scholarly journals 1186 Developing And Testing A Web-based Provider Training For Cognitive Behavioral Therapy Of Insomnia

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A453-A453
Author(s):  
D Taylor ◽  
B Bunnell ◽  
C Calhoun ◽  
K Pruiksma ◽  
J Dietch ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Knowledge Acquisition ◽  
Mental Health Problems ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Provider Training ◽  
Web Based ◽  
Website Usability ◽  
Time Interaction ◽  
Beta Testing

Abstract Introduction Chronic insomnia is a common, debilitating disorder and a risk factor for significant medical morbidity, mental health problems, and workplace difficulties. Cognitive behavioral therapy for insomnia (CBT-I) is the gold standard treatment for insomnia. However, few providers are trained in CBT-I, in part due to a bottleneck in training availability and the time and cost associated with current training platforms. To address this training deficit, our team developed and evaluated CBTIweb.org, a web-based provider training course for CBT-I. Methods Feedback from alpha- and beta-testing of CBTIweb.org was collected and used to optimize course content and functionality. Then, a comparison study was conducted in which licensed providers were randomized to complete either the online CBTIweb.org course (n=21) or an in-person CBT-I training (n=23). During all phases of development, providers completed a Computer System Usability Questionnaire (CSUQ), investigator-developed website usability and content questionnaires, and pre/post-training competency assessments. Results Independent samples t-tests indicated significant improvements in CSUQ, and website usability and content questionnaires responses from alpha- to beta-testing (all ps < .05). Linear mixed-effects modeling revealed significant within-subject increases in knowledge acquisition (F(34.7) = 65.4, p < 0.001; baseline = 69% correct, post-training = 92% correct) when collapsed across in-person and web-based groups. The interaction group by time interaction was non-significant (F(34.7) = 1.7, p = 0.204), indicating similar gains in knowledge (i.e., equivalence) between the in-person and the CBTIweb.org training formats. Conclusion Alpha and beta testers of CBTIweb.org reported high levels of satisfaction while also noting areas for improvement, which were used to update the site. Findings suggest the final CBTIweb.org product successfully trained clinicians compared to an in-person workshop, given knowledge acquisition improvements. CBTIweb.org is an efficient and effective training platform for clinicians to gain knowledge and competence in the most effective treatment for insomnia. Support W81XWH-17-1-0165

scholarly journals Developing and Testing a Web-Based Provider Training for Cognitive Behavioral Therapy of Insomnia

2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 230-238
Author(s):  
Daniel J Taylor ◽  
Jessica R Dietch ◽  
Kristi Pruiksma ◽  
Casey D Calhoun ◽  
Melissa E Milanak ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Knowledge Acquisition ◽  
Behavioral Health ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Health Providers ◽  
Provider Training ◽  
Web Based ◽  
Satisfaction Questionnaire ◽  
Knowledge Gains

ABSTRACT Introduction Chronic insomnia is a common and debilitating disease that increases risk for significant morbidity and workplace difficulties. Cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment, but there is a critical lack of behavioral health providers trained in CBT-I because, in part, of a bottleneck in training availability and costs. The current project developed and evaluated a web-based provider training course for CBT-I: CBTIweb.org. Materials and Methods Subject matter experts developed the content for CBTIweb.org. Then, trainees completed alpha testing (n = 24) and focus groups, and the site was improved. Next, licensed behavioral health providers and trainees completed beta testing (n = 41) and the site underwent another round of modifications. Finally, to compare CBTIweb.org to an in-person workshop, licensed behavioral health providers were randomly assigned to CBTIweb.org (n = 21) or an in-person workshop (n = 23). All participants were CBT-I naïve and completed the following assessments: Computer System Usability Questionnaire, Website Usability Satisfaction Questionnaire, Website Content Satisfaction Questionnaire, and Continuing Education knowledge acquisition questionnaires. Results Alpha and beta testers of CBTIweb.org reported high levels of usability and satisfaction with the site and showed significant within-group knowledge acquisition. In the pilot comparison study, linear fixed-effects modeling on the pre-/postquestionnaires revealed a significant main effect for time, indicating a significant increase in knowledge acquisition from 69% correct at baseline to 92% correct at posttraining collapsed across in-person and CBTIweb.org groups. The interaction effect of Time by Condition was nonsignificant, indicating equivalence in knowledge gains across both groups. Conclusion CBTIweb.org appears to be an engaging, interactive, and concise provider training that can be easily navigated by its users and produce significant knowledge gains that are equivalent to traditional in-person workshops. CBTIweb.org will allow for worldwide dissemination of CBT-I to any English-speaking behavioral health providers. Future research will work on translating this training to other languages and extending this web-based platform to the treatment of other sleep disorders (e.g., nightmares) and populations (e.g., pediatric populations with insomnia).

