| 1. |
- Bäckman, Lisa, et al.
(author)
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Effects of internet-based enhanced acceptance and commitment therapy integrating interoceptive exposure for panic disorder and the association between working alliance and outcome: A randomized controlled trial
- 2024
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In: Sweesrii 2024.
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Conference paper (other academic/artistic)abstract
- This study investigated the effectiveness of an improved internet-based Acceptance and Commitment Therapy (iACT) adapted for individuals with Panic Disorder (PD) and concurrent agoraphobia (AF), incorporating interoceptive exposure for better customization. The treatment, spanning eight modules over 10 weeks, demonstrated significant symptom reduction in the primary outcome Panic Disorder Severity Scale (PDSS-SR), with a large effect size (d=0.92) in a randomized controlled trial involving a wait-list control group (n=79). However, no significant impact was observed on the secondary outcome, Brunnsviken Brief Quality of Life Inventory (BBQ). Notably, 43% of of the assessed participants in the treatment group were diagnosed free from panic disorder. Utilizing weekly ratings of therapist-client working alliance (WAI-SR-T/C) and PDSS-SE, we explored their connection throughout the treatment and its association with the final outcome. We found a relation between therapist working alliance and the reduction of panic symptoms during treatment. However, there was no significant relationship observed for client-rated working alliance or with the final treatment outcome. This study suggests that this enhanced iACT can be an effective method for treating panic disorder and shows promise for use, particularly in cases where panic disorder is accompanied by agoraphobia. It is also shedding light on the role of alliance in internet-based treatments, however, here it is important to acknowledge that the sample size was small.
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| 2. |
- Ivanova, Ekaterina, et al.
(author)
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Guided and unguided transdiagnostic Acceptance and Commitment Therapy for anxiety disorders provided via a computer and a smartphone application : A randomized controlled trial
- 2016
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In: EABCT 2016 Abstract Book. ; , s. 530-530
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Conference paper (peer-reviewed)abstract
- Technology-assisted psychological treatments are becoming well-known in the scientific networks throughout the world and are being implemented into routine health care in a number of countries. The interest in evaluating the potential of different devices is growing. The main objective of the current study was to evaluate the effects of guided and unguided computerand smartphone-based Acceptance and Commitment Therapy (ACT) for social anxiety disorder (SAD) and panic disorder (PD).A total of 152 participants were randomized into a guided treatment group, an unguided treatment group and a waiting list control group. Both treatment groups got access to a computer-based ACT-treatment and a smartphone application (app) with corresponding content. The eight modules treatment program covered a number of topics such as the nature of anxiety, functional analyses, acceptance, mindfulness and valued actions. The purpose of the app was to make it easier for the participants to access the key points of the program and to do homework assignments in their everyday life. Automatic messages in the app aimed to give feedback to the participants on their work as well as to prompt them to continue with the program. In addition to that, the participants in the guided group got therapist support via the app. The therapists were encouraged to work with each of their patient 15 min/week during the 10 weeks treatment period and focus on motivating, validating and correcting mistakes. On the whole group level GAD-7 was used as the primary outcome measure. LSAS and PDSS-SR were used for subgroup analyses in SAD and PD participants respectively. The measurements were collected at pre-, mid- and post-treatment and at 12-months follow-up.There were no significant differences in adherence between the treatment groups except for significantly higher rates of smartphone usage in the guided group. No significant differences in treatment outcome were found between the treatment groups with moderate within-group effects (Cohen’s d = 0.75 for the guided and Cohen’s d = 0.66 for the unguided group). The treated participants improved significantly in comparison to the control group both on the whole group level (between group Cohen’s d = 0.39) and for the participants suffering primarily from SAD (between group Cohen’s d = 0.70). Within group effect sizes were large for the PD-participants (Cohen’s d = 1.00) but the study was very underpowered in this part.Discussion. The treatment program as it was used in the present study appeared to be effective in treating social anxiety disorder and decreasing general anxiety symptoms, but the effects are smaller than seen in previous studies. The guided treatment was not clearly superior to the unguided one. The study contributes to the growing body of evidence on technology-assisted ACT.Conclusion. Computer- and smartphone-based ACT can be made into an effective treatment for anxiety disorders. A smartphone application seems to have a clear potential to partly compensate for the absence of therapist support which needs to be studied further.
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| 3. |
- Kivi, Marie, et al.
(author)
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Internet therapy for depression in primary care - a RCT
- 2013
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In: European Society for Research on Internet Internvention (ESRII) 2013.
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Conference paper (other academic/artistic)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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| 4. |
- Nissling, Linnea, 1991, et al.
(author)
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Internet-delivered Acceptance and Commitment Therapy for adolescents with anxiety disorders
- 2023
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In: SweSRII – The 12th Swedish Congress on Internet Interventions..
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Conference paper (other academic/artistic)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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| 5. |
- van Breda, Ward, et al.
(author)
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A feature representation learning method for temporal datasets
- 2016
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In: PROCEEDINGS OF 2016 IEEE SYMPOSIUM SERIES ON COMPUTATIONAL INTELLIGENCE (SSCI). - : IEEE. - 9781509042401
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Conference paper (peer-reviewed)abstract
- Predictive modeling of future health states can greatly contribute to more effective health care. Healthcare professionals can for example act in a more proactive way or predictions can drive more automated ways of therapy. However, the task is very challenging. Future developments likely depend on observations in the (recent) past, but how can we capture this history in features to generate accurate predictive models? And what length of history should we consider? We propose a framework that is able to generate patient tailored features from observations of the recent history that maximize predictive performance. For a case study in the domain of depression we find that using this method new data representations can be generated that increase the predictive performance significantly.
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| 6. |
- Vernmark, Kristofer, et al.
(author)
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The role of therapeutic alliance in blended treatment for depression
- 2017
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Conference paper (peer-reviewed)abstract
- Introduction: Blended Cognitive Behaviour Therapy (bCBT) uses a combination of face-to-face sessions and online material, such as self-help modules, and can be used in the treatment of depression. The blended format has the potential of integrating internet-based components into treatment without completely removing the traditional face-to-face setting. This way of delivery can lower the threshold when it comes to using digital components in CBT. The role of therapeutic alliance in this format is yet to be explored, specifically the role of therapist rated alliance, as most studies only include patient rated measurements of alliance. Methods: Working alliance and depression ratings from 73 participants in a study on bCBT for depression (part of the E-COMPARED project) was analysed using growth curve models. Results: High ratings for both patient-and therapist rated working alliance were found. Therapist rated alliance predicted a positive change (decreased PHQ-9 scores) in depression during treatment. Discussion: Ratings of therapeutic alliance was similar to what have been seen in face-to-face and internet-based treatment. Patient rated alliance could not predict change rate in depression, which is a common finding in ICBT-studies. However, therapist rated alliance had a significant correlation with change rate and predicted a decrease in depression during treatment. These results sheds more light on the concept and role of therapeutic alliance in internet-based and blended treatments.
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