| 1. |
- Jacobsson, Christian, et al.
(författare)
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The Effect of Teambuilding on Team Development: A Quasi-Experiment within a Swedish State Authority
- 2017
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Ingår i: Clinical and Experimental Psychology. - : OMICS Publishing Group. - 2471-2701. ; 3:3, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- The effect of teambuilding on team development was studied with a quasi-experimental design by evaluating consultants’ teambuilding interventions in 20 experimental groups within a Swedish state authority. These were compared to 22 control groups that did not receive an intervention. Team development was assessed through pre- and post-test with the “Group Development Questionnaire” (GDQ). Results indicated that experimental groupshad significant higher values on scale IV in the GDQ in the post-test compared to control groups. There were no significant differences between experimental and control groups on GDQ scale I-III across time. The results indicate that teambuilding contributes to team development and encourages to further research with regard to “real life” work groups.
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| 2. |
- Larsson, Anna, et al.
(författare)
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IMPACT (Internet-Mediated Psychological treatment - Acceptance and Commitment Therapy) in youths: The role of parental support
- 2022
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Ingår i: SWESRII, 2022.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Internet-delivered cognitive behavioral therapy (iCBT) for youths has not yet been established as an evidence-based method in primary care. Thus, the research project IMPACT (Internet-Mediated Psychological treatment - Acceptance and Commitment Therapy) aims to investigate iCBT for youths between 13-18 years old in primary care compared to treatment as usual (TAU). Method: IMPACT consists of 3 studies: Study 1 is a qualitative thematic analysis of the attitudes and experiences. Study 2 is a mixed-method design investigating the experiences and perceived effects of iCBT and study 3 is a quantitative 1-year follow-up of treatment results of iCBT and TAU. Results: In study 1, the therapists reported positive experiences of using iCBT for youths and considered it a valuable alternative to face-to-face treatment and an appreciated variation in their schedules. Nevertheless, the therapists also reported challenges in selecting, motivating and interacting with the patients and suggested that parental support can increase compliance and improve treatment results. In study 2, the quantitative analysis indicated that iCBT was successful in symptom reduction and underlined that the motivation of the youths was crucial for the treatment outcome. The youths valued independence and freedom in managing the treatment on their own terms whereas the parents expressed uncertainty about their role and how to support their youths. This study further supports the importance of parental involvement in iCBT for youths in supporting and reminding during the course of treatment and collaborating with the therapist. Based on the results in study 1 and 2, a separate parental support programme was developed in the shape of a shorter iCBT programme for the parents to use in parallel with their youths doing iCBT treatment. In study 3, the youths with parental support had significantly higher compliance compared to both TAU and iCBT without parental support. Conclusion: Internet treatment in primary care is accepted by both therapists, youths and their parents in the research project. Furthermore, youth motivation was paramount for treatment outcome and parental support was identified as an important factor.
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| 3. |
- Lilja, Josefine, et al.
(författare)
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Psychometric properties and validation of the Swedish Five Facet Mindfulness Questionnaire in a clinical and non-clinical sample among meditators and non-meditators
- 2020
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Ingår i: Scandinavian Journal of Psychology. - : WILEY. - 0036-5564 .- 1467-9450. ; 61:3, s. 369-379
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Tidskriftsartikel (refereegranskat)abstract
- Over a period of 15 years several attempts to conceptualize mindfulness have been presented and revised, but there is still no clear or agreed-upon definition. The use of mindfulness-based interventions has increased in clinical and research settings the last couple of years, including in Sweden. As a clinician it is crucial to know if a treatment works through the theoretically postulated mechanisms of change. Mindfulness is a concept that is difficult to measure. The overall aim of the current project was to examine the psychometric properties of the Swedish version of the Five Facet Mindfulness Questionnaire (FFMQ_SWE) using three different studies. To test the construct validity of the FFMQ_SWE a hierarchal confirmatory factor analysis was performed in a meditating non-clinical sample, to examine if all the five facets would load on an overall mindfulness construct. Psychometric properties of the instrument were examined in a non-clinical and a clinical sample, and discriminative relationships with other variables were analysed. The convergent validity was examined by analysing the correlations between FFMQ_SWE and Hospital Anxiety and Depression Scale, Sense of Coherence and Difficulties in Emotion Regulation Scale. Test-retest reliability was tested by distributing FFMQ_SWE at two occasions. The hierarchal confirmatory factor analysis showed good fit in a population of meditators. The FFMQ_SWE showed good convergent validity and test-retest reliability in both clinical and non-clinical populations. In sum, the Swedish version of the FFMQ showed good psychometric properties and can be a useful instrument as an evaluation of treatment effects in both health care settings and research settings.
