Dissemination of computer-assisted cognitive-behavior therapy for depression in primary care

Antle, Becky F.; Owen, Jesse; Eells, Tracy D.; Wells, Michael J.; Harris, Lesley; Cappiccie, Amy; Wright, Brent D.; Williams, Stuart J.; Wright, Jesse H.

doi:10.1016/j.cct.2018.11.001

Cited by 14 publications

(9 citation statements)

References 41 publications

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“…CBT is recommended therapy for MDD with several pieces of evidence that diminish the uneasiness of social interaction and help the person to overcome emotional disturbance [21]. It effectively works face-to-face, applying a speci c agenda [22] and goal setting [18]. CBT provides psychoeducation, cognitive restructuring, identifying, evaluating and responding to automatic thoughts, emotions and beliefs using various techniques and homework assignments, yielding positive outcomes [23].…”

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Cognitive Behavior Therapy (CBT), Islam-Based Interventions (IBIs) and Pharmacotherapy (PTh) for Patients with Major Depressive Disorder-Mild (MDD-m): A Randomized Control Trial

Abbas

Shahbaz

Rauf³

et al. 2022

Preprint

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Background: Major depressive disorders (MDD) is common worldwide, and it causes significant functional impairment. Evidence-based therapies significantly address MDD symptoms severity; therefore, we aimed to investigate the effectiveness of pharmacotherapy (PTh), cognitive behaviour therapy (CBT), and Islam-based interventions (IBIs) to treat symptoms severity of patients MDD-m. Methods: This RCT was conducted by the Department of Applied Psychology, Government College University Faisalabad, from December 20, 2020, to October 31, 2021, at different hospitals in Faisalabad, Pakistan. Patients with MDD-m were allocated to three different evidence-based treatment approaches (i.e. PTh, CBT, & IBIs). Patients Health Questionnaire; Positive & Negative Affect Scale, Digit Span Scale, Standard Progressive Matrices, Self-Esteem Scale and Decision-Making Questionnaire were administered. SPSS version 27 was used to analyze the data. Results: A total of 210 were approached, 159 were assessed for eligibility, and 118 met the inclusion criteria, including males 66(55.94%) and females 52(44.06%) with the age range of 22 to 46 years. Findings reported all the treatment interventions produced significant treatment outcomes to reduce the depressive symptoms and improve memory, reasoning ability, decision-making skills, self-esteem, and wellbeing. PTh was an effective supportive intervention, while CBT and IBIs played an effective role as reeducative constructive therapies. Conclusion: All three interventions seem to be effective for major depressive disorder with mild severity, and CBT and IBIs emerged as more efficient and constructive therapies for MDD-m.

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Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Cognitive Behavior Therapy (CBT), Islam-Based Interventions (IBIs) and Pharmacotherapy (PTh) for Patients with Major Depressive Disorder-Mild (MDD-m): A Randomized Control Trial

Abbas

Shahbaz

Rauf³

et al. 2022

Preprint

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“…The web-based platform of the current edition of GDA is well suited to a range of remote applications and, since completing this study, our groups have gained extensive experience using telephone and videoconferencing. In our experience, both of these forms of support are judged to be useful by therapists and highly acceptable by depressed patients [44]. Other investigators have reported successful use of email or chat room support for delivery of CCBT [35].…”

Section: Discussionmentioning

confidence: 99%

Improving Cost-effectiveness and Access to Cognitive Behavior Therapy for Depression: Providing Remote-Ready, Computer-Assisted Psychotherapy in Times of Crisis and Beyond

