scholarly journals Virtual reality cognitive-behavioural therapy versus cognitive-behavioural therapy for paranoid delusions: a study protocol for a single-blind multi-Centre randomised controlled superiority trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. Berkhof ◽  
E. C. D. van der Stouwe ◽  
B. Lestestuiver ◽  
E. van’t Hag ◽  
R. van Grunsven ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Psychotic Disorder ◽  
Cognitive Behavioural Therapy ◽  
Psychotic Disorders ◽  
Psychological Treatment ◽  
Daily Life ◽  
Time Frame ◽  
Behavioural Therapy ◽  
Social Situations ◽  
Cognitive Behavioural

Abstract Background Seventy per cent of patients with psychotic disorders has paranoid delusions. Paranoid delusions are associated with significant distress, hospital admission and social isolation. Cognitive-behavioural therapy for psychosis (CBTp) is the primary psychological treatment, but the median effect size is only small to medium. Virtual reality (VR) has a great potential to improve the effectiveness of CBTp. In a previous study, we found that VR based CBT (VRcbt) for paranoid delusions is superior to waiting list. As a next step, a direct comparison with CBTp is needed. The present study aims to investigate whether VRcbt is more effective and cost-effective than regular CBTp in treating paranoid delusions and improving daily life social functioning of patients with psychotic disorders. Methods A total of 106 patients with DSM-5 diagnosis of psychotic disorder and at least moderate level of paranoid ideations will be recruited for this multicentre randomized controlled trial (RCT). Patients will be randomized to either VRcbt or standard CBTp for paranoid delusions. VRcbt consists of maximum 16 sessions in virtual social situations that trigger paranoid ideations and distress, delivered in an 8–12 week time frame. Standard CBTp also consists of maximum 16 sessions including exposure and behavioural experiments, delivered in an 8–12 week time frame. The two groups will be compared at baseline, post-treatment and six months follow-up. Primary outcome is the level of paranoid ideations in daily life social situations, measured with ecological momentary assessments (EMA) at semi-random moments ten times a day during seven days, before and after treatment. Every session, participants and therapists will rate the level of paranoid ideation and global clinical impression. Discussion Comparison of VRcbt and CBTp will provide information about the relative (cost-) effectiveness of VRcbt for this population. VRcbt may become a preferred psychological treatment for paranoid delusions and social anxiety in patients with psychotic disorder. Trial registration Netherlands Trial Register, NL7758. Registered on 23 May 2019.

scholarly journals M36. VIRTUAL REALITY COGNITIVE BEHAVIORAL THERAPY FOR PARANOID DELUSIONS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S148-S148
Author(s):  
Maureen Berkhof ◽  
Elisabeth van der Stouwe ◽  
Bart Lestestuiver ◽  
Erna van ‘t Hag ◽  
de Vos Maarten ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Cognitive Behavioral Therapy ◽  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Psychological Treatment ◽  
Daily Life ◽  
Behavioral Therapy ◽  
Cost Effective ◽  
Social Situations

Abstract Background Seventy percent of patients with schizophrenia and other psychotic disorders has paranoid delusions. Paranoid delusions are associated with great distress, hospital admission and social isolation. Cognitive behavioral therapy (CBT) is the main psychological treatment, but the median effect size is only small to medium. Virtual reality (VR) has a great potential to improve psychological treatment of paranoid delusions. In a previous study, we found that VR based CBT (VRcbt) for paranoid delusions is effective compared to waiting list. As a next step, a direct comparison with standard CBT is needed. The aim of this project is to investigate if VRcbt is more (cost-)effective than standard CBT for treatment of paranoid delusions and improving daily life social functioning of patients with schizophrenia and related psychotic disorders. Three research questions will be addressed: 1. Does VRcbt lead to better clinical and social outcomes? 2. Are fewer treatment sessions needed to achieve meaningful clinical change? 3. Is VRcbt more cost-effective at 6 months follow-up? Methods A total of 106 patients with DSM-5 diagnosis of psychotic disorder and at least moderate level of paranoid ideations will be randomized to either VRcbt or standard CBT treatment for paranoid delusions. VRcbt consists of maximum 16 sessions in virtual social situations that trigger paranoid ideations and distress, delivered in an 8–12 week time frame. Standard CBT also consists of maximum 16 sessions, aiming at reappraisal of the meaning of paranoid beliefs to reduce distress and improve coping in daily life, including the use of exposure and behavioral experiments. Participants will be interviewed and tested at baseline, post-treatment and at six months follow-up. Primary outcome is level of paranoid ideations in daily life social situations, measured with ecological momentary assessments (EMA) at semi-random moments ten times a day during seven days, before and after treatment. Every session, participants and therapists will rate level of paranoid ideation and global clinical impression. Results Seven mental health services throughout the Netherlands participate in this RCT. Up until now, fourteen psychologists have been trained in VRcbt and the first patients have been included in the trial. Discussion Comparison of VRcbt and cbt will provide information about the relative (cost-)effectiveness of VRcbt for this population. VRcbt may become the preferred psychological treatment for paranoid delusions and social anxiety in patients with psychotic disorder.