361 Relative Effectiveness of Cognitive Behavioral Therapy and its Components in Improving Insomnia Symptoms in Older Adults

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A144-A144
Author(s):  
Kathleen O’Hora ◽  
Beatriz Hernandez ◽  
Laura Lazzeroni ◽  
Jamie Zeitzer ◽  
Leah Friedman ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Sleep Onset ◽  
Post Treatment ◽  
Cognitive Behavioral ◽  
Sleep Onset Latency ◽  
Significant Group ◽  
Time Interaction ◽  
Insomnia Symptoms

Abstract Introduction The prevalence of insomnia complaints in older adults is 30–48%, compared to 10–15% in the general population. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a first-line, non-pharmacological sleep treatment for Insomnia. However, the relative impact of Behavioral (BT) and Cognitive (CT) components compared to that of CBT-I in older adults is unknown. Methods 128 older adults with insomnia were randomized to receive CBT-I, BT, or CT. Sleep diaries and the Insomnia Severity Index (ISI) were collected pre- and post-treatment and at a 6-month follow-up. We conducted split-plot linear mixed models with age and sex as covariates to assess within and between subject changes to test effects of group, time, and their interaction on ISI, sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), time in bed (TIB), sleep efficiency (SE), and percent of treatment responders (ISI decrease>7) and remitters (ISI<8). Effect size (d) was calculated by dividing the difference between means by the root-mean-squared error of the mixed effects model. Results All treatments lead to a significant improvement across outcome measures at post-treatment (p’s<0.001) and 6-months (p’s<0.01), with the exception of TIB, response, and remission. For TIB, there was a significant Group x Time interaction (p<0.001): while all treatments significantly reduced TIB post-treatment relative to baseline, CBT-I (p<0.001,d=-2.26) and BT (p<0.001,d=-1.59) performed significantly better than CT (p=0.003, d=-0.68). In contrast, at 6-months CBT-I (p<0.001,d=-1.16) performed significantly better at reducing TIB than CT (p=0.195,d=-0.24) or BT (p=0.023,d=-0.61) relative to baseline. There was also a non-significant trend for a Group x Time interaction for remission status (p=0.062). Whereas, the percentage of remitters within all groups post-treatment did not differ from chance (p>0.234), at 6 months, the percentage of remitters was significantly higher than chance in CBT-I (73.63%,p=0.026) and BT (78.08%,p=0.012), but not CT (47.85%,p=0.826). There were no other significant time or interaction effects (all p>0.05). Conclusion CBT-I and its components are effective in improving subjective insomnia symptoms in older adults. Evidence suggests CBT-I may be superior to either CT or BT alone in improving TIB in older adults. Support (if any) NIMHR01MH101468; MIRECC at VAPAHCS

scholarly journals Development of an Internet-Based Cognitive Behavioral Therapy Self-Help Program for Arabic-Speaking Immigrants: Mixed-Methods Study (Preprint)

2018 ◽  
Author(s):  
Tomas Nygren ◽  
Matilda Berg ◽  
Ali Sarkohi ◽  
Gerhard Andersson
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Focus Groups ◽  
Health Care Providers ◽  
Mental Health Problems ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Cognitive Behavioral ◽  
Care Providers ◽  
Self Help ◽  
Arabic Speaking