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| 4. |
- Lilja, Josefine, et al.
(författare)
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Youths’ and Parents’ Experiences and Perceived Effects of Internet-Based Cognitive Behavioral Therapy for Anxiety Disorders in Primary Care: Mixed Methods Study
- 2021
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Ingår i: JMIR Pediatrics and Parenting. - : JMIR Publications Inc.. - 2561-6722. ; 4:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Anxiety is common among youths in primary care. Face-to-face treatment has been the first choice for clinicians, but during the COVID-19 pandemic, digital psychological interventions have substantially increased. Few studies have examined young people’s interest in internet treatment or the attitudes they and their parents have toward it. Objective: This study aims to investigate adolescents’ and parents’ attitudes toward and experiences of internet-based cognitive behavioral anxiety treatment in primary care and its presumptive effects. Methods: The study used mixed methods, analyzing qualitative data thematically and quantitative data with nonparametric analysis. Participants were 14 adolescents and 14 parents recruited in adolescent primary health care clinics. The adolescents and their parents filled out mental health questionnaires before and after treatment, and were interviewed during ongoing treatment. Results: The quantitative data indicated that the internet-delivered cognitive behavioral therapy program used in this study was successful in reducing symptoms (χ22=8.333; P=.02) and that adolescents’ motivation is essential to the treatment outcome (r=0.58; P=.03). The qualitative results show that youths highly value their independence and freedom to organize treatment work on their own terms. The parents expressed uncertainty about their role and how to support their child in treatment. It was important for parents to respect the youths’ need for autonomy while also engaging with them in the treatment work. Conclusions: Internet treatment in primary care is accepted by both youths and their parents, who need clarification about the difference between their role and the therapist’s role. Patient motivation should be considered before treatment, and therapists need to continue to develop the virtual alliance. Finally, primary care should be clearer in informing adolescents and their parents about the possibility of internet treatment.
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| 5. |
- Nissling, Linnea, 1991, et al.
(författare)
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Effectiveness of and processes related to internet-delivered acceptance and commitment therapy for adolescents with anxiety disorders : a randomized controlled trial
- 2023
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Ingår i: RESEARCH IN PSYCHOTHERAPY-PSYCHOPATHOLOGY PROCESS AND OUTCOME. - : PAGEPress Publications. - 2499-7552 .- 2239-8031. ; 26:2
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Tidskriftsartikel (refereegranskat)abstract
- Early access to evidence-based help is crucial for adolescents with anxiety disorders. Internet-delivered acceptance and commitment therapy (iACT) may offer adolescents increased access to care and more flexibility in engaging with treatment when and how they prefer. Process-based therapies, such as ACT, focus on the-oretically derived and empirically tested key mechanisms in treat-ment that enable change. This study aimed to investigate the effectiveness of iACT for adolescents with anxiety disorders. The study also assessed the relationship between psychological flexi-bility and treatment outcomes and the relationship between par-ticipating adolescents' and therapists' perceived alliance and treatment outcomes. This was a randomized controlled trial com-paring a 10-week intervention group with a wait-list control group. The 52 participants, aged 15 to 19, were recruited from all over Sweden. The treatment was effective in increasing quality of life and psychological flexibility, with moderate between-group effect sizes based on observed values. Changes in psychological flexibility was associated with changes in anxiety symptoms. The results further showed a statistically significant between-group difference in post-treatment diagnoses. No significant time per group interaction was found for anxiety symptoms, as both groups improved. Working alliance was rated as high by both participat-ing adolescents and therapists but showed no significant relation-ship with treatment outcomes. Participants found the treatment an acceptable intervention. This study shows promising results for iACT in treating adolescents with anxiety disorders. The results suggest the model of psychological flexibility as an important process of change in treatment outcomes. Future research should validate these findings in larger samples and clinical contexts.
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| 6. |
- Nissling, Linnea, 1991, et al.
(författare)
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Effects of patient-driven iCBT for anxiety in routine primary care and the relation between increased experience of empowerment and outcome : A randomized controlled trial
- 2021
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Ingår i: Internet Interventions. - : Elsevier. - 2214-7829. ; 26
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Tidskriftsartikel (refereegranskat)abstract
- Background: The World Health Organization has declared that primary care should be organized to empower individuals, families, and communities to optimize health. Internet cognitive behavioral therapy (iCBT) tailored by psychologists' initial assessments to meet patients' specific needs have shown promising effects. However, few studies have evaluated patient involvement in decisions during iCBT. Aim: This study aimed to explore the effect of patient-driven iCBT compared to standard iCBT on perceived control over treatment, adherence, and level of anxiety symptoms. A secondary aim was to assess the relationship between changes in empowerment and changes in anxiety symptoms. Method: Participants were patients recruited form primary care and assessed as meeting the criterion for an anxiety disorder. Participants were randomized to patient-driven iCBT (n = 27) or standard iCBT (n = 28). Patient-driven iCBT was adapted to participants' preferences regarding for example focus of treatment program and order of modules. Participants randomized to the control condition received the standard iCBT program for anxiety disorders at the participating unit. The outcome measures were patients' perceived control over treatment, adherence to treatment, symptoms of anxiety, depression and general disability as well as the experience of empowerment. Results: Participants in patient-driven iCBT had statistically higher perceived control over treatment (t(43) = 2.13, p = .04). Symptoms were significantly reduced in both arms with regards to anxiety, depression, and general disability. A significant time per condition interaction effect for anxiety symptoms was observed (df = 45.0; F = 3.055; p = .038), where the patient-driven condition had a significantly larger reduction in anxiety. For both groups a significant correlation of r = 0.47 was found between changes in empowerment and changes in anxiety. Conclusion: Results indicate that iCBT that is patient-driven, may have a greater effect on anxiety, than standard iCBT. The effect on perceived control over treatment might also be larger in patient-driven treatments than in standard iCBT. Internet-based therapies inherently promote as active agents of their own care and might be well suited for promoting perceived control and empowerment. Findings need to be replicated given the small sample size and the explorative nature of the study.
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| 7. |
- Nissling, Linnea, 1991
(författare)
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Enhancing the Patient’s Role: Exploring patient influence in acceptance-based cognitive behavior therapy delivered via internet
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The global primary health care declaration emphasizes empowering patients to exert influence over their own health. A person-centered approach to care involves a shift from the traditional passive patient role to active involvement in health care decisions. Internet-delivered cognitive behavioral therapy (ICBT) increases access to care and is effective for various mental health conditions. Aims: The overarching aim of this doctoral thesis was to enhance the patient’s role by exploring how patient influence can be conceptualized and integrated into acceptance-based transdiagnostic ICBT for anxiety disorders treated in Swedish primary care. Results: Four studies were performed within the scope of this doctoral dissertation. Study I used mixed methods to investigate patient experiences and the feasibility and acceptability of adding peer support workers (PSWs) into acceptance-influenced ICBT for anxiety disorders. Incorporating PSWs into ICBT was practically feasible and well received by participants in a small sample of primary care patients (n=9). The qualitative results emphasized the personal relationship in therapeutic guidance and the sense of empowerment from sharing experiences. Study II was an RCT investigating a patient-driven acceptance-influenced ICBT for patients with anxiety disorders treated in primary care (n=55). Participants in the patient-driven intervention chose and self-tailored their treatment, resulting in greater perceived control and reduced anxiety symptoms compared to standard treatment. A medium-sized association was observed between changes in anxiety symptoms and empowerment. Study III assessed the effectiveness of an internet-delivered acceptance and commitment therapy (ACT) for adolescents with anxiety disorders in an RCT. Participants (n=52) were a self-selected group recruited from all over Sweden. The treatment was effective in increasing quality of life and psychological flexibility and had a positive effect on post-treatment diagnoses. A strong association was found between changes in psychological flexibility and anxiety symptoms. Study IV was a psychometric evaluation of the Swedish version of the Empowerment Scale – Making Decisions conducted on clinical patients in primary care (n=210) and psychiatric care (n=221) using confirmatory factor analysis (CFA). Results showed that none of the previously suggested factor solutions, tested through CFA, could be confirmed in our samples of primary care and psychiatric care patients and that it is doubtful whether the scale represents a single empowerment construct. Conclusions: This doctoral thesis contributes to the field of internet-delivered mental health interventions by exploring the integration of patient influence through acceptance and commitment therapy, incorporating patient-driven components, and making patients’ experiences part of treatment. The research underscores the potential for improving treatment outcomes and quality of life, promoting psychological flexibility, belonging, and a sense of control over one’s care. The studies serve as a foundation for future research and development, paving the way for person-centered and tailored approaches in digital mental health treatments
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| 8. |
- Nissling, Linnea, 1991, et al.
