scholarly journals Virtual reality-based cognitive behavioural therapy for patients with generalized social anxiety disorder: a pilot study

2019 ◽  
Vol 47 (6) ◽  
pp. 745-750 ◽  
Author(s):  
Chris N.W. Geraets ◽  
Wim Veling ◽  
Maartje Witlox ◽  
Anton B.P. Staring ◽  
Suzy J.M.A. Matthijssen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Virtual Reality ◽  
Social Anxiety ◽  
Social Activity ◽  
Behavioural Therapy ◽  
Post Treatment ◽  
Cognitive Behavioural

AbstractBackground:Patients with generalized social anxiety disorder (SAD) avoid various social situations and can be reluctant to engage in in vivo exposure therapy. Highly personalized practising can be required before patients are ready to perform in vivo exposure. Virtual reality-based therapy could be beneficial for this group.Aims:To assess the feasibility and potential effect of virtual reality-based cognitive behavioural therapy (VR-CBT) for patients with severe generalized SAD.Methods:Fifteen patients with generalized SAD attended up to 16 VR-CBT sessions. Questionnaires on clinical and functional outcomes, and diary assessments on social activity, social anxiety and paranoia were completed at baseline, post-treatment and at 6-months follow-up.Results:Two patients dropped out of treatment. Improvements in social anxiety and quality of life were found at post-treatment. At follow-up, depressive symptoms had decreased, and the effect on social anxiety was maintained. With respect to diary assessments, social anxiety in company and paranoia were significantly reduced by post-treatment. These improvements were maintained at follow-up. No increase was observed in social activity.Conclusions:This uncontrolled pilot study demonstrates the feasibility and treatment potential of VR-CBT in a difficult-to-treat group of patients with generalized SAD. Results suggest that VR-CBT may be effective in reducing anxiety as well as depression, and can increase quality of life.

A Cognitive-Behavioural, Group-Based Intervention for Social Anxiety in Schizophrenia

2000 ◽  
Vol 34 (5) ◽  
pp. 809-813 ◽  
Author(s):  
Stephen Halperin ◽  
Paula Nathan ◽  
Peter Drummond ◽  
David Castle
Keyword(s):  
Quality Of Life ◽  
Social Anxiety ◽  
Intervention Group ◽  
Behavioural Therapy ◽  
Control Group ◽  
Wait List ◽  
Wait List Control ◽  
Cognitive Behavioural

Objective: The objective of this study was to investigate the efficacy of group-based cognitive-behavioural therapy (CBT) for social anxiety in schizophrenia. Method: Patients with schizophrenia (20) with comorbid social anxiety were randomly assigned to the group-based CBT or wait-list control condition. Pre-, post- and 6-week follow-up ratings included measures of social anxiety and avoidance, mood and quality of life. Results: The intervention group improved on all outcome measures and the control group showed no change in symptomatology. Conclusions: Group-based CBT is effective in treating social anxiety in schizophrenia.

scholarly journals Therapist-guided internet-delivered cognitive–behavioural therapy supplemented with group exposure sessions for adolescents with social anxiety disorder: a feasibility trial

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018345 ◽  
Author(s):  
Martina Nordh ◽  
Sarah Vigerland ◽  
Lars-Göran Öst ◽  
Brjánn Ljótsson ◽  
David Mataix-Cols ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Behavioural Therapy ◽  
Social Anxiety Disorder ◽  
Behavioural Therapy ◽  
Post Treatment ◽  
Feasibility Trial ◽  
Cognitive Behavioural ◽  
Exposure Sessions

ObjectivesSocial anxiety disorder (SAD) is one of the most common psychiatric disorders in youth, with a prevalence of about 3%–4% and increased risk of adverse long-term outcomes, such as depression. Cognitive–behavioural therapy (CBT) is considered the first-line treatment for youth with SAD, but many adolescents remain untreated due to limited accessibility to CBT. The aim of this study was to develop and evaluate the feasibility and preliminary efficacy of a therapist-guided internet-delivered CBT treatment, supplemented with clinic-based group exposure sessions (BIP SOFT).DesignA proof-of-concept, open clinical trial with 6-month follow-up.ParticipantsThe trial was conducted at a child and adolescent psychiatric research clinic, and participants (n=30) were 13–17 years old (83% girls) with a principal diagnosis of SAD.Intervention12 weeks of intervention, consisting of nine remote therapist-guided internet-delivered CBT sessions and three group exposure sessions at the clinic for the adolescents and five internet-delivered sessions for the parents.ResultsAdolescents were generally satisfied with the treatment, and the completion rate of internet modules, as well as attendance at group sessions, was high. Post-treatment assessment showed a significant decrease in clinician-rated, adolescent-rated and parent-rated social anxiety (d=1.17, 0.85 and 0.79, respectively), as well as in general self-rated and parent-rated anxiety and depression (d=0.76 and 0.51), compared with pretreatment levels. Furthermore, 47% of participants no longer met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for SAD at post-treatment. At a 6-month follow-up, symptom reductions were maintained, or further improved, and 57% of participants no longer met criteria for SAD.ConclusionTherapist-guided and parent-guided internet-delivered CBT, supplemented with a limited number of group exposure sessions, is a feasible and promising intervention for adolescents with SAD.Trial registration numberNCT02576171; Results.

