Pathophysiology of Tinnitus and Evidence-Based Options for Tinnitus Management

2017 ◽  
Vol 2 (2) ◽  
pp. 157-168
Author(s):  
James A. Henry
Keyword(s):  
Mental Health ◽  
Cognitive Behavioral Therapy ◽  
Hearing Aids ◽  
Behavioral Therapy ◽  
Evidence Based ◽  
Sound Therapy ◽  
Starting Point ◽  
Evidence Based Guidelines ◽  
To Receive ◽  
Audiologic Evaluation

Tinnitus is the perception of sound that has no source outside of the head – it is a “phantom” sound. A great many people experience chronic tinnitus, which can be problematic to different degrees. To date, no cure for tinnitus has been discovered in spite of worldwide efforts from researchers studying the pathophysiological mechanisms of tinnitus. Until a cure is discovered, individuals whose tinnitus is bothersome have evidence-based options available. Tinnitus management is provided mainly by audiologists, otolaryngologists, and mental health (MH) providers. The starting point for most patients is to receive an audiologic evaluation. Audiologists can provide tinnitus counseling and fit hearing aids, both of which can be beneficial for tinnitus management. Patients with symptoms of secondary tinnitus (somatosounds) should be referred to an otolaryngologist for a medical examination. If further tinnitus-specific services are needed for primary (idiopathic) tinnitus, then MH providers can offer cognitive-behavioral therapy and audiologists can facilitate different approaches to sound therapy. It is essential for all providers to follow evidence-based guidelines when offering tinnitus management services.

Clinician-Reported Modification to a CBT Approach in Children’s Mental Health

2019 ◽  
Vol 28 (2) ◽  
pp. 104-113 ◽  
Author(s):  
Rosemary D. Meza ◽  
Nathaniel Jungbluth ◽  
Georganna Sedlar ◽  
Prerna Martin ◽  
Lucy Berliner ◽  
...  
Keyword(s):  
Mental Health ◽  
Cognitive Behavioral Therapy ◽  
Children And Adolescents ◽  
Behavioral Therapy ◽  
Evidence Based ◽  
Implementation Climate ◽  
Evidence Based Treatment ◽  
Training Post ◽  
The Impact ◽  
Client Needs

Examining the nature and determinants of evidence-based treatment (EBT) modification is an important step toward understanding the impact of modifications and informing modification guidelines. We examined the prevalence, types, reasons for, and predictors of clinician-reported modification to cognitive behavioral therapy (CBT) for children and adolescents. Ninety-eight clinicians trained in CBT completed surveys on their intent to modify CBT, perceptions of CBT characteristics, confidence in their ability to appropriately deliver CBT in complex clinical situations, and organizational EBT implementation climate post-training. Post-consultation, clinicians self-reported the types and reasons for modifications they performed. Ninety-three percent of clinicians reported they modified CBT, primarily with fewer than half of their clients. Client needs and clinician preference or style accounted for the highest proportion of modification reasons. The number of reported modifications performed was predicted by clinician confidence in their ability to deliver CBT appropriately ( b = .90, p = .01) and their intent to modify ( b = .55, p = .01).

Social media adaptation of the evidence-based Mothers and Babies group cognitive behavioral therapy intervention to prevent depression in perinatal youth: a qualitative study (Preprint)

2020 ◽  
Author(s):  
Anupa Gewali ◽  
Alana Lopez ◽  
Kristin Dachelet ◽  
Elise Healy ◽  
Marimirca Jean-Baptiste ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Media ◽  
Cognitive Behavioral Therapy ◽  
Healthcare Workers ◽  
Perinatal Depression ◽  
Behavioral Therapy ◽  
Evidence Based ◽  
Mental Wellness ◽  
Group Cbt ◽  
Media Group

