| 1. |
- Andersson, Gerhard, et al.
(författare)
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Therapeutic alliance in guided internet-delivered cognitive behavioural treatment of depression, generalized anxiety disorder and social anxiety disorder
- 2012
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Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 50:9, s. 544-550
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Tidskriftsartikel (refereegranskat)abstract
- Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in several controlled trials, but the mechanisms of change are largely unknown. Therapeutic alliance is a factor that has been studied in many psychotherapy trials, but the role of therapeutic alliance in ICBT is less well known. The present study investigated early alliance ratings in three separate samples. Participants from one sample of depressed individuals (N = 49), one sample of individuals with generalized anxiety disorder (N = 35), and one sample with social anxiety disorder (N = 90) completed the Working Alliance Inventory (WAI) modified for ICBT early in the treatment (weeks 3-4) when they took part in guided ICBT for their conditions. Results showed that alliance ratings were high in all three samples and that the WAI including the subscales of Task, Goal and Bond had high internal consistencies. Overall, correlations between the WAI and residualized change scores on the primary outcome measures were small and not statistically significant. We conclude that even if alliance ratings are in line with face-to-face studies, therapeutic alliance as measured by the WAI is probably less important in ICBT than in regular face-to-face psychotherapy.
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| 2. |
- Bjärehed, Jonas, et al.
(författare)
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Internetbehandling med KBT : En praktisk handbok
- 2013
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Bok (populärvet., debatt m.m.)abstract
- Internetbaserad KBT ger tillgång till fungerande behandling för psykisk ohälsa på patientens villkor. Metoden har utvecklats i snabb takt genom utbredda forskningsinsatser, där Sverige kan betraktas som världsledande inom området.Internetbehandling med KBT ger en grundlig genomgång av behandlingsarbetet med betoning på praktiska aspekter och tillämpningen i olika verksamheter. Särskilt fokus ligger på att skapa ett fungerande behandlingsupplägg, praktiska förberedelser, behandlarens roll och viktiga terapeutfärdigheter samt hur vanliga svårigheter hanteras. Läsaren får också en teoretisk orientering, kunskap om befintligt forskningsstöd och vilka fördelar metoden har för patienter, behandlare och verksamheter. Fallexempel, checklistor och annat praktiskt material gör boken till ett mycket användbart hjälpmedel.Besök gärna författarnas egen Facebook-sida för boken, eller lyssna på programmet Vetenskap och Miljö i Sveriges Radio där man diskuterar nätet som terapirum.
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| 3. |
- Carlbring, Per, et al.
(författare)
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Internet-based behavioral activation and acceptance-based treatment for depression : a randomized controlled trial
- 2013
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 148:2-3, s. 331-337
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundInternet-based cognitive behavior therapy for depression has been tested in several trials but there are no internet studies on behavioral activation (BA), and no studies on BA over the internet including components of acceptance and commitment therapy (ACT). The aim of this study was to develop and test the effects of internet-delivered BA combined with ACT against a waiting list control condition as a first test of the effects of treatment.MethodsSelection took place with a computerized screening interview and a subsequent semi-structured telephone interview. A total of 80 individuals from the general public were randomized to one of two conditions. The treatment lasted for 8 weeks after which both groups were assessed. We also included a 3 month follow-up. The treatment included interactive elements online and a CD-ROM for mindfulness and acceptance exercises. In addition, written support and feedback was given by a therapist every week.ResultsResults at posttreatment showed a large between group effect size on the Beck Depression inventory IId=0.98 (95%CI=0.51–1.44). In the treated group 25% (10/40) reached remission defined as a BDI score≤10 vs. 5% (2/40) in the control group. Results on secondary measures were smaller. While few dropped out from the study (N=2) at posttreatment, the average number of completed modules was M=5.1 out of the seven modules.LimitationsThe study only included a waiting-list comparison and it is not possible to determine which treatment components were the most effective.ConclusionsWe conclude that there is initial evidence that BA with components of ACT can be effective in reducing symptoms of depression.
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| 4. |
- Kivi, Marie, et al.
(författare)
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Internet-Based Therapy for Mild to Moderate Depression in Swedish Primary Care: Short Term Results from the PRIM-NET Randomized Controlled Trial
- 2014
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Ingår i: Cognitive Behaviour Therapy. - : Informa UK Limited. - 1650-6073 .- 1651-2316. ; 43:4
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Tidskriftsartikel (refereegranskat)abstract
- Depression presents a serious condition for the individual and a major challenge to health care and society. Internet-based cognitive behavior therapy (ICBT) is a treatment option supported in several trials, but there is as yet a lack of effective studies of ICBT in “real world” primary care settings. We examined whether ICBT differed from treatment-as-usual (TAU) in reducing depressive symptoms after 3 months. TAU comprised of visits to general practitioner, registered nurse, antidepressant drugs, waiting list for, or psychotherapy, or combinations of these alternatives. Patients, aged $18 years, who tentatively met criteria for mild to moderate depression at 16 primary care centers in the south-western region of Sweden were recruited and then assessed in a diagnostic interview. A total of 90 patients were randomized to either TAU or ICBT. The ICBT treatment included interactive elements online, a workbook, a CD with mindfulness and acceptance exercises, and minimal therapist contact. The treatment period lasted for 12 weeks after which both groups were assessed. The main outcome measure was Beck Depression Inventory-II (BDI-II). Additional measures were Montgomery A ° sberg Depression Rating Scale – self rating version (MADRS-S) and Beck Anxiety Inventory (BAI). The analyses revealed no significant difference between the two groups at post treatment, neither on BDI-II, MADRS-S, nor BAI. Twenty patients (56%) in the ICBT treatment completed all seven modules. Our findings suggest that ICBT may be successfully delivered in primary care and that the effectiveness, after 3 months, is at par with TAU.
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| 5. |
- Kivi, Marie, et al.
(författare)
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Internet therapy for depression in primary care - a RCT
- 2013
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Ingår i: European Society for Research on Internet Internvention (ESRII) 2013.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- This study aims to investigate whether Cognitive Behavior Internet therapy (iCBT) for depression is as effective as usual treatment in primary care (PC) settings. Previous research shows good efficacy for iCBT for depression. It might also be a way to cost-efficiently offer evidence based psychological treatment to more patients, given the substantial shortage of trained CBT-therapists in PC. So far, few studies are conducted with a focus on the effectiveness in PC-settings. We identified patients with mild to moderate depression at 16 participating PC Centers in the Västra Götaland region. Before inclusion a structured interview was performed by a psychologist/¬psychotherapist to ascertain that the patients met the inclusion criteria. A total of 90 patients were included. The patients were then randomly assigned to either Internet therapy (iCBT) or to treatment as usual (TAU). The iCBT encompasses a 12-week access to a Behavioral Activation treatment program on the internet (Depressionshjälpen), a workbook, support by the evaluating psychologist/psychotherapist via 3 telephone calls (week 1, 4-5 and 8-12), and weekly contact via secure e-mail. More intense telephone and e mail contacts are available when needed. The primary outcome measure is BDI-II, secondarily MADRS-S is also used. Our findings at post-treatment is that iCBT is as effective as TAU also in PC-settings. Data from the 3- and 9-month follow-ups will be available in 2014.
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| 6. |
- Vernmark, Kristofer, et al.
(författare)
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Internet administered guided self-help versus individualized e-mail therapy: A randomized trial of two versions of CBT for major depression
- 2010
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Ingår i: BEHAVIOUR RESEARCH AND THERAPY. - : Elsevier Science B.V., Amsterdam.. - 0005-7967 .- 1873-622X. ; 48:5, s. 368-376
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Tidskriftsartikel (refereegranskat)abstract
- Internet-delivered psychological treatment of major depression has been investigated in several trials, but the role of personalized treatment is less investigated. Studies suggest that guidance is important and that automated computerized programmes without therapist support are less effective. Individualized e-mail therapy for depression has not been studied in a controlled trial. Eighty-eight individuals with major depression were randomized to two different forms of Internet-delivered cognitive behaviour therapy (CBT), or to a waiting-list control group. One form of Internet treatment consisted of guided self-help, with weekly modules and homework assignments. Standard CBT components were presented and brief support was provided during the treatment. The other group received e-mail therapy, which was tailored and did not use the self-help texts i.e., all e-mails were written for the unique patient. Both treatments lasted for 8 weeks. In the guided self-help 93% completed (27/29) and in the e-mail therapy 96% (29/30) completed the posttreatment assessment. Results showed significant symptom reductions in both treatment groups with moderate to large effect sizes. At posttreatment 34.5% of the guided self-help group and 30% of the e-mail therapy group reached the criteria of high-end-state functioning (Beck Depression Inventory score below 9). At six-month follow-up the corresponding figures were 47.4% and 43.3%. Overall, the difference between guided self-help and e-mail therapy was small, but in favour of the latter. These findings indicate that both guided self-help and individualized e-mail therapy can be effective.
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