| 1. |
- Ahorsu, Daniel Kwasi, et al.
(författare)
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Testing an app-based intervention to improve insomnia in patients with epilepsy : A randomized controlled trial
- 2020
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Ingår i: Epilepsy & Behavior. - : Elsevier BV. - 1525-5050 .- 1525-5069. ; 112
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Insomnia has adverse effects on people with epilepsy. We aimed to test a novel cognitive behavioral therapy for insomnia (CBT-I) app-based intervention on insomnia symptoms and social psychological factors in people with epilepsy and to examine the possible mechanisms among the factors.Methods: Participants were recruited from neurology clinics in Iran and comprised individuals diagnosed with epilepsy and having moderate to severe insomnia. A two-arm randomized controlled trial design was used, consisting of a treatment group (CBT-I; n = 160) and control group (patient education; n = 160). Primary outcomes were self-reported sleep quality, insomnia severity, and sleep hygiene behavior and objective sleep characteristics measured by actigraphy. Secondary outcomes were attitude, perceived behavioral control, intention, action planning, coping planning, behavioral automaticity, self-monitoring, anxiety, depression, and quality of life (QoL). All outcomes were measured at baseline, and at one, three, and six months postintervention, except objective sleep, which was assessed at baseline, and one and six months postintervention. Data were analyzed using linear mixed models.Results: Current findings showed that sleep quality, insomnia severity, sleep hygiene behavior, and sleep onset latency were significantly improved in the CBT-I group compared with the patient education group at all measurement points. Also, the CBT-I group had significantly improved anxiety, depression, and QoL compared with the patient education group. Mediation analyses showed that attitude, intention, coping planning, self-monitoring, and behavioral automaticity significantly mediated the effect of the intervention on sleep outcomes.Conclusion: Results support the use of the CBT-I app to improve sleep outcomes among people with epilepsy.
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| 2. |
- Andersson, Gerhard, et al.
(författare)
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Cognitive behavioral therapy delivered using the internet
- 2021
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Ingår i: Handbook of cognitive behavioral therapy, Volume 2. - Washington : American Psychological Association (APA). - 9781433833502 ; , s. 607-631
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Bokkapitel (refereegranskat)abstract
- The internet is no longer something new. It has existed now for a long time and has been part of many peoples' lives for at least 20 years. The internet increasingly informs many aspects of our lives, including the economy, health care, and delivery of psychological treatments. There are many areas in which the internet has had an impact on cognitive behavioral therapy (CBT). This chapter describes challenges when delivering CBT via the internet, comments on assumptions behind treatment programs, and describes the main approaches, outcomes, and potential mechanisms of change. Further, the authors comment on the dissemination of internet-delivered CBT (ICBT), as well as applications for diverse target groups, and possible future developments. Although ICBT may appear as something new, it is almost as old as the internet itself, and the research field is very large, with more than 200 controlled trials.
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| 3. |
- Andersson, Gerhard, et al.
(författare)
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How well does internet-based CBT work for depression in Sweden? A patient-level meta-analysis
- 2023
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Ingår i: Abstracts and Program Parallel Sessions. ; , s. 50-51
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Konferensbidrag (refereegranskat)abstract
- Background: Several studies and meta-analysis suggest that ICBT works for patients with mild to moderate depression/depressive symptoms. Given the quality of the data is is now possible to conduct IPMAs. Several IPMAs have been published with data from different countries. A problem with that approach is the some studies may be left out as data are not provided. The aim of this IPMA was to study the effects focusing on Swedish data only with less loss of data/studies.Methods: We were able to include data from 16 studies with a total of 2952 participants. Missing data were imputed. The overall effect-size for nine studies compared to wait-list was d = 0.63 95 % CI [0.48, 0.78] and within-group effect-size for 15 studies d = 1.17 95 % CI [1.11, 1.22]. The results were surprisingly similar across different subgroups. Women had on average more symptoms before treatment and also reported a larger symptom decrease after treatment.Conclusions: Results show a large effect of ICBT on depressive symptoms in a Swedish setting, including in routine care. This meta-analysis supports treatment of depressive symptoms with ICBT in Sweden.
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| 4. |
- Andersson, Gerhard, et al.
(författare)
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Internet Interventions in Clinical Psychology
- 2022. - 2
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Ingår i: Comprehensive Clinical Psychology. - : Elsevier. - 9780128222324 ; , s. 194-205
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Bokkapitel (refereegranskat)abstract
- The internet and modern information technology have influenced society and also the practice of clinical psychology. In this chapter, we describe how internet-delivered psychological assessment and treatment procedures work and provide an updated review of the evidence. Therapist-supported internet interventions, mainly derived from cognitive behavior therapy treatment protocols, have been developed and tested in a large number of controlled trials and also for a range of psychiatric and somatic problems and conditions. There are clear indications that internet interventions can be as effective as seeing a therapist face-to-face, that long-term effects can be obtained, and that it has been possible to transfer internet interventions to more regular service provision (e.g., effectiveness trials).
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| 5. |
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| 6. |
- Berg, Ida, et al.
(författare)
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“Good job!” : Therapists' encouragement, affirmation, and personal address in internet-based cognitive behavior therapy for adolescents with depression
- 2022
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Ingår i: Internet Interventions. - : Elsevier. - 2214-7829. ; 30
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Tidskriftsartikel (refereegranskat)abstract
- Internet-delivered interventions are generally effective for psychological problems. While the presence of a clinician guiding the client via text messages typically leads to better outcomes, the characteristics of what constitutes high-quality communication are less well investigated. This study aimed to identify how an internet therapist most effectively communicates with clients in internet-delivered cognitive behavioral therapy (ICBT). Using data from a treatment study of depressed adolescents with a focus on participants who had a positive outcome, messages from therapists were analyzed using thematic analysis. The study focused on the therapist's 1) encouragement and 2) affirmation, and how the therapists used 3) personal address. The analysis resulted in a total of twelve themes (Persistence Wins, You Are a Superhero, You Make Your Luck, You Understand, Hard Times, You Are Like Others, My View on the Matter, Time for a Change, Welcome In, Let Me Help You, You Affect Me, and I Am Human). Overall, the themes form patterns where treatment is described as hard work that requires a motivated client who is encouraged by the therapist. The findings are discussed based on the cognitive behavioral theoretical foundation of the treatment, prior research on therapist behaviors, and the fact that the treatment is provided over the internet.
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| 7. |
- Buhrman, Monica, 1974-, et al.
(författare)
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Treating perfectionism using internet-based cognitive behavior therapy : A study protocol for a randomized controlled trial comparing two types of treatment
- 2020
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Ingår i: Internet Interventions. - : Elsevier BV. - 2214-7829. ; 21
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Tidskriftsartikel (refereegranskat)abstract
- Perfectionism is characterized by setting high standards and striving for achievement, sometimes at the expense of social relationships and wellbeing. Despite sometimes being viewed as a positive feature by others, people with perfectionism tend to be overly concerned about their performance and how they are being perceived by people around them. This tends to create inflexible standards, cognitive biases, and performance-related behaviors that maintain a belief that self-worth is linked to accomplishments. Cognitive behavior therapy has been shown to be a viable treatment for perfectionism, both in terms of reducing levels of perfectionism and improving psychiatric symptoms. Furthermore, a number of recent studies indicate that it can be successfully delivered via the Internet, both with regular support and guidance on demand from a therapist. In the present study protocol, a clinical trial for perfectionism is described and outlined. In total, 128 participants will be recruited and randomized to either a treatment that has already been demonstrated to have many benefits, Internet-based Cognitive Behavior Therapy for perfectionism (iCBT-P), or an active comparison condition, Internet-based Unified Protocol (iUP), targeting the emotions underlying depression and anxiety disorders. The results will be investigated with regard to self-reported outcomes of perfectionism, psychiatric symptoms, self-compassion, and quality of life, at post-treatment and at six- and 12-month follow-up. Both iCBT-P and iUP are expected to have a positive impact, but the difference between the two conditions in terms of their specific effects and adherence are currently unknown and will be explored. The clinical trial is believed to lead to a better understanding of how perfectionism can be treated and the specificity of different treatments.
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| 8. |
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| 9. |
- Carlbring, Per, et al.
(författare)
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A randomized controlled trial of an online deliberate practice course for cognitive-behavioral therapists
- 2022
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Ingår i: EABCT 2022: Re-Thinking CBT: providing startegies for a new way of living. ; , s. 61-61
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Deliberate Practice has been proposed for improving therapist effectiveness. Deliberate Practice emphasizes the importance of feedback, expert mentorship, repetition, and individualized learning objectives. The primary analysis tested whether an online, 8-week Deliberate Practice course for cognitive-behavioral therapists would influence patient-rated working alliance compared to a waiting list.Methods: Therapists (n=37) with an undergraduate diploma in cognitive behavior therapy were recruited using social media and the mailing lists of the Swedish Association of Behaviour Therapy (“Beteendeterapeutiska föreningen”). For two weeks before and two weeks after the intervention, therapists in both groups recruited their adult patients in individual therapy to complete the Session Alliance Inventory anonymously. Delayed responses the week after this period were included. Therapists were randomized to Deliberate Practice or Waitlist. The Deliberate Practice intervention consisted of one 75-minute zoom weekly workshop over eight weeks. Each workshop specified a therapist’s skill and related skill criteria (e.g., Responding to client resistance) and involved 50 minutes of focused role-plays with repetition and feedback.Results: A linear mixed model found a trend (p < .06) towards a significant group and time interaction effect. The interaction was unexpected: the Deliberate Practice group decreased their composite Session Alliance Inventory scores (d = -.40), and the waitlist group increased their scores (d = .49).Discussion: This pioneering randomized controlled study combined a comprehensive and online-based Deliberate Practice course with a patient-rated working alliance scale. Surprisingly, a close-to-significant effect indicated that the intervention had a negative impact, while the waiting list had a positive outcome. However, power requirements were not met, and methodological issues such as attrition and bias were limitations. Recommendations for future research are presented.
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