Use and acceptability of unsupported online computerized cognitive behavioral therapy for depression and associations with clinical outcome

Graaf, L. Esther de; Huibers, Marcus J.H.; Riper, Heleen; Gerhards, S.A.H.; Arntz, Arnoud

doi:10.1016/j.jad.2008.12.009

Cited by 77 publications

(72 citation statements)

References 25 publications

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“…It should be noted here that measures of adherence vary across studies, which influences comparability. A possible explanation for low adherence in this trial lies in the absence of guidance, as poorer adherence has previously been reported for unguided web-based treatment trials (de Graaf et al, 2009;Kenwright et al, 2005). In addition, elements inherent to the target population may play a role.…”

Section: Discussionmentioning

confidence: 86%

Online self-help for suicidal thoughts: 3-month follow-up results and participant evaluation

Spijker

Straten

Kerkhof

2015

Internet Interventions

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a b s t r a c tBackground: As a substantial proportion of people with suicidal thoughts does not receive treatment, the internet can be a utilized to reach more people who need support. Aims: To examine maintenance of effects of online self-help for suicidal thoughts at 3-month follow-up within the intervention group of a randomized controlled trial (of which between-group 6-week post-test results have previously been reported, showing a small effect of 0.28 for suicidal thoughts in favour of the intervention group), and to investigate acceptability of the intervention through participant evaluation. Methods: 236 adults with mild to moderate suicidal thoughts were randomized to the intervention (n = 116) or a waitlist control group (n = 120). Assessments took place at baseline, post-test (6 weeks later), and follow-up (3 months after post-test). This paper reports on the intervention group and follow-up assessment only. Results: Effects established at 6-week post-test were generally maintained at 3-month follow-up in the intervention group. Participant evaluation revealed that a majority thought their suicidal thoughts had decreased during the study, that adherence to the intervention was below average, and that levels of satisfaction were acceptable. Limitations: The control group could not serve as a comparator as they had received access to the intervention at post-test. Conclusions: Effects of online self-help for suicidal thoughts can be maintained for up to three months. Participant evaluation indicated that online self-help for suicidal thoughts is acceptable, but there is also room for improvement.

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Section: Discussionmentioning

confidence: 86%

Online self-help for suicidal thoughts: 3-month follow-up results and participant evaluation

Spijker

Straten

Kerkhof

2015

Internet Interventions

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“…Fourthly, follow-up data were not included in our study and thus we were not able to examine predictors of long-term effectiveness of ICBT for social anxiety. Since an earlier study indicated that predictors for short-term and long-term improvements might be different [46], future studies should include more follow-up data and identify factors associated with maintenance of symptom improvement.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Treatment Outcomes and Adherence in Internet-based Cognitive Behavioral Therapy for Social Anxiety in China (Preprint)

Chen¹,

Rodriguez²,

Qian³

et al. 2018

Preprint

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Abstract:Background: Although internet-based cognitive behavior therapy (ICBT) is an effective treatment approach for social anxiety disorder (SAD), a substantial proportion of patients do not achieve clinically significant improvement. More research is needed to identify which factors predict treatment adherence and outcomes. Objective: The aims of this study were to (1) identify demographic and clinical factors that are associated with treatment adherence and outcomes in ICBT for social anxiety in China, (2) explore whether a low-intensity therapist support approach results in improved treatment adherence or outcomes and (3) adopt qualitative methods to explore motivating factors and barriers of adherence as well as other potentially enhancing strategies. Methods: Data were collected within the context of a previously published study, in which participants (N=255) were assigned to either therapist-guided ICBT (N=183) or self-guided ICBT (N=72) groups. The Chinese version of the Social Phobia Scale (SPS) and Social Interaction Anxiety Scale (SIAS) were completed at both pre-and post-treatment. Treatment adherence and outcomes were analyzed using a two-step linear and logistic regression approach. Clinical and demographic characteristics were examined. Qualitative data concerning motivating factors and barriers to adhere to ICBT were obtained. Results: No significant group differences were found for treatment adherence or outcomes (Ps > . 05). Participants diagnosed with Social Anxiety Disorder were significantly less likely to dropout (OR 0.531, P = .03). Furthermore, older participants (B = 0.17, SE = 0.04, P = .008) and participants with a diagnosis of SAD (B = 0.16, SE = 0.44, P = .01) tended to complete more modules. Participants who completed more modules (B = 0.24, SE = 0.03, P = .01) and participants who identified as female (B = -0.20, SE = 0.18, P = .04) reported greater improvements on the SIAS. Conclusions: Motivating factors and barriers to adherence, clinical implications, limitations, and future directions are discussed. Several recommendations are proposed for future research: (1) identify and evaluate more effective forms of low-intensity therapist support for enhancing treatment outcomes and adherence in ICBT for SAD; (2) include larger, more diverse samples; and (3) develop a coherent theoretical model of treatment adherence in online interventions.

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“…A recent study reported that CCBT is acceptable to clients and to professionals, and that it could play a valuable part in a stepped care system (MacGregor, Hayward, Peck, & Wilkes, 2009). Although CCBT is an effective treatment for depression, means to improve treatment adherence are needed to address high dropout rates (e.g., de Graaf, Huibers, Riper, Gerhards, & Arntz, 2009;Waller & Gilbody, 2009).…”

Section: Discussionmentioning

confidence: 99%

Patients' and providers' perspectives on bibliotherapy in primary care

McKenna

Hevey

Martin³

2010

Clin Psychology and Psychoth

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Bibliotherapy is a form of self-administered treatment in which structured materials provide a means to alleviate distress. Although the treatment has evidence of effectiveness, evaluations of bibliotherapy have typically focused on outcomes, and the perspectives of both the client and the service provider have been understudied. In the present study, eleven users of a bibliotherapy scheme were interviewed regarding their experiences of bibliotherapy. In addition, five referring practitioners to the scheme were also interviewed. Thematic analyses revealed three super-ordinate themes in the transcripts: participants' personal experiences of the bibliotherapy scheme factors that facilitate change and the influence of the professionals involved. The implications of these findings for bibliotherapy schemes are considered.

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Use and acceptability of unsupported online computerized cognitive behavioral therapy for depression and associations with clinical outcome

Cited by 77 publications

References 25 publications

Online self-help for suicidal thoughts: 3-month follow-up results and participant evaluation

Online self-help for suicidal thoughts: 3-month follow-up results and participant evaluation

Predictors of Treatment Outcomes and Adherence in Internet-based Cognitive Behavioral Therapy for Social Anxiety in China (Preprint)

Patients' and providers' perspectives on bibliotherapy in primary care

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