Cost-effectiveness and cost-utility evaluation of the individual vs. group transdiagnostic psychological treatment for emotional disorders in Primary Care (PsicAP-Costs) v2

2021 ◽  
Author(s):  
Angel Aguilera-Martin ◽  
Mario Gálvez-Lara ◽  
Fátima Cuadrado ◽  
Eliana Moreno ◽  
Francisco García-Torres ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Emotional Disorders ◽  
Cognitive Behavioural Therapy ◽  
Psychological Treatment ◽  
Behavioural Therapy ◽  
Cost Utility ◽  
Cognitive Behavioural ◽  
Utility Evaluation ◽  
The Individual

The aim of this study is to compare, in cost-effectiveness and cost-utility terms, a brief transdiagnostic cognitive-behavioural therapy in two different modes, individual and group, with the treatment usually administered in primary care (TAU). Participants between 18 and 65 years old and with, according to the pretreatment evaluation, mild to moderate emotional disorders will be randomly allocated to the three clusters. They will be assessed again immediately after treatment and 6 and 12 months later. ClinicalTrials.gov: NCT04847310

Physical Activity of Patients With Chronic Pain Receiving Acceptance and Commitment Therapy or Cognitive Behavioural Therapy

2014 ◽  
Vol 31 (2) ◽  
pp. 131-143 ◽  
Author(s):  
Katherine VanBuskirk ◽  
Scott Roesch ◽  
Niloofar Afari ◽  
Julie Loebach Wetherell
Keyword(s):  
Physical Activity ◽  
Chronic Pain ◽  
Cognitive Behavioural Therapy ◽  
Acceptance And Commitment Therapy ◽  
Psychological Treatment ◽  
Behavioural Therapy ◽  
Tailored Interventions ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Cognitive Behavioural

Physical activity is positively related to various indices of quality of life and is found to reduce symptoms in individuals with chronic pain. This manuscript presents findings from a post hoc analysis investigating whether treatment-related improvements from psychological treatment for chronic pain are mediated by changes in physical activity (PA). Secondary analyses sought to determine predictor variables of PA in patients with chronic pain and to determine the relationship between objective and self-report measurements of PA. The effect of psychological treatment on physical activity was assessed using accelerometers in a sample of participants with chronic pain in a randomised controlled trial comparing 8 weeks of acceptance and commitment therapy (ACT) to cognitive behavioural therapy (CBT). Participants wore actigraph accelerometers for 7 consecutive days at baseline, post-treatment, and at 6-month follow-up. Hierarchical linear modelling analyses found that the variance in physical activity was not significantly predicted by time (b = 104.67, p = .92) or treatment modality (b = −1659.34, p = .57). Women had greater increases in physical activity than did men (b = 6804.08, p = .02). Current ‘gold standard’ psychological treatments for chronic pain were not found to significantly increase physical activity, an important outcome to target in the treatment of physical and mental health. These results suggest that tailored interventions with greater emphasis on exercise may complement psychological treatment for chronic pain. In particular, gender-tailored interventions may capitalise on physical activity differences found between men and women.

scholarly journals The Combination of Cognitive-Behavioural Therapy with Virtual Reality for the Treatment of Postnatal Depression in a Brief Intervention Context: A Single-Case Study Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-20
Author(s):  
George Stamou ◽  
Azucena Garcia-Palacios ◽  
Brendon J. Woodford ◽  
Carlos Suso-Ribera ◽  
Cristina Botella
Keyword(s):  
Virtual Reality ◽  
Cognitive Behavioural Therapy ◽  
Postnatal Depression ◽  
Single Case ◽  
Behavioural Therapy ◽  
Study Trial ◽  
Single Case Study ◽  
Cognitive Behavioural ◽  
The Individual

