scholarly journals Effectiveness of small group cognitive behavioural therapy for anxiety and depression in Ebola treatment centre staff in Sierra Leone

Author(s):  
Charles L. Cole ◽  
Samantha Waterman ◽  
Elaine Catherine Margaret Hunter ◽  
Vaughan Bell ◽  
Neil Greenberg ◽  
...  
2021 ◽  
Author(s):  
Alissa Pencer ◽  
Victoria C. Patterson ◽  
Meghan A. Rossi ◽  
Lori Wozney

BACKGROUND Internet-based cognitive-behavioural therapy (iCBT) is a necessary step towards increasing the accessibility of mental health services. Yet, few iCBT programs have been evaluated for their fidelity to therapeutic principles of CBT or usability standards. Additionally, many existing iCBT programs do not include treatments targeting both anxiety and depression – commonly co-occurring conditions. OBJECTIVE Evaluate the usability and fidelity of Tranquility, a novel iCBT program for anxiety, to CBT principles, and engage in a co-design process to adapt Tranquility to include treatment elements for depression. METHODS CBT experts (n = 6) and mental health informed peers (n = 6) reviewed the iCBT program Tranquility. CBT experts assessed Tranquility’s fidelity to CBT principles and were asked to identify necessary interventions for depression using two simulated client case examples. Mental health informed peers engaged in two co-design focus groups to discuss adaptations to the existing anxiety program and the integration of interventions for depression. Both groups completed online surveys assessing Tranquility’s usability and the likelihood that they would recommend the program. RESULTS CBT experts’ mean rating of Tranquility’s fidelity to CBT was 91%, indicating a high fidelity to CBT. Five out of six CBT experts and all mental health informed peers (88% of participants) rated Tranquility as satisfactory, indicating that they may recommend Tranquility to others, and they rated its usability highly (M = 76.56, SD = 14.07). Mental health informed peers provided suggestions about how to leverage engagement with Tranquility (e.g., add incentives, notification control). CONCLUSIONS This preliminary study demonstrated Tranquility’s strong fidelity to CBT and usability standards. Results highlight the importance of involving stakeholders in the co-design process and future opportunities to increase engagement.


2018 ◽  
Vol 4 (4) ◽  
pp. 00094-2018 ◽  
Author(s):  
Karen Heslop-Marshall ◽  
Christine Baker ◽  
Debbie Carrick-Sen ◽  
Julia Newton ◽  
Carlos Echevarria ◽  
...  

Anxiety is an important comorbidity in chronic obstructive pulmonary disease (COPD). We investigated if cognitive behavioural therapy (CBT), delivered by respiratory nurses, reduced symptoms of anxiety and was cost-effective.Patients with COPD and anxiety were randomised to CBT or self-help leaflets. Anxiety, depression and quality of life were measured at baseline, 3, 6 and 12 months. A cost-effectiveness analysis was conducted from a National Health Service hospital perspective and quality-adjusted life-years estimated using the EuroQol-5D questionnaire.In total, 279 patients were recruited. Group mean change from baseline to 3 months in the Hospital Anxiety and Depression Anxiety Subscale was 3.4 (95% CI 2.62–4.17, p<0.001) for the CBT group and 1.88 (95% CI 1.19–2.55, p<0.001) in the leaflet group. The CBT group was superior to leaflets at 3 months (mean difference in the Hospital Anxiety and Depression Anxiety Subscale was 1.52, 95% CI 0.49–2.54, p=0.003). Importantly, the CBT intervention was more cost-effective than leaflets at 12 months, significantly lowering hospital admissions and attendance at emergency departments.CBT delivered by respiratory nurses is a clinically and cost-effective treatment for anxiety in patients with COPD relative to self-help leaflets.


2019 ◽  
pp. 204946371989580
Author(s):  
Dianne Wilson ◽  
Shylie Mackintosh ◽  
Michael K Nicholas ◽  
G Lorimer Moseley ◽  
Daniel S J Costa ◽  
...  