BACKGROUND Adolescents and young adults age <25 (youth) are at higher risk of perinatal depression than older women and experience elevated barriers to in-person care. Digital platforms such as social media offer an accessible avenue to deliver group cognitive behavioral therapy (CBT) to perinatal youth. OBJECTIVE Our goal was to develop the IMAGINE intervention, a facilitated social media group CBT intervention to prevent perinatal depression in US youth, by adapting the Mothers and Babies (MB) course, an evidence-based in-person group CBT intervention. In order to inform this adaptation, we sought perspectives of youth and healthcare provider stakeholders on perinatal youth’s mental health needs and social media group design recommendations. We report findings from stakeholder interviews and document the IMAGINE adaptation process. METHODS We conducted 21 semi-structured in-depth individual interviews with 10 pregnant or postpartum youth age 14-24 and 6 healthcare workers. All interviews were recorded, transcribed, and analyzed using deductive and inductive approaches to characterize perceptions of challenges and facilitators to youth perinatal mental health. Using a human-centered design approach, stakeholder perspectives were incorporated into IMAGINE design. We classified MB adaptations to develop IMAGINE according to the Framework for Modification and Adaptation, reporting the nature, timing, reason and goal of the adaptations. RESULTS Youth and healthcare workers described stigma associated with young pregnancy and parenting, social isolation, and lack of material resources as significant challenges to youth mental wellness. They identified non-judgmental support, peer companionship, and access to step-by-step guidance as facilitators of youth mental wellness. They endorsed the utility of a social media group to prevent perinatal depression and recommended that IMAGINE facilitate peer support, deliver content asynchronously to accommodate varied schedules, use a confidential platform, and facilitate discussion of topics beyond the MB curriculum, such as navigating support resources or asking medical questions. IMAGINE was adapted from MB to accommodate stakeholder recommendations and facilitate transition to online delivery. Content was tailored to be multimodal (text, images and video) and language was shortened and simplified. All content was designed for asynchronous engagement and redundancy was added to accommodate intermittent access. Structure was loosened to allow the intervention facilitator to respond in real-time to youth topics of interest. A social media platform was selected that allows multiple conversation “channels” and conceals group member identity. All adaptations sought to preserve fidelity to MB core components. CONCLUSIONS Our findings highlight the impact of stigmatization of young pregnancy and social determinants of health on youth perinatal mental health. Stakeholders supported use of a social media group to create a supportive community and improve access to evidence-based depression prevention. Our study demonstrates how a validated intervention can be tailored to this unique group.

scholarly journals User Experience of Cognitive Behavioral Therapy Apps for Depression: An Analysis of App Functionality and User Reviews (Preprint)

2018 ◽  
Author(s):  
Katarzyna Stawarz ◽  
Chris Preist ◽  
Debbie Tallon ◽  
Nicola Wiles ◽  
David Coyle
Keyword(s):  
Mental Health ◽  
Cognitive Behavioral Therapy ◽  
User Experience ◽  
Behavioral Therapy ◽  
Well Being ◽  
Cognitive Behavioral ◽  
Evidence Based ◽  
User Reviews ◽  
Mental Well Being ◽  
Health And Well Being

BACKGROUND Hundreds of mental health apps are available to the general public. With increasing pressures on health care systems, they offer a potential way for people to support their mental health and well-being. However, although many are highly rated by users, few are evidence-based. Equally, our understanding of what makes apps engaging and valuable to users is limited. OBJECTIVE The aim of this paper was to analyze functionality and user opinions of mobile apps purporting to support cognitive behavioral therapy for depression and to explore key factors that have an impact on user experience and support engagement. METHODS We systematically identified apps described as being based on cognitive behavioral therapy for depression. We then conducted 2 studies. In the first, we analyzed the therapeutic functionality of apps. This corroborated existing work on apps’ fidelity to cognitive behavioral therapy theory, but we also extended prior work by examining features designed to support user engagement. Engagement features found in cognitive behavioral therapy apps for depression were compared with those found in a larger group of apps that support mental well-being in a more general sense. Our second study involved a more detailed examination of user experience, through a thematic analysis of publicly available user reviews of cognitive behavioral therapy apps for depression. RESULTS We identified 31 apps that purport to be based on cognitive behavioral therapy for depression. Functionality analysis (study 1) showed that they offered an eclectic mix of features, including many not based on cognitive behavioral therapy practice. Cognitive behavioral therapy apps used less varied engagement features compared with 253 other mental well-being apps. The analysis of 1287 user reviews of cognitive behavioral therapy apps for depression (study 2) showed that apps are used in a wide range of contexts, both replacing and augmenting therapy, and allowing users to play an active role in supporting their mental health and well-being. Users, including health professionals, valued and used apps that incorporated both core cognitive behavioral therapy and non-cognitive behavioral therapy elements, but concerns were also expressed regarding the unsupervised use of apps. Positivity was seen as important to engagement, for example, in the context of automatic thoughts, users expressed a preference to capture not just negative but also positive ones. Privacy, security, and trust were crucial to the user experience. CONCLUSIONS Cognitive behavioral therapy apps for depression need to improve with respect to incorporating evidence-based cognitive behavioral therapy elements. Equally, a positive user experience is dependent on other design factors, including consideration of varying contexts of use. App designers should be able to clearly identify the therapeutic basis of their apps, but they should also draw on evidence-based strategies to support a positive and engaging user experience. The most effective apps are likely to strike a balance between evidence-based cognitive behavioral therapy strategies and evidence-based design strategies, including the possibility of eclectic therapeutic techniques.