BACKGROUND Recent years have seen an increase in Arabic-speaking immigrants in Sweden and other European countries, with research showing this group to suffer from elevated levels of various forms of psychological disorders. There is a lack of treatment options for immigrants with mild to moderate mental health problems, with barriers including lack of accessible services and concerns that problems will not be understood by health care providers. OBJECTIVE This study aims to describe the process of developing a transdiagnostic internet-based cognitive behavioral therapy self-help program in Arabic for mild to moderate symptoms of common psychological problems such as anxiety, depression, and insomnia. METHODS The iterative development process, including feedback from 105 pilot users as well as 2 focus groups, is described. RESULTS Overall, the modules were rated as acceptable by the pilot users, with overall ratings ranging from 3 to 4 points on average for the respective modules on a 5-point Likert scale. Feedback from the 2 focus groups was overall positive with regard to the content and structure of the program but also included suggestions for improving the Arabic translation as well as the usability of the material. CONCLUSIONS An internet-based self-help program that is deemed acceptable by an Arabic-speaking audience can be successfully developed, thus providing increased access to psychological help for an at-risk population. However, further research regarding the efficacy of this type of intervention is warranted.

A Systematic Meta-Review of Internet-Based Cognitive Behavioral Therapy (ICBT)

2018 ◽  
Author(s):  
Quincy J. J. Wong ◽  
Alison L. Calear ◽  
Helen Christensen
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Is Implementation ◽  
Treatment And Prevention ◽  
Meta Review ◽  
Adolescents And Adults ◽  
Meta Analyses

Internet-based cognitive behavioral therapy (ICBT) is the provision of cognitive behavioral therapy (CBT) using the Internet as a platform for delivery. The advantage of ICBT is its ability to overcome barriers to treatment associated with traditional face-to-face CBT, such as poor access, remote locations, stigmas around help-seeking, the wish to handle the problem alone, the preference for anonymity, and costs (time and financial). A large number of randomized controlled trials (RCTs) have tested the acceptability, efficacy, and cost-effectiveness of ICBT for anxiety disorders, mood disorders, and associated suicidality. A meta-review was conducted by searching PsycINFO and PubMed for previous systematic reviews and meta-analyses of ICBT programs for anxiety, depression, and suicidality in children, adolescents, and adults. The results of the meta-review indicated that ICBT is effective in the treatment and prevention of mental health problems in adults and the treatment of these problems in youth. Issues of adherence and privacy have been raised. However, the major challenge for ICBT is implementation and uptake in the “real world.” The challenge is to find the best methods to embed, deliver, and implement ICBT routinely in complex health and education environments.

scholarly journals Randomized Trial of Web-Based Training to Promote Counselor Use of Cognitive Behavioral Therapy Skills in Client Sessions

2013 ◽  
Vol 34 (2) ◽  
pp. 179-187 ◽  
Author(s):  
Mary Jo Larson ◽  
Maryann Amodeo ◽  
Joseph S. LoCastro ◽  
Jordana Muroff ◽  
Lauren Smith ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Randomized Trial ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Web Based

scholarly journals Patient Experiences of Web-Based Cognitive Behavioral Therapy for Heart Failure and Depression: Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Johan Lundgren ◽  
Peter Johansson ◽  
Tiny Jaarsma ◽  
Gerhard Andersson ◽  
Anita Kärner Köhler
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Depressive Symptoms ◽  
Cognitive Behavioral Therapy ◽  
Real Time ◽  
Behavioral Therapy ◽  
Theory And Practice ◽  
Cognitive Behavioral ◽  
Web Based ◽  
Patients With Heart Failure

BACKGROUND Web-based cognitive behavioral therapy (wCBT) has been proposed as a possible treatment for patients with heart failure and depressive symptoms. Depressive symptoms are common in patients with heart failure and such symptoms are known to significantly worsen their health. Although there are promising results on the effect of wCBT, there is a knowledge gap regarding how persons with chronic heart failure and depressive symptoms experience wCBT. OBJECTIVE The aim of this study was to explore and describe the experiences of participating and receiving health care through a wCBT intervention among persons with heart failure and depressive symptoms. METHODS In this qualitative, inductive, exploratory, and descriptive study, participants with experiences of a wCBT program were interviewed. The participants were included through purposeful sampling among participants previously included in a quantitative study on wCBT. Overall, 13 participants consented to take part in this study and were interviewed via telephone using an interview guide. Verbatim transcripts from the interviews were qualitatively analyzed following the recommendations discussed by Patton in Qualitative Research & Evaluation Methods: Integrating Theory and Practice. After coding each interview, codes were formed into categories. RESULTS Overall, six categories were identified during the analysis process. They were as follows: “Something other than usual health care,” “Relevance and recognition,” “Flexible, understandable, and safe,” “Technical problems,” “Improvements by real-time contact,” and “Managing my life better.” One central and common pattern in the findings was that participants experienced the wCBT program as something they did themselves and many participants described the program as a form of self-care. CONCLUSIONS Persons with heart failure and depressive symptoms described wCBT as challenging. This was due to participants balancing the urge for real-time contact with perceived anonymity and not postponing the work with the program. wCBT appears to be a valuable tool for managing depressive symptoms.

Effectiveness of Self-Guided Virtual Reality-based Cognitive Behavioral Therapy for Panic Disorder (Preprint)

2021 ◽  
Author(s):  
Bokyoung Shin ◽  
Jooyoung Oh ◽  
Byung-Hoon Kim ◽  
Hesun Erin Kim ◽  
Hyunji Kim ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Panic Disorder ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Mobile App ◽  
Cognitive Behavioral ◽  
Sensitivity Index ◽  
Time Interaction ◽  
Panic Symptoms ◽  
Distress Scale

BACKGROUND Virtual reality (VR) is an effective technique as a traditional cognitive behavioral therapy (CBT) and a promising tool for treating panic disorder (PD) symptoms because VR exposure can be safer, with higher acceptability, than in vivo exposure; it is more immersive than exposure through imagination. CBT techniques can be delivered more effectively using VR. Thus far, VR has required high quality devices; however, the development of mobile VR technology has improved users' availability. Meanwhile, a well-structured form of VR can be reproduced and used anywhere, which means that VR is appropriate for self–guided treatment to address the high-treatment costs of evidence–based therapy and the lack of professional therapists. This study investigates the potential of self-guided VR as an alternative to high-cost treatment. OBJECTIVE The study’s main goal is to offer data about the efficacy of the mobile app–based self-led VR CBT in the treatment of PD. METHODS 54 subjects with PD were enrolled and randomly assigned to either the VR treatment group or waitlist group. The VR treatment was designed for a total of 12 sessions in 4 weeks. The VR comprises 4 steps in which patients are gradually exposed to phobic stimuli while learning to cope with panic symptoms. The effectiveness of the treatment was assessed through the PD Severity Scale (PDSS), the Hamilton Rating Scale for Depression (HRSD), the body sensation questionnaire (BSQ), the Albany Panic and Phobia Questionnaire (APPQ), the Anxiety Sensitivity Index (ASI), the state-trait anxiety inventory (STAI), the hospital anxiety and depression scale (HADS), the social avoidance and distress scale (K-SAD), the inventory for depressive symptomatology self-report (KIDS-SR), and the perceived stress scale, (PSS). Additionally, physiological changes using heart rate variability (HRV) were evaluated. RESULTS In total, 40 subjects (20 VR treatment and 20 waitlist patients) were included in the final analysis. For the PDSS scores, the main time (F_1,39 = 20.76, P < 0.01, η_p^2 = 0.09) and group-by-time interaction (F_1,39 = 10.59, P < 0.01, η_p^2 = 0.04) effects were significant. The post-hoc tests showed that the PDSS scores decreased significantly in the VR group (t_37 = 2.68; P = 0.01), but not in the waitlist group. The group-by-time interaction effect on the HADS total scores (F_1,39 = 5.51, P = 0.02, η_p^2 = 0.01) was significant, as was the main time effect on the STAI_total (F_1,39 = 4.32; P = 0.04) and STAI_S (F_1,39 = 6.00; P = 0.01) scores; however, there were no statistically significant between-group differences on the other scales. CONCLUSIONS The self-guided, mobile app–based VR was effective in treating panic symptoms and helped restore the autonomic nervous system, demonstrating the validity of VR for self-guided treatment and its cost-effective therapeutic approach.

scholarly journals Web-Based Cognitive Behavioral Therapy Intervention for the Prevention of Suicidal Ideation in Medical Interns

2015 ◽  
Vol 72 (12) ◽  
pp. 1192 ◽  
Author(s):  
Constance Guille ◽  
Zhuo Zhao ◽  
John Krystal ◽  
Breck Nichols ◽  
Kathleen Brady ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Web Based ◽  
Medical Interns ◽  
Therapy Intervention
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