Introduction:Menopause has been associated with elevated risk of mood disturbances. This relationship has been attributed to a number of factors including alterations in hormone levels, psychosocial factors, and insomnia associated with menopause. While cognitive behavioral therapy for insomnia (CBT-I) has been shown to also reduce depression in the general population, the effectiveness of CBT-I in reducing depression associated with menopause has not been tested. Methods: 122 females with insomnia concurrent with menopause were randomized into three conditions: CBT-I (N=41), Sleep Restriction Therapy (SRT, N=41) and an Information-only control condition (IC, N=40). Outcome measures included Insomnia Severity Index (ISI), and Beck Depression Inventory (BDI-II; sans sleep items). All measures were conducted pre-, post-treatments, and at 6 months follow-up. Results: dCBT-I resulted in a robust significant improvement in ISI (-8.2 ± 5.3 points) compared to control (-4.0 ± 4.2 points). The post-treatment remission rate (ISI≤10) was significantly greater in the dCBT-I condition (67.1%) compared to the control group (33.7%; p<.01). Similar results were observed for depression symptoms, with the dCBT-I condition exhibiting decreased depression severity (-3.0 ± 4.1 points, from 7.2 ± 4.2 pre-treatment) compared to the control condition (-1.2 ± 3.2 points, from 7.1 ± 3.9 pre-treatment, p<.01). Whereas depression rates (QIDS≥10) were comparable between conditions at pre-treatment (control: 28.3%; dCBT-I: 24.0%, p>.05), the dCBT-I condition exhibited a significantly lower rate of clinically significant depression at post-treatment (8.2%) compared to the control group (19.0%, p<.01). Results stratified by demographics indicated that dCBT-I yielded a near identical and significant decrease in both insomnia and depression symptom severity across all demographic groups. Conclusion: Findings from this study provide evidence for the effectiveness of CBT-I for insomnia associated with menopause, and also suggest its potential for reducing concurrent depression. Furthermore, gains in depression symptoms appear to be sustained up to 6 months following CBT-I, and may also continue to decrease over time.
Cancer patients, survivors, and their families have significant needs for 1) information about diagnosis and treatment, 2) help with symptom management, 3) communication and coordination of care, and 4) prevention and surveillance of further problems. Provision of cancer-related information helps patients and their families to accept their diagnosis, improve symptom management and treatment compliance, and reduce anxiety and uncertainty, thus increasing overall quality of life. Our research team has designed a web portal to serve as the application architecture for online access to evidencebased cancer information and interactive interventions. In this seminar, we will share the results of our research and discuss implications for practice.Peer support is an evidence-based approach for chronic disease prevention and control. However, models of peer support differ on important dimensions including how peer supporters are identified, whether they are paid or volunteer, and how peer support is delivered and tracked. With a background of common core functions of peer support (assistance in daily behavior, social/emotional support, linkage to clinical care, ongoing support), this seminar will teach participants how to design feasible and effective peer support programs through key tasks of identifying, recruiting, training, and tracking peer supporters. Instructors will draw on their experiences with multi-ethnic populations and programs based in communities and health centers in Alabama, California, and Michigan as part of Peers for Progress, an international program of the American Academy of Family Physicians Foundation to promote peer support in prevention and health care. Participants will learn about varied methods for identifying, recruiting, and selecting peer supporters and how these might differ based on cultural and contextual factors, including payment/incentive structure. Participants will receive examples of training materials and discuss how these materials were conceptualized from both a theoretical and practical perspective. Participants will also learn varied approaches to evaluating training outcomes, including methods to assess intervention fidelity during implementation. Concepts and strategies will be reinforced through case examples, simulations, and a hands-on exercise.This seminar will cover the application of Acceptance and Commitment Therapy (ACT) for individuals with a variety of health related problems (e.g. smoking, cancer, diabetes etc). ACT is based on the view that most psychological difficulties and suffering are a result of experiential avoidance and fusion with literal thinking getting in the way of value guided action and living. ACT teaches clients how to connect with their values, become more accepting of the world within (thoughts, memories, experiences, sensations etc) and move towards valued action and change in their lives. Concepts will be illustrated using live demonstrations, experiential exercises (acceptance, mindfulness, defusion), metaphors, and worksheets. This worksh...
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