Mental Health Spillover Effects Among Cohabitating Caregivers of Sierra Leonean Youth Receiving a Cognitive Behavioral Therapy‐Based Intervention

2021 ◽  
Vol 56 (S2) ◽  
pp. 40-41
Author(s):  
Alethea Desrosiers ◽  
Carolyn Schafer ◽  
Jordan Freeman ◽  
Alpha Vandi ◽  
Miriam Hinton ◽  
...  
Keyword(s):  
Mental Health ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Spillover Effects ◽  
Cognitive Behavioral ◽  
Sierra Leonean

scholarly journals Brief Psychotherapy for Depression: A Systematic Review and Meta-Analysis

2012 ◽  
Vol 43 (2) ◽  
pp. 129-151 ◽  
Author(s):  
Jason A. Nieuwsma ◽  
Ranak B. Trivedi ◽  
Jennifer McDuffie ◽  
Ian Kronish ◽  
Dinesh Benjamin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Problem Solving ◽  
Cognitive Behavioral Therapy ◽  
Systematic Reviews ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Cognitive Behavioral ◽  
Evidence Based ◽  
Brief Psychotherapy ◽  
Problem Solving Therapy

Objective: Because evidence-based psychotherapies of 12 to 20 sessions can be perceived as too lengthy and time intensive for the treatment of depression in primary care, a number of studies have examined abbreviated psychotherapy protocols. The purpose of this study was to conduct a systematic review and meta-analysis to determine the efficacy of brief psychotherapy (i.e., < 8 sessions) for depression. Methods: We used combined literature searches in PubMed, EMBASE, PsycINFO, and an Internet-accessible database of clinical trials of psychotherapy to conduct two systematic searches: one for existing systematic reviews and another for randomized controlled trials (RCTs). Included studies examined evidence-based psychotherapy(s) of eight or fewer sessions, focused on adults with depression, contained an acceptable control condition, were published in English, and used validated measures of depressive symptoms. Results: We retained 2 systematic reviews and 15 RCTs evaluating cognitive behavioral therapy, problem-solving therapy, and mindfulness-based cognitive therapy. The systematic reviews found brief psychotherapies to be more efficacious than control, with effect sizes ranging from −0.33 to −0.25. Our meta-analysis found six to eight sessions of cognitive behavioral therapy to be more efficacious than control (ES −0.42, 95% CI −0.74 to −0.10, I2 = 56%). A sensitivity analysis controlled for statistical heterogeneity but showed smaller treatment effects (ES −0.24, 95% CI −0.42 to −0.06, I2 = 0%). Conclusions: Depression can be efficaciously treated with six to eight sessions of psychotherapy, particularly cognitive behavioral therapy and problem-solving therapy. Access to non-pharmacologic treatments for depression could be improved by training healthcare providers to deliver brief psychotherapies.

A Model for Sustaining Evidence-Based Practices in a Statewide System

2017 ◽  
Vol 98 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Jason M. Lang ◽  
Kellie G. Randall ◽  
Michelle Delaney ◽  
Jeffrey J. Vanderploeg
Keyword(s):  
Public Health ◽  
Cognitive Behavioral Therapy ◽  
Quality Indicators ◽  
Behavioral Therapy ◽  
Health Impact ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
The Public ◽  
The Past ◽  
Large Systems

Over the past 20 years, efforts have been made to broadly disseminate evidence-based practices (EBPs). However, the public health impact of EBPs has yet to be realized and most EBPs are not sustained. Few structured models exist for disseminating and sustaining EBPs across large systems. This article describes the EBP Dissemination and Support Center (DSC) model and how it was used to sustain trauma-focused cognitive behavioral therapy (TF-CBT) across Connecticut. More than 600 clinicians at 35 agencies have been trained and nearly all agencies have sustained TF-CBT for up to 9 years. More than 6,200 children have received TF-CBT and have shown improvements in outcomes and quality indicators. Recommendations are made for using or adapting the DSC model.

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