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- Nordgreen, T, et al.
(författare)
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Guided self-help via internet for panic disorder: Dissemination across countries
- 2010
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Ingår i: COMPUTERS IN HUMAN BEHAVIOR. - : Elsevier Science B.V., Amsterdam.. - 0747-5632. ; 26:4, s. 592-596
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Tidskriftsartikel (refereegranskat)abstract
- Guided self-help via Internet is a promising way of treating panic disorder (PD). The present study examined the effects of a self-help program via Internet with weekly therapist contact for PD after disseminated to a new country. Predictors of outcome were also examined. The study was an open trial with 27 participants with PD with or without agoraphobia as their primary diagnose. Medium to large effects on PD-symptoms were reported after treatment and at 6 months follow-up, with smaller effects on secondary outcome measures, i.e. depression, interpersonal problems, and sleep problem. The attrition rate of 30% in present study was higher than in Swedish studies. Predictor analysis showed that participants with longer duration of PD-symptoms had less improvement on all outcome measurers, whereas higher age predicted more improvement. The guided self-help program remained effective when disseminated to a new country, but the high attrition rate needs to be addressed in future studies.
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| 2. |
- Nordgreen, T., et al.
(författare)
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Stepped care for social anxiety disorder or panic disorder : A randomised controlled trial
- 2017
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Konferensbidrag (refereegranskat)abstract
- 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.
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| 3. |
- Jakobsen, H., et al.
(författare)
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Guided Internet-based cognitive behavioral therapy for mild and moderate depression: A benchmarking study
- 2017
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Ingår i: Internet Interventions. - : Elsevier B.V.. - 2214-7829. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Major depression is among the most common and debilitating disorders worldwide, associated with large societal and individual costs. Effective treatments exist, but accessibility is scarce. Guided Internet-Based Cognitive Behavioral Therapy (guided iCBT) is a promising approach to reach more people in need of help. In the present pilot study, we investigated the outcome of a guided iCBT program for mild and moderate depression when disseminated from Sweden to Norway. The guided iCBT intervention was implemented within a university-based outpatient clinic by six student therapists under supervision. Twenty-two participants with mild and moderate depression were included in the study. Large treatment effects were found for depressive symptoms, whereas small to medium effects were observed for anxiety symptoms. More than half (55%) of the participants were classified as recovered at post-treatment and more than a third (41%) at follow-up. No participants had a significant deterioration from pre- to post-treatment, but two reported a significant deterioration from post-treatment to 6-month follow-up. Benchmarking the present results against those reported in the four original Swedish studies, we found that the treatment effect in the Norwegian study was slightly higher at post-treatment and slightly lower at 6-month follow-up compared to the outcome in the Swedish studies. The results should be interpreted with caution, as our sample was small and had no control group. � 2016 The Authors
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