Postnatal depression (PND) is a mood disorder with potentially devastating effects to the individual on many levels. It can affect cognitive functioning, motivation, and self-esteem. The person can socially withdraw from their immediate familial or social circle. It can affect bonding and quality time between the mother and baby. There are many effective therapeutic treatments used for the treatment of PND such as cognitive-behavioural therapy (CBT) and interpersonal psychotherapy (IPT). This study using a single-case study trial with 15 participants investigates the clinical usefulness of combining CBT with virtual reality (VR). Results show that the combination of CBT with VR is an effective treatment for PND. In addition, VR can enhance awareness, decision-making, and self-appreciation within the individual and can also have real-life applications. This study also shows that the combination of VR and CBT is feasible, while the use of such a technology is well accepted.

scholarly journals Physical exercise as an add-on treatment to cognitive behavioural therapy for anxiety: a systematic review

2021 ◽  
pp. 1-15
Author(s):  
Kristian Pihl Frederiksen ◽  
Silje Haukenes Stavestrand ◽  
Simen Kildahl Venemyr ◽  
Kristine Sirevåg ◽  
Anders Hovland
Keyword(s):  
Systematic Review ◽  
Physical Exercise ◽  
Anxiety Disorders ◽  
Cognitive Behavioural Therapy ◽  
Psychological Treatment ◽  
Meta Analysis ◽  
Behavioural Therapy ◽  
Control Group ◽  
Cognitive Behavioural ◽  
Combined Interventions

Abstract Background: Cognitive behavioural therapy (CBT) is currently the treatment of choice for most anxiety disorders. Yet, with recovery rates of approximately 50%, many patients fail to achieve complete remission. This has led to increased efforts to enhance treatment efficacy. Physical exercise (PE) has in recent years been advocated as means to augment the effects of CBT for anxiety disorders. PE appears to reduce anxiety through other mechanisms than CBT, some of which might also have the potential to augment the effects of psychological treatment. Aims: The current review aimed to summarize and discuss the current research status on CBT augmented with PE for anxiety. Method: A systematic literature search was conducted in the databases PsychInfo, Medline and Web of Science to evaluate the potential augmentative effect of combining PE with CBT for anxiety disorders. These effects were intended to be evaluated in a meta-analysis, but findings from the few and diverse studies were better summarized in a systematic review. Results: Eight articles were included in this review, of which two had no control group, while six had from two to four experimental arms. Six of the studies concluded in favour of benefits of add-on PE, while two studies found no added benefits of the combined interventions. Conclusions: The combination of PE and CBT appears feasible. Add-on PE seems to be more beneficial for clinical populations, when administered regularly several times per week, across several weeks. Future studies should investigate further how and for whom to best combine PE and CBT.

scholarly journals Enduring effects of psychological treatments for anxiety disorders: meta-analysis of follow-up studies

2018 ◽  
Vol 212 (6) ◽  
pp. 333-338 ◽  
Author(s):  
Borwin Bandelow ◽  
Anne Sagebiel ◽  
Michael Belz ◽  
Yvonne Görlich ◽  
Sophie Michaelis ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Cognitive Behavioural Therapy ◽  
Psychological Treatment ◽  
Meta Analysis ◽  
Behavioural Therapy ◽  
Control Groups ◽  
Cognitive Behavioural ◽  
Significant Difference

BackgroundIt is a widespread opinion that after treatment with psychotherapy, patients with anxiety disorders maintain their gains beyond the active treatment period, whereas patients treated with medication soon experience a relapse after treatment termination.AimsWe aimed to provide evidence on whether enduring effects of psychotherapy differ from control groups.MethodWe searched 93 randomised controlled studies with 152 study arms of psychological treatment (cognitive–behavioural therapy or other psychotherapies) for panic disorder, generalised anxiety disorder and social anxiety disorder that included follow-up assessments. In a meta-analysis, pre-post effect sizes for end-point and all follow-up periods were calculated and compared with control groups (medication: n = 16 study arms; pill and psychological placebo groups: n = 17 study arms).ResultsGains with psychotherapy were maintained for up to 24 months. For cognitive–behavioural therapy, we observed a significant improvement over time. However, patients in the medication group remained stable during the treatment-free period, with no significant difference when compared with psychotherapy. Patients in the placebo group did not deteriorate during follow-up, but showed significantly worse outcomes than patients in cognitive–behavioural therapy.ConclusionsNot only psychotherapy, but also medications and, to a lesser extent, placebo conditions have enduring effects. Long-lasting treatment effects observed in the follow-up period may be superimposed by effects of spontaneous remission or regression to the mean.Declaration of interestIn the past 12 months and in the near future, Dr Bandelow has been/will be on the speakers/advisory board for Hexal, Mundipharma, Lilly, Lundbeck, Pfizer and Servier. Dr Wedekind was on the speakers' board of AstraZeneca, Essex Pharma, Lundbeck and Servier. All other authors have nothing to declare.

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