Background Guided internet-based psychological interventions show substantial promise for expanding access to evidence-based mental health care. However, this can only be achieved if results of tightly controlled studies from the treatment developers can also be achieved in other independent settings. This dissemination depends critically on developing efficient and effective ways to train professionals to deliver these interventions. Unfortunately, descriptions of therapist training and its evaluation are often limited or absent within dissemination studies. Objective This study aimed to describe and evaluate a program of therapist training to deliver internet-based Cognitive Therapy for social anxiety disorder (iCT-SAD). As this treatment was developed in the United Kingdom and this study was conducted in Hong Kong with local therapists, an additional objective was to examine the feasibility, acceptability, and initial efficacy of iCT-SAD in this cultural context, based on data from a pilot case series. Methods Training in iCT-SAD was provided to 3 therapists and included practice of the face-to-face format of therapy under clinical supervision, training workshops, and treating 6 patients with the iCT-SAD program. Training progress was evaluated using standardized and self-report measures and by reviewing patient outcomes. In addition, feedback from patients and therapists was sought regarding the feasibility and acceptability of the program. Results The training program was effective at increasing therapists’ iCT-SAD knowledge and skills, resulting in levels of competence expected of a specialist Cognitive Behavioral Therapy practitioner. The 6 patients treated by the trainees all completed their treatment and achieved a mean pre- to posttreatment change of 53.8 points (SD 39.5) on the primary patient outcome measure, the Liebowitz Social Anxiety Scale. The within-group effect size (Cohen d ) was 2.06 (95% CI 0.66-3.46). There was evidence to suggest that the patients’ clinical outcomes were sustained at 3-month follow-up. These clinical results are comparable to those achieved by UK patients treated by the developers of the internet program. Patient and therapist feedback did not identify any major cultural barriers to implementing iCT-SAD in Hong Kong; some modest language suggestions were made to assist understanding. Conclusions The therapist training implemented here facilitated the successful dissemination of an effective UK-developed internet intervention to Hong Kong. The treatment appeared feasible and acceptable in this setting and showed highly promising initial efficacy. A randomized controlled trial is now required to examine this more robustly. As therapist training is critical to the successful dissemination of internet interventions, further research to develop, describe, and evaluate therapist training procedures is recommended.

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Background Given the absence of a brief scale that reconciles and encompasses different conceptual definitions of well-being (physical, psychological, social and spiritual), the present research aimed at developing and validating a Comprehensive Well-Being Scale (CWBS) that encompasses these different conceptual definition and extend the definition of well-being to transcendental well-being among individuals in recovery of mental illness. The present research focuses on testing the scale among people in recovery of mental illness so that a brief and theoretically comprehensive scale would be available for mental health organization to evaluate the well-being of service users, and to develop and evaluate well-being related services. Methods A 56-item preliminary well-being scale was developed by a professional panel. In Study 1, 300 mental health service users in Hong Kong were recruited. Twenty items were selected through principal component analysis to form the CWBS. In Study 2, another sample of 300 service users was recruited. Confirmatory factor analysis was done to confirm a two-factor structure. Validity of the scale was also examined. Results The CWBS yielded good internal consistency (Cronbach’s alphas = .79–.91). The finding supported a two-factor structure, namely Intrapersonal Well-Being, and Transpersonal Well-Being, χ2 (169) = 335.61, p < .001, CFI = .90, RMSEA = .06, SRMR = .06. Conclusions The CWBS established concurrent and construct validity in assessing well-being among Chinese in recovery of mental illness in Hong Kong. It provided theoretical and practical implications for measuring well-being. Theoretically, it extended the concept of well-being to encompass transcendental well-being in model of recovery among individuals recovery from mental illness. Practically, it provided a tool for evaluation of well-being and service development in mental health organization.

Background: To cope with the rising demand for psychological treatment, evidence-based low-intensity cognitive behavioural therapy (LiCBT) delivered by trained para-professionals was introduced internationally. Aims: This pilot study aimed at examining the effectiveness of LiCBT in Hong Kong. Method: This study was of an uncontrolled pre- and post-treatment design, testing LiCBT at a local community mental health centre in Hong Kong. Two hundred and eighty-five Chinese adult help-seekers to the centre attended two or more sessions of LiCBT delivered by trained para-professionals. These participants also rated their depression and anxiety on the Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder Scale-7 (GAD-7), respectively, at pre- and post-treatment. Results: Comparison of the pre- and post-treatment PHQ-9 and GAD-7 scores of 285 participants indicated significant improvements in depression and anxiety with large effect sizes (depression: d = 0.87; anxiety: d = 0.95). For those participants reaching the clinical level of either depression and/or anxiety at pre-treatment (n = 229, 80.4%), they reported even larger effect sizes (depression: d = 1.00; anxiety: d = 1.15). The recovery rate was 55.9% with a reliable improvement rate of 63.9%. An average of 5.6 sessions was offered to the participants with each session spanning a mean of 42 minutes. The baseline clinical conditions and participants’ educational level were predictive of post-treatment recovery. Conclusions: The results supported the effectiveness and cost-efficiency of LiCBT for depression and anxiety at a Hong Kong community mental health centre. The effect sizes and the recovery and reliable improvement rates achieved were comparable to those reported from countries such as the UK and Australia.

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