 6. |
- Rozental, Alexander, et al.
(författare)
-
Consensus statement on defining and measuring negative effects of Internet interventions
- 2014
-
Ingår i: Internet Interventions. - : Elsevier BV. - 2214-7829. ; 1:1, s. 12-19
-
Tidskriftsartikel (refereegranskat)abstract
- Internet interventions have great potential for alleviating emotional distress, promoting mental health, and enhancing well-being. Numerous clinical trials have demonstrated their efficacy for a number of psychiatric conditions, and interventions delivered via the Internet will likely become a common alternative to face-to-face treatment. Meanwhile, research has paid little attention to the negative effects associated with treatment, warranting further investigation of the possibility that some patients might deteriorate or encounter adverse events despite receiving best available care. Evidence from research of face-to-face treatment suggests that negative effects afflict 5–10% of all patients undergoing treatment in terms of deterioration. However, there is currently a lack of consensus on how to define and measure negative effects in psychotherapy research in general, leaving researchers without practical guidelines for monitoring and reporting negative effects in clinical trials. The current paper therefore seeks to provide recommendations that could promote the study of negative effects in Internet interventions with the aim of increasing the knowledge of its occurrence and characteristics. Ten leading experts in the field of Internet interventions were invited to participate and share their perspective on how to explore negative effects, using the Delphi technique to facilitate a dialog and reach an agreement. The authors discuss the importance of conducting research on negative effects in order to further the understanding of its incidence and different features. Suggestions on how to classify and measure negative effects in Internet interventions are proposed, involving methods from both quantitative and qualitative research. Potential mechanisms underlying negative effects are also discussed, differentiating common factors shared with face-to-face treatments from those unique to treatments delivered via the Internet. The authors conclude that negative effects are to be expected and need to be acknowledged to a greater extent, advising researchers to systematically probe for negative effects whenever conducting clinical trials involving Internet interventions, as well as to share their findings in scientific journals.
|
|
| 7. |
- Rozental, Alexander, et al.
(författare)
-
Consensus statement on defining and measuring negative effects of Internet interventions
- 2014
-
Ingår i: Oral Abstracts from the 7th Scientific Meeting of the International Society for Research on Internet Interventions. ; , s. 39-39
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: Internet interventions provide a potential for promoting mental health and alleviating emotional distress. A large number of clinical trials have demonstrated their efficacy for several psychiatric conditions, and Internet interventions will likely become a common and valuable alternative within the regular health care. In the meantime, research has paid little attention to the possibility that some treatments might be associated with different types of negative effects. Evidence from face-to-face treatments suggests that 5-10% of all patients deteriorate despite receiving best available care. In addition, other forms of negative effects may exist as well, e.g., social stigmatization, interpersonal difficulties, and decreased self-esteem. However, a lack of agreement on how to define and measure negative effects has left researchers without practical guidelines for monitoring and reporting deterioration and adverse events in clinical trials, warranting a consensus for conducting research on negative effects.Method: The objective of the current paper is to provide recommendations that could promote the study of negative effects in Internet interventions. Ten leading experts in the field of Internet interventions were invited to participate and share their perspective on how to explore negative effects, using the Delphi technique to facilitate a dialogue and reach an agreement.Results: The importance of conducting further research on negative effects is discussed, and suggestions on how to classify and measure negative effects are provided, involving methods from quantitative and qualitative research. Potential mechanisms underlying negative effects are also presented, differentiating factors shared with face-to-face treatments from those unique to treatments delivered via the Internet.Conclusion: Negative effects should be expected and need to be recognized to a greater extent, and researchers are advised to systematically probe for negative effects whenever conducting clinical trials involving Internet interventions, as well as to share their findings in scientific journals.
|
|
| 8. |
- Rozental, Alexander, et al.
(författare)
-
Consensus statement on defining and measuring negative effects of Internet interventions
- 2014
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Internet interventions have a great potential for alleviating emotional distress and promoting mental health. A number of clinical trials have demonstrated their efficacy for several psychiatric conditions, and Internet interventions will likely become a common alternative to face-to-face treatments. Meanwhile, research has paid little attention to the potential negative effects associated with treatment, warranting further investigation of the possibility that some patients might deteriorate or experience adverse events. Evidence from face-to-face treatments suggests that negative effects afflict 5-10% of all patients undergoing treatment in terms of deterioration alone. However, there is currently a lack of consensus on how to define and measure negative effects in psychotherapy research in general, leaving researchers without practical guidelines for monitoring and reporting negative effects in clinical trials.Method: The current paper seeks to provide recommendations that could promote the study of negative effects in Internet interventions with the aim of increasing the knowledge of its occurrence and characteristics. Ten leading experts in the field of Internet interventions were invited to participate and share their perspective on how to explore negative effects, using the Delphi technique to facilitate a dialogue and reach an agreement.Results: The importance of conducting further research on negative effects is emphasized, and suggestions on how to classify and measure negative effects in Internet interventions are provided, involving methods from both quantitative and qualitative research. Potential mechanisms underlying negative effects are also presented, differentiating common factors shared with face-to-face treatments from those unique to treatments delivered via the Internet.Conclusion: Negative effects are to be expected and need to be acknowledged to a greater extent, advising researchers to systematically probe for negative effects whenever conducting clinical trials involving Internet interventions, as well as to share their findings in scientific journals.
|
|
| 9. |
|
|
| 10. |
- Rozental, Alexander, et al.
(författare)
-
Group versus Internet-based cognitive-behavioral therapy for procrastination : Study protocol for a randomized controlled trial.
- 2014
-
Ingår i: Internet Interventions. - : Elsevier BV. - 2214-7829. ; 1:2, s. 84-89
-
Tidskriftsartikel (refereegranskat)abstract
- Procrastination is defined as a voluntarily delay of an intended course of action despite expecting to be worse-off for the delay, and is considered a persistent behavior pattern that can result in major psychological suffering. About one-fifth of the adult population and half of the student population are presumed having substantial difficulties due to recurrent procrastination in their everyday lives. However, chronic and severe procrastinators seldom receive adequate care due to preconceptions and the lack of understanding regarding procrastination and the treatment interventions that are assumed beneficial. Cognitive-behavioral therapy is often deemed a treatment of choice, although the evidence supporting its use is scarce, and only one randomized controlled trial has been performed. The primary aim of the proposed study is therefore to test the efficacy of cognitive-behavioral therapy delivered as either a group intervention or via the Internet. Participants will consist of students recruited through the Student Health Centre at Karolinska Institutet. A randomized controlled trial with a sample size of 100 participants divided into blocks of thirty will be used, comparing an eight-week Internet-based cognitive-behavioral therapy intervention, and an eight-week group cognitive-behavioral therapy based intervention. It is believed that the proposed study will result in two important findings. First, different treatment interventions in cognitive-behavioral therapy are assumed to be helpful for people suffering from problems caused by procrastination. Second, both an Internet-based cognitive-behavioral therapy intervention and a group intervention are presumed suitable for administering treatment for procrastination, which is considered important as the availability of adequate care is limited, particularly among students. The proposed study will increase the knowledge regarding the efficacy of different treatments of procrastination, as well as enhance the overall comprehension of the difficulties related to dilatory behavior.
|
|
