| 1. |
- Andersson, Gerhard, et al.
(författare)
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Long-term effects of internet-supported cognitive behaviour therapy
- 2018
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Ingår i: Expert Review of Neurotherapeutics. - : Informa UK Limited. - 1473-7175 .- 1744-8360. ; 18:1, s. 21-28
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Forskningsöversikt (refereegranskat)abstract
- Introduction: Internet-supported and therapist-guided cognitive behaviour therapy (ICBT) is effective for a range of problems in the short run, but less is known about the long-term effects with follow-ups of two years or longer.Areas covered: This paper reviews studies in which the long-term effects of guided ICBT were investigated. Following literature searches in PubMed and other sources meta-analytic statistics were calculated for 14 studies involving a total of 902 participants, and an average follow-up period of three years. Studies were from Sweden (n = 11) or the Netherlands (n = 3). Long-term outcome studies were found for panic disorder, social anxiety disorder, generalized anxiety disorder, depression, mixed anxiety and depression, obsessive-compulsive disorder, pathological gambling, stress and chronic fatigue. The duration of the treatments was usually short (8–15 weeks). The pre-to follow-up effect size was Hedge’s g = 1.52, but with a significant heterogeneity. The average symptom improvement across studies was 50%. Treatment seeking in the follow-up period was not documented and few studies mentioned negative effects.Expert commentary: While effects may be overestimated, it is likely that therapist-supported ICBT can have enduring effects. Long-term follow-up data should be collected for more conditions and new technologies like smartphone-delivered treatments.
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| 2. |
- Carlbring, Per, et al.
(författare)
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Internet-Based vs. Face-to-Face CBT : Systematic Review and Meta-Analysis
- 2018
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Konferensbidrag (refereegranskat)abstract
- During the last two decades, Internet-delivered cognitive behavior therapy (ICBT) has been tested in hundreds of randomized controlled trials, often with promising results. However, the control groups were often waitlist, care-as-usual or attention control. Hence, little is known about the relative efficacy of ICBT as compared to face-to-face cognitive behavior therapy (CBT). In addition, the long-term effects of ICBT is largely unknown.In this presentation a systematic review and meta-analysis, which included 1418 participants, will be presented. Out of the 2078 articles screened, a total of 20 studies met all inclusion criteria. These included studies on social anxiety disorder, panic disorder, depression, body dissatisfaction etc. Results showed a pooled effect size at post-treatment of Hedges g = 0.05 (95% CI, -0.09 to 0.20), indicating that ICBT and face-to-face treatment produced equivalent overall effects.We also reviewed studies in which the long-term effects of guided ICBT were investigated. Following a new set of literature searches in PubMed and other sources meta-analytic statistics were calculated for 14 studies involving a total of 902 participants, and an average follow-up period of three years. The duration of the actual treatments was usually short (8-15 weeks). The pre-to follow-up (>2 yrs) effect size was Hedge’s g = 1.52, but with a significant heterogeneity. The average symptom improvement across studies was 50%.While the overall results indicate equivalence, there have been few studies of the individual psychiatric and somatic conditions so far, and for the majority, guided ICBT has not been compared against face-to-face treatment. Thus, more research, preferably with larger sample sizes, is needed to establish the general equivalence of the two treatment formats. While effects may be overestimated, it is likely that therapist-supported ICBT can have enduring effects.
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| 3. |
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| 4. |
- Rozental, Alexander, et al.