This study explored whether the psychological composition of a group, with respect to mood, catastrophising, fear of movement and pain self-efficacy characteristics at baseline, is associated with individuals’ treatment outcomes following group cognitive behavioural therapy (CBT)-based programmes for chronic pain. Retrospective analyses of outcomes from two independently run CBT-based pain management programmes (Programme A: N = 317 and Programme B: N = 693) were conducted. Mixed modelling analyses did not consistently support the presence of associations between group median scores of depression, catastrophising or fear avoidance with outcomes for individuals in either programme. These results suggest that the psychological profiles of groups are not robust predictors of individual outcomes in CBT groups for chronic pain. By implication, efforts made to consider group composition with respect to psychological attributes may be unnecessary.


2006 ◽  
Vol 189 (6) ◽  
pp. 527-532 ◽  
Author(s):  
Christine Barrowclough ◽  
Gillian Haddock ◽  
Fiona Lobban ◽  
Steve Jones ◽  
Ron Siddle ◽  
...  

BackgroundThe efficacy of cognitive–behavioural therapy for schizophrenia is established, but there is less evidence for a group format.AimsTo evaluate the effectiveness of group cognitive – behavioural therapy for schizophrenia.MethodIn all, 113 people with persistent positive symptoms of schizophrenia were assigned to receive group cognitive – behavioural therapy or treatment as usual. The primary outcome was positive symptom improvement on the Positive and Negative Syndrome Scales. Secondary outcome measures included symptoms, functioning, relapses, hopelessness and self-esteem.ResultsThere were no significant differences between the cognitive-behavioural therapy and treatment as usual on measures of symptoms or functioning or relapse, but group cognitive – behavioural therapy treatment resulted in reductions in feelings of hopelessness and in low self-esteem.ConclusionsAlthough group cognitive – behavioural therapy may not be the optimum treatment method for reducing hallucinations and delusions, it may have important benefits, including feeling less negative about oneself and less hopeless for the future.


2019 ◽  
Vol 27 (3) ◽  
pp. 258-268 ◽  
Author(s):  
Selina K Berg ◽  
Trine B Rasmussen ◽  
Margrethe Herning ◽  
Jesper H Svendsen ◽  
Anne V Christensen ◽  
...  

Aim The aim of this study was to investigate the effect of a cognitive behavioural therapy intervention provided by trained cardiac nurses plus usual care compared with usual care alone in patients with an implanted cardioverter defibrillator who, prior to randomization, had presented with symptoms of anxiety measured by the Hospital Anxiety and Depression Scale. Background Around 20–25% of all patients with an implanted cardioverter defibrillator experience anxiety. Among these patients anxiety is associated with mortality, presumably explained by risk behaviour and activation of the autonomic nervous system. We hypothesised that cognitive behavioural therapy provided by cardiac nurses in an out-patient setting would be an effective treatment of anxiety. Methods This was an investigator-initiated randomised clinical superiority trial with blinded outcome assessment, with 1:1 randomisation to cognitive behavioural therapy plus usual care or to usual care. The primary outcome was Hospital Anxiety and Depression Scale-Anxiety mean score at 16 weeks. Secondary outcomes included Hospital Anxiety and Depression Scale-Depression, Becks Anxiety Inventory, HeartQoL and Hamilton Anxiety Scale. Primary outcome analysis was based on the intention-to-treat principle. Results A total of 88 participants were included, 66% men, mean age 64.3 years and 61% had primary indication implantable cardioverter defibrillator. A significant difference after 16 weeks was found between groups: intervention group (Hospital Anxiety and Depression Scale-A mean (standard deviation) 4.95 points (3.30) versus usual care group 8.98 points (4.03) ( p < 0.0001)). Cohen's d was –0.86, indicating a strong clinical effect. The effect was supported by secondary outcomes. Conclusion Cognitive behavioural therapy provided by cardiac nurses to patients with a positive screening for anxiety had a statistically and clinically significant effect on anxiety compared with patients not receiving cognitive behavioural therapy.


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