Effects of brief mindfulness-based cognitive behavioural therapy on health-related quality of life and sense of coherence in atrial fibrillation patients

2018 ◽  
Vol 17 (7) ◽  
pp. 589-597 ◽  
Author(s):  
Dan Malm ◽  
Bengt Fridlund ◽  
Helena Ekblad ◽  
Patric Karlström ◽  
Emma Hag ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Sense Of Coherence ◽  
Behavioural Therapy ◽  
Health Related Quality ◽  
Cognitive Behavioural ◽  
Related Quality ◽  
Health Related

Background: The aim of this study was to evaluate the effects of a brief dyadic cognitive behavioural therapy (CBT) programme on the health-related quality of life (HRQoL), as well as the sense of coherence in atrial fibrillation patients, up to 12 months post atrial fibrillation. Methods: A longitudinal randomised controlled trial with a pre and 12-month post-test recruitment of 163 persons and their spouses, at a county hospital in southern Sweden. In all, 104 persons were randomly assigned to either a CBT ( n=56) or a treatment as usual (TAU) group ( n=55). The primary outcome was changes in the HRQoL (Euroqol questionnaire; EQ-5D), and the secondary outcomes were changes in psychological distress (hospital anxiety and depression scale; HADS) and sense of coherence (sense of coherence scale; SOC-13). Results: At the 12-month follow-up, the CBT group experienced a higher HRQoL than the TAU group (mean changes in the CBT group 0.062 vs. mean changes in the TAU group −0.015; P=0.02). The sense of coherence improved in the CBT group after the 12-month follow-up, compared to the TAU group (mean changes in the CBT group 0.062 vs. mean changes in the TAU group −0.16; P=0.04). The association between the intervention effect and the HRQoL was totally mediated by the sense of coherence ( z=2.07, P=0.04). Conclusions: A dyadic mindfulness-based CBT programme improved HRQoL and reduced psychological distress up to 12 months post atrial fibrillation. The sense of coherence strongly mediated the HRQoL; consequently, the sense of coherence is an important determinant to consider when designing programmes for atrial fibrillation patients.

scholarly journals Combining escitalopram and cognitive–behavioural therapy for social anxiety disorder: Randomised controlled fMRI trial

2016 ◽  
Vol 209 (3) ◽  
pp. 229-235 ◽  
Author(s):  
Malin Gingnell ◽  
Andreas Frick ◽  
Jonas Engman ◽  
Iman Alaie ◽  
Johannes Björkstrand ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Behavioural Therapy ◽  
Social Anxiety Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Behavioural Therapy ◽  
Post Treatment ◽  
Cognitive Behavioural ◽  
Amygdala Reactivity

BackgroundSelective serotonin reuptake inhibitors (SSRIs) and cognitive–behavioural therapy (CBT) are often used concomitantly to treat social anxiety disorder (SAD), but few studies have examined the effect of this combination.AimsTo evaluate whether adding escitalopram to internet-delivered CBT (ICBT) improves clinical outcome and alters brain reactivity and connectivity in SAD.MethodDouble-blind, randomised, placebo-controlled neuroimaging trial of ICBT combined either with escitalopram (n = 24) or placebo (n = 24), including a 15-month clinical follow-up (trial registration: ISRCTN24929928).ResultsEscitalopram+ICBT, relative to placebo+ICBT, resulted in significantly more clinical responders, larger reductions in anticipatory speech state anxiety at post-treatment and larger reductions in social anxiety symptom severity at 15-month follow-up and at a trend-level (P = 0.09) at post-treatment. Right amygdala reactivity to emotional faces also decreased more in the escitalopram+ICBT combination relative to placebo+ICBT, and in treatment responders relative to non-responders.ConclusionsAdding escitalopram improves the outcome of ICBT for SAD and decreased amygdala reactivity is important for anxiolytic treatment response.

Accelerated Outpatient Individual Cognitive Behavioural Therapy for Social Anxiety Disorder: A Preliminary Pilot Study

2018 ◽  
Vol 46 (6) ◽  
pp. 690-705 ◽  
Author(s):  
Bethany M. Wootton ◽  
Alexandra Hunn ◽  
Annabelle Moody ◽  
Bethany R. Lusk ◽  
Valerie A. Ranson ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Behavioural Therapy ◽  
Social Anxiety Disorder ◽  
Group Treatment ◽  
Preliminary Investigation ◽  
Behavioural Therapy ◽  
Post Treatment ◽  
Cognitive Behavioural

