scholarly journals Treating anxiety and depression in older adults: randomised controlled trial comparing guided V. self-guided internet-delivered cognitive–behavioural therapy

BJPsych Open ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 50-58 ◽  
Author(s):  
Nickolai Titov ◽  
Vincent J. Fogliati ◽  
Lauren G. Staples ◽  
Milena Gandy ◽  
Luke Johnston ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Cognitive Behavioural ◽  
Randomised Controlled

BackgroundSymptoms of anxiety and depression are prevalent in older adults.AimsTo compare clinician-guided and self-guided versions of a transdiagnostic internet-delivered cognitive–behavioural therapy (iCBT) intervention for adults aged 60 years and above.MethodAdults (n=433) with symptoms of anxiety and depression were randomly allocated to: (1) clinician-guided treatment (n=153); (2) initial clinician interview followed by self-guided treatment (n=140); or (3) self-guided treatment without interview (n=140).ResultsLarge reductions (d ≥1.00) in symptoms of depression and anxiety were observed across groups, and sustained at follow-up. