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Stepped care for so...
Stepped care for social anxiety disorder or panic disorder : A randomised controlled trial
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Nordgreen, T. (författare)
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Haug, T. (författare)
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- Öst, Lars-Göran (författare)
- Stockholms universitet,Klinisk psykologi
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visa fler...
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Andersson, Gerhard (författare)
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- Carlbring, Per (författare)
- Stockholms universitet,Klinisk psykologi
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Kvale, G. (författare)
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Heiervang, E. (författare)
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Havik, O. (författare)
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visa färre...
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(creator_code:org_t)
- 2017
- 2017
- Engelska.
- Relaterad länk:
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https://urn.kb.se/re...
Abstract
Ämnesord
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- Background: Stepped Care is considered a cost-effective way to deliver health care but few studies have investigated stepped care models for psychological treatments. Internet-based psychological treatment might be a highly suitable first step in a stepped care model. The aim of this study was to assess the effectiveness of a cognitive behavioral therapy (CBT) stepped care model (psychoeducation, guided Internet-based treatment, and face-to-face CBT) compared with direct face-to-face (FtF) CBT.Methods: Patients with panic disorder or social anxiety disorder were randomized to either stepped care (n = 85) or direct FtF CBT (n = 88). Recovery was defined as meeting two of the following three criteria: loss of diagnosis, below cut-off for self-reported symptoms, and functional improvement.Results: No significant differences in intention-to-treat recovery rates were identified between stepped care (40.0%) and direct FtF CBT (43.2%). The majority of the patients who recovered in the stepped care did so at the less therapist-demanding steps (26/34, 76.5%). Moderate to large within-groups effect sizes were identified at posttreatment and 1-year follow-up. The attrition rates were high: 41.2% in the stepped care condition and 27.3% in the direct FtF CBT condition.Discussion: These findings indicate that the outcome of a stepped care model for anxiety disorders is comparable to that of direct FtF CBT. The rates of improvement at the two less therapist- demanding steps indicate that stepped care models might be useful for increasing patients’ access to evidence-based psychological treatments for anxiety disorders. However, attrition in the stepped care condition was high. This may reflect inflexible stepping-up criteria. Limitations of this study will be discussed together with suggestions for more relevant and flexible stepping up criteria.
Ämnesord
- SAMHÄLLSVETENSKAP -- Psykologi (hsv//swe)
- SOCIAL SCIENCES -- Psychology (hsv//eng)
Nyckelord
- artificial intelligence
- machine learning
- prediction
- stepped care
- Psychology
- psykologi
Publikations- och innehållstyp
- ref (ämneskategori)
- kon (ämneskategori)