Background: Social anxiety disorder (SAD) is a common and chronic mental health condition. Given the significant prevalence and impairment caused by SAD, it is important to investigate novel ways to improve the efficacy of cognitive behavioural therapy (CBT) for SAD. One approach may be to provide CBT in an accelerated fashion, which involves multiple sessions per week. Such accelerated treatments have been shown to be effective in other anxiety disorders, but in SAD this accelerated treatment has only been studied in a group treatment format. Aims: The aim of this study was to provide a preliminary investigation of the efficacy of individual accelerated CBT (aCBT) in the treatment of SAD. Method: The studied utilized an open trial design. Seventeen participants commenced the treatment, which consisted of 12 sessions delivered over 4 weeks. Results: The results indicated that participants obtained moderate to large effect sizes on measures of SAD at post-treatment (range d = 0.76–0.92) and 3-month follow-up (range d = 1.31–1.79). In addition, at post-treatment, 59% of participants no longer met criteria for SAD, and this number increased to 71% at 3-month follow-up. Conclusions: The results provide preliminary evidence to suggest that individual aCBT may be an important treatment option for individuals with SAD.

scholarly journals A Tailored, Therapist-Guided Internet-Based Cognitive Behavioral Intervention as an Addition to Care as Usual for Patients With Rheumatoid Arthritis: Economic Evaluation alongside an RCT (Preprint)

2018 ◽  
Author(s):  
Maaike Ferwerda ◽  
Sylvia van Beugen ◽  
Henriët van Middendorp ◽  
Henk Visser ◽  
Harald Vonkeman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Usual Care ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Healthcare Use ◽  
Cognitive Behavioural ◽  
Related Quality ◽  
Health Related

BACKGROUND A chronic somatic condition, such as rheumatoid arthritis (RA), can significantly reduce health related quality of life due to psychological, social and physical consequences. Cognitive behavioural therapy can aid in improving outcomes for patients, for example in terms of disease trajectory, health care utilization, and workplace disability of patients. In recent years internet-based cognitive behavioural therapy has been proposed as an effective and efficient way to offer cognitive behavioural therapy and further implementation. However, little research has been conducted to support this proposition. OBJECTIVE To stimulate the implementation of effective treatment strategies for improving health-related quality of life (HRQoL) of patients with rheumatoid arthritis (RA), cost-benefit ratios are required to inform stake-holders. A cost-effectiveness study from a societal perspective was conducted alongside a randomized controlled trial on a tailored and therapist-guided internet-based cognitive behavioural intervention (ICBT) for patients with elevated levels of distress, as an addition to usual care alone. METHODS Data were collected at baseline/pre-intervention, 6 months/post-intervention, and three-monthly thereafter during one year follow-up. Effects were measured in quality-adjusted life years (QALYs) and costs from a societal perspective including healthcare sector costs (including healthcare use, medication, and intervention costs), patient travel costs for healthcare use, and costs associated with loss of labor. RESULTS The intervention improved quality of life compared to usual care alone (Δ QALYs= 0.059), but also led to higher costs (Δ= € 4.211,44), which reduced substantially when medication costs were left out of the equation (Δ= € 1.862,72). Most (93%) of the simulated ICERS were in the north-east quadrant, suggesting a high probability that the intervention is effective in improving HRQoL, but at a greater monetary cost for society compared to usual care alone. CONCLUSIONS A tailored and guided ICBT intervention as an addition to usual care for patients with RA with heightened distress was effective in gaining quality of life. Consequently, implementation of the ICBT into standard healthcare for patients with RA is recommended, yet further study into cost reductions in this population is warranted. CLINICALTRIAL National trial registry number:NTR2100

Feasibility trial of virtual reality exposure therapy for selective mutism

2021 ◽  
pp. 135910452110569
Author(s):  
Yi Ren Tan ◽  
Yoon Phaik Ooi ◽  
Rebecca P Ang ◽  
Dion H Goh ◽  
Clare Kwan ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Exposure Therapy ◽  
Selective Mutism ◽  
Behavioural Therapy ◽  
Feasibility Trial ◽  
Virtual Reality Exposure Therapy ◽  
Cognitive Behavioural ◽  
Evidence Based Care ◽  
Virtual Reality Exposure

Virtual reality exposure therapy (VRET) has been commonly utilised as an extension of cognitive behavioural therapy (CBT). However, most studies examined its effectiveness among adults, with no study focusing on children with selective mutism (SM). We aimed to examine its feasibility and acceptability among children with SM. Twenty children aged 6–12 with SM diagnosis were recruited and completed six therapist-guided VRET sessions. Parents and clinicians completed measures at pre-VRET, post-VRET, 1-month and 3-month follow-up visits. At post-VRET, parent and child participants completed the acceptability questionnaires. Findings suggested the feasibility of VRET as all participants completed the programme with no attrition. Parents and child participants also reported VRET to be an acceptable and effective treatment for SM. Significant improvement in overall functioning were found at post-treatment and follow-up measures, but there were no significant changes in parent-rated speech frequency and anxiety measures. These support the acceptability of VRET as an adjunct modality (and not substitute) of CBT in SM treatment. Future studies, with more robust experimental designs and larger sample sizes, can be conducted to confirm its efficacy. As technology becomes more sophisticated, tools such as virtual environments can be explored to enhance evidence-based care for children and their families.

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