| 1. |
- Berg, Matilda, et al.
(författare)
-
The role of knowledge in internet-based cognitive behavioural therapy for adolescent depression : Results from a randomised controlled study
- 2019
-
Ingår i: Internet Interventions. - : Elsevier. - 2214-7829. ; 15, s. 10-17
-
Tidskriftsartikel (refereegranskat)abstract
- Background and objectivesClients' knowledge about their condition and treatment is considered crucial for general health improvement, and knowledge acquisition is an essential part in internet-based cognitive behavioural therapy (ICBT). Yet, little is known about the role of knowledge and how it influences treatment outcome. This study aimed to examine if explicit knowledgeincreased following ICBT for adolescent depression, if knowledge gainwould be associated with symptom reduction, and if pre-existing knowledge predicted changes in depressive symptoms.MethodsSeventy-one adolescents were randomised to a therapist-supported ICBT or a attention control condition. A measure of depression (BDI-II) and a knowledge test dealing with depression, comorbid anxiety, and its CBT-treatment were administered before and after treatment.ResultsSignificant improvements in knowledge were observed following ICBT compared to the attention control (between-group Cohen's d = 1.25, 95% CI [0.67–1.79]). On average, participants in the treatment group answered 1.4 more questions correctly at post treatment compared to the control group. No relation between change in knowledge and change in depressive symptoms could be observed. Knowledge scores at baseline were high for both groups, with participants answering approximately 75% of the questions correct. A higher level of initial knowledge level predicted poorer treatment response (Parson's r = −0.38, p = .048).ConclusionsThe findings indicate that knowledge about basic concepts and principles about depression, anxiety, and CBT increases following ICBT. This increase in knowledge was not related to change in depressive symptoms, indicating that knowledge is a different construct. The results also suggest that clients who are more knowledgeable prior to treatment might benefit less from ICBT. In sum, the results highlight the need to further examine the role of knowledge in ICBT.
|
|
| 2. |
- Nissling, Linnea, 1991, et al.
(författare)
-
Effectiveness of and processes related to internet-delivered acceptance and commitment therapy for adolescents with anxiety disorders : a randomized controlled trial
- 2023
-
Ingår i: RESEARCH IN PSYCHOTHERAPY-PSYCHOPATHOLOGY PROCESS AND OUTCOME. - : PAGEPress Publications. - 2499-7552 .- 2239-8031. ; 26:2
-
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.
|
|
| 3. |
- Nissling, Linnea, 1991, et al.
(författare)
-
Internet-delivered Acceptance and Commitment Therapy for adolescents with anxiety disorders
- 2023
-
Ingår i: SweSRII – The 12th Swedish Congress on Internet Interventions..
-
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.
|
|
| 4. |
- Schuster, Raphael, et al.
(författare)
-
Advantages and disadvantages of online and blended therapy: Replication and extension of findings on psychotherapists appraisals
- 2020
-
Ingår i: Internet Interventions. - : ELSEVIER. - 2214-7829. ; 21
-
Tidskriftsartikel (refereegranskat)abstract
- Therapists hold a key role for the uptake of digital mental health interventions (DMHI) within regular care services but have demonstrated cautious attitudes towards such interventions. It is relevant to explore in detail what factors may positively influence therapists perception when considering DMHI implementation within routine care. We recently assessed therapist views towards Internet-based and blended treatment in Austria (low implementation level). The present study aims at testing the reliability of previous findings, and moreover, it compares therapists appraisals to a country with advanced DMHI implementation (Sweden). An online survey was conducted February through June of 2019. Respondents were recruited via email and social media. The survey assessed first-hand experience with Internet-based treatment (IT) and blended treatment (BT). To start, the survey presented a short informational video to half of the respondents, then assessed therapists views on 17 advantages and 13 disadvantages of IT and BT on 6-point Likert scales. In total N = 300 therapists responded to the invitation, of which N = 165 provided full survey data (Germany 114/220, 52%; Sweden 51/80, 64%). German therapists rated the advantages of IT and BT as neutral (IT, M = 3.6; BT, M = 3.8) and to some extent agreed with disadvantages of IT (IT, M = 4.5; BT, M = 3.5). In comparison, Swedish therapists rated significantly greater advantages (IT, M = 4.6; BT, M = 4.5) and less disadvantages (IT, M = 3.2; BT, M = 2.8). Effect sizes ranged from d = 0.89 to d = 1.83; all Ps < .001. Those with first-hand experience with DMHI reported more positive appraisals in both countries. No significant effect was found for exposure to the short informational video. The German sample represented essential characteristics of current German therapists; in comparison Swedish respondents skewed towards younger less experienced therapists (Ps < .001). Those confounders accounted for a small non-significant proportion of variance (0.1-4.7%). We found that therapists considered blended treatment to have less disadvantages than Internet treatment, and that first-hand experience with DMHI, but not exposure to an acceptance facilitating video clip, predicted greater acceptability on individual level. The responses among German therapists closely resembled findings from our preceding study in Austria, indicating that reliable results can be achieved in small survey studies if sample and population parameters correspond. Swedish therapists held significantly more favorable attitudes towards both interventions. The comparison between countries, however, is limited by a number of potential confounding variables.
|
|
| 5. |
- Topooco, Naira, 1980-, et al.
(författare)
-
Chat- and internet-based cognitive-behavioural therapy in treatment of adolescent depression : randomised controlled trial
- 2018
-
Ingår i: British Journal of Psychiatry. - : Royal College of Psychiatry. - 0007-1250 .- 1472-1465. ; 26:4, s. 199-207
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Depression is a major contributor to the burden of disease in the adolescent population. Internet-based interventions can increase access to treatment.Aims: To evaluate the efficacy of internet-based cognitive-behavioural therapy (iCBT), including therapist chat communication, in treatment of adolescent depression.Method: Seventy adolescents, 15-19 years of age and presenting with depressive symptoms, were randomised to iCBT or attention control. The primary outcome was the Beck Depression Inventory II (BDI-II).Results: Significant reductions in depressive symptoms were found, favouring iCBT over the control condition (F(1,67) = 6.18, P < 0.05). The between-group effect size was Cohen's d = 0.71 (95% CI 0.22-1.19). A significantly higher proportion of iCBT participants (42.4%) than controls (13.5%) showed a 50% decrease in BDI-II score post-treatment (P < 0.01). The improvement for the iCBT group was maintained at 6 months.Conclusions: The intervention appears to effectively reduce symptoms of depression in adolescents and may be helpful in overcoming barriers to care among young people.Declaration of interest: N.T. and G.A. designed the programme. N.T. authored the treatment material. The web platform used for treatment is owned by Linköping University and run on a non-for-profit basis. None of the authors receives any income from the programme.
|
|