(författare)
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Internet-delivered Acceptance and Commitment Therapy for adolescents with anxiety disorders
- 2023
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Ingår i: SweSRII – The 12th Swedish Congress on Internet Interventions..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background Anxiety disorders are common causes of mental illness in adolescents. Acceptance and Commitment Therapy delivered through internet (iACT) shows promising results for adults with anxiety disorders, but few studies exist on internet-delivered ACT programs for adolescents. Aims investigate the effectiveness of internet-delivered ACT for adolescents with anxiety disorders assess the relationship between psychological flexibility and treatment outcomes assess the relationship between adolescents and therapists perceived alliance and treatment outcomes. Population 52 adolescents aged 15 to 19 and from all over Sweden were recruited through advertisements on social media, in schools, primary health care centers and outpatient psychiatric clinics and were assessed by the diagnostic interview M.I.N.I Kid as meeting criteria for one or several anxiety diagnosis. Intervention An internet-delivered ACT treatment, “Ångesthjälpen UNG”, was developed (Psykologpartners, 2017). Outcomes The treatment increased the adolescents’ self-rated quality of life and psychological flexibillity (moderate between-group effect sizes, d=.65 and d=.51) Post treatment assessment with M.I.N.I Kid showed diminished anxiety diagnoses No significant group difference was found for anxiety symptoms, as both groups improved Changes in psychological flexibility were associated with changes in anxiety symptoms Working alliance was rated as high by both adolescents and therapists but showed no significant relationship with treatment outcomes Take-home message This study shows promising results for internet-delivered ACT in treating adolescents with anxiety disorders. The results suggest the model of psychological flexibility as an important process of change in treatment outcomes. Future research should validate these findings in larger samples and in clinical contexts.
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| 9. |
- Nissling, Linnea, 1991, et al.
(författare)
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Primary Care Peer-Supported Internet-Mediated Psychological Treatment for Adults With Anxiety Disorders: Mixed Methods Study.
- 2020
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Ingår i: JMIR formative research. - : JMIR Publications Inc.. - 2561-326X. ; 4:8
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Tidskriftsartikel (refereegranskat)abstract
- The effect of internet-delivered cognitive behavioral therapy (iCBT) on anxiety in adults is well-known. However, patient dropouts and poor adherence to treatment are common. Feelings of belonging and empowerment from the treatment might be key to the completion of iCBT. Peer support workers are people with a personal experience of mental health problems, trained to provide professional support to people who require mental health care.This study aims to assess patient experiences; the feasibility, safety, and acceptability; and preliminary effectiveness on anxiety and depression, empowerment, and adherence to treatment in an 8-week peer-supported iCBT program for patients with anxiety disorders treated in primary care.This was a single-arm mixed methods feasibility study. Participants were patients referred to a central unit for iCBT in primary care. Quantitative data were collected pre-, post-, and 3 months postintervention. Qualitative data were collected through semistructured interviews.A total of 9 participants completed the quantitative outcome assessment. Statistically significant improvements were observed in perceived empowerment at a 3-month follow-up, and significant decreases in anxiety, depression, and psychological distress at the end of the treatment were maintained at a 3-month follow-up. In total, 8 of the 9 patients showed improvement in the severity of their symptoms of anxiety. Adherence to treatment was good among the participants. No serious adverse events were reported. Eight participants were enrolled in the qualitative analysis. The qualitative results showed 3 main themes: (1) real contact in an online world, (2) empowering experiences, and (3) being behind the wheel. Qualitative results largely emphasized the personal relationship and supported the acceptability of adding peer support to iCBT.Peer support in digital treatment seems to be a safe and acceptable intervention. The preliminary results suggest the effectiveness of peer support on patient empowerment, anxiety, depression, psychological distress, and adherence to treatment. The results indicate the need for future studies to evaluate the effect of adding peer support to iCBT in larger randomized controlled trials.
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