(författare)
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Guided web-based cognitive behavior therapy for perfectionism : Results from two different randomized controlled trials
- 2018
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 20:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Perfectionism can become a debilitating condition that may negatively affect functioning in multiple areas, including mental health. Prior research has indicated that internet-based cognitive behavioral therapy can be beneficial, but few studies have included follow-up data.Objective: The objective of this study was to explore the outcomes at follow-up of internet-based cognitive behavioral therapy with guided self-help, delivered as 2 separate randomized controlled trials conducted in Sweden and the United Kingdom.Methods: In total, 120 participants randomly assigned to internet-based cognitive behavioral therapy were included in both intention-to-treat and completer analyses: 78 in the Swedish trial and 62 in the UK trial. The primary outcome measure was the Frost Multidimensional Perfectionism Scale, Concern over Mistakes subscale (FMPS CM). Secondary outcome measures varied between the trials and consisted of the Clinical Perfectionism Questionnaire (CPQ; both trials), the 9-item Patient Health Questionnaire (PHQ-9; Swedish trial), the 7-item Generalized Anxiety Disorder scale (GAD-7; Swedish trial), and the 21-item Depression Anxiety Stress Scale (DASS-21; UK trial). Follow-up occurred after 6 months for the UK trial and after 12 months for the Swedish trial.Results: Analysis of covariance revealed a significant difference between pretreatment and follow-up in both studies. Intention-to-treat within-group Cohen d effect sizes were 1.21 (Swedish trial; 95% CI 0.86-1.54) and 1.24 (UK trial; 95% CI 0.85-1.62) for the FMPS CM. Furthermore, 29 (59%; Swedish trial) and 15 (43%; UK trial) of the participants met the criteria for recovery on the FMPS CM. Improvements were also significant for the CPQ, with effect sizes of 1.32 (Swedish trial; 95% CI 0.97-1.66) and 1.49 (UK trial; 95% CI 1.09-1.88); the PHQ-9, effect size 0.60 (95% CI 0.28-0.92); the GAD-7, effect size 0.67 (95% CI 0.34-0.99); and the DASS-21, effect size 0.50 (95% CI 0.13-0.85).Conclusions: The results are promising for the use of internet-based cognitive behavioral therapy as a way of targeting perfectionism, but the findings need to be replicated and include a comparison condition.
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| 5. |
- Rozental, Alexander, et al.
(författare)
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Negative effects in psychotherapy : commentary and recommendations for future research and clinical practice
- 2018
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Ingår i: BJPsych Open. - : Royal College of Psychiatrists. - 2056-4724. ; 4:4, s. 307-312
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Tidskriftsartikel (refereegranskat)abstract
- Background: Psychotherapy can alleviate mental distress and improve quality of life, but little is known about its potential negative effects and how to determine their frequency.Aims: To present a commentary on the current understanding and future research directions of negative effects in psychotherapy.Method: An anonymous survey was distributed to a select group of researchers, using an analytical framework known as strengths, weaknesses, opportunities and threats.Results: The researchers perceive an increased awareness of negative effects in psychotherapy in recent years, but also discuss some of the unresolved issues in relation to their definition, assessment and reporting. Qualitative methods and naturalistic designs are regarded as important to pursue, although a number of obstacles to using such methods are identified.Conclusion: Negative effects of psychotherapy are multifaceted, warranting careful considerations in order for them to be monitored and reported in research settings and routine care.
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| 6. |
- Rozental, Alexander, et al.
(författare)
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Targeting Procrastination Using Psychological Treatments : A Systematic Review and Meta-Analysis
- 2018
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Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 9
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Forskningsöversikt (refereegranskat)abstract
- Background: Procrastination can be stressful and frustrating, but it seldom causes any major distress. However, for some people, it can become problematic, resulting in anxiety, lowered mood, physical complaints, and decreased well-being. Still, few studies have investigated the benefits of targeting procrastination. In addition, no attempt has previously been made to determine the overall efficacy of providing psychological treatments.Methods: A systematic review and meta-analysis was conducted by searching for eligible records in Scopus, Proquest, and Google Scholar. Only randomized controlled trials comparing psychological treatments for procrastination to an inactive comparator and assessing the outcomes by a self-report measure were included. A random effects model was used to determine the standardized mean difference Hedge's g at post-treatment. Furthermore, test for heterogeneity was performed, fail-safe N was calculated, and the risk of bias was explored. The study was pre-registered at Prospero: CRD42017069981.Results: A total of 1,639 records were identified, with 12 studies (21 comparisons, N = 718) being included in the quantitative synthesis. Overall effect size g when comparing treatment to control was 0.34, 95% Confidence Interval [0.11, 0.56], but revealing significant heterogeneity, Q(20) = 46.99, p < 0.00, and I2 = 61.14%, 95% CI [32.83, 84.24]. Conducting a subgroup analysis of three out of four studies using cognitive behavior therapy (CBT) found an effect size g of 0.55, 95% CI [0.32, 0.77], and no longer showing any heterogeneity, Q(4) = 3.92, p = 0.42, I2 = 0.00%, 95% CI [0.00, 91.02] (N = 236). Risk of publication bias, as assessed by the Egger's test was not significant, z = −1.05, p = 0.30, fail-safe N was 370 studies, and there was some risk of bias as rated by two independent researchers. In terms of secondary outcomes, the self-report measures were too varied to present an aggregated estimate.Conclusions: Psychological treatments seem to have small benefits on procrastination, but the studies isplayed significant between-study variation. Meanwhile, CBT was associated with a moderate benefit, but consisted of only three studies. Recommendations for future research are provided, including the use of more valid and reliable outcomes and a screening interview at intake.
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