Thase

McCrone

Barrett

et al. 2020

Psychother Psychosom

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Introduction: There is growing evidence that computer-delivered or computer-assisted forms of cognitive behavior therapy (CCBT) are helpful, but cost-effectiveness versus standard therapies is not well established. Objective: To evaluate the cost-effectiveness of a therapist-supported method for CCBT in comparison to standard cognitive behavior therapy (CBT). Methods: A total of 154 drug-free major depressive disorder outpatients were randomly assigned to either 16 weeks of standard CBT (up to twenty 50-min sessions) or CCBT using the Good Days Ahead program (including up to 5.5 h of therapist contact). Outcomes were assessed at baseline, weeks 8 and 16, and at 3 and 6 months posttreatment. Economic analyses took into account the costs of services received and work/social role impairment. Results: In the context of almost identical efficacy, a form of CCBT that used only about one third the amount of therapist contact as conventional CBT was highly cost-effective compared to conventional therapy and reduced the adjusted cost of treatment by USD 945 per patient. Conclusions: A method of CCBT that blended internet-delivered modules and abbreviated therapeutic contact reduced the cost of treatment substantially without adversely affecting outcomes. Results suggest that use of this approach can more than double the access to CBT. Because clinician support in CCBT can be provided by telephone, videoconference, and/or email, this highly efficient form of treatment could be a major advance in remote treatment delivery.

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“…If patients met exclusion criteria not requiring an evaluation with the Mini International Diagnostic Interview (MINI), 35 they were not assessed further with the MINI and the reading subtest of the Wide Range Achievement Test (WRAT). 36 Exclusion criteria were (1) PHQ-9 score less than 10; (2) refusal to provide informed consent; (3) aged 17 years or younger; 4) selfreport of inability to read English; (5) significant suicidal risk found on CSSRS (Antle et al 32 ); (6) severe medical disorders that would interfere with CCBT (eg, liver failure, terminal cancer); (7) dementia or other organic brain disorders; and (8) MINI diagnosis of psychotic disorder or bipolar disorder. During the first 6 months of recruitment, patients were excluded for scoring less than a ninth-grade level on the WRAT reading test.…”

Section: Study Design Setting and Participantsmentioning

confidence: 99%

“…Concerns regarding previous CCBT research include potential bias of recruitment strategies (eg, online advertisements, requirement for internet access) that preferentially select those with high levels of education and computer skills, limited inclusion of persons with lower income and lack of internet access, and insufficient attention to implementation issues. [29][30][31][32] The objectives of the current investigation were to (1) evaluate the effectiveness of CCBT compared with treatment as usual (TAU) in primary care patients with depression; (2) evaluate the feasibility of CCBT in a primary care population with substantial numbers of patients with low levels of education, reading skills, and/or internet access: (3) perform an exploratory analysis of factors associated with differential treatment outcome; and (4) evaluate the medical care utilization costs of CCBT vs TAU. The economic analysis results will be reported separately.…”

Section: Introductionmentioning

confidence: 99%

Effect of Computer-Assisted Cognitive Behavior Therapy vs Usual Care on Depression Among Adults in Primary Care

et al. 2022

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IMPORTANCE Depression is a common disorder that may go untreated or receive suboptimal care in primary care settings. Computer-assisted cognitive behavior therapy (CCBT) has been proposed as a method for improving access to effective psychotherapy, reducing cost, and increasing the convenience and efficiency of treatment for depression.OBJECTIVES To evaluate whether clinician-supported CCBT is more effective than treatment as usual (TAU) in primary care patients with depression and to examine the feasibility and implementation of CCBT in a primary care population with substantial numbers of patients with low income, limited internet access, and low levels of educational attainment. DESIGN, SETTING, AND PARTICIPANTSThis randomized clinical trial included adult primary care patients from clinical practices at the University of Louisville who scored 10 or greater on the Patient Health Questionnaire-9 (PHQ-9) and were randomly assigned to CCBT or TAU for 12 weeks of active treatment. Follow-up assessments were conducted 3 and 6 months after treatment completion.

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Dissemination of computer-assisted cognitive-behavior therapy for depression in primary care

Cited by 14 publications

References 41 publications

WITHDRAWN: Cognitive Behavior Therapy (CBT), Islam-Based Interventions (IBIs) and Pharmacotherapy (PTh) for Patients with Major Depressive Disorder-Mild (MDD-m): A Randomized Control Trial

WITHDRAWN: Cognitive Behavior Therapy (CBT), Islam-Based Interventions (IBIs) and Pharmacotherapy (PTh) for Patients with Major Depressive Disorder-Mild (MDD-m): A Randomized Control Trial

Improving Cost-effectiveness and Access to Cognitive Behavior Therapy for Depression: Providing Remote-Ready, Computer-Assisted Psychotherapy in Times of Crisis and Beyond

Effect of Computer-Assisted Cognitive Behavior Therapy vs Usual Care on Depression Among Adults in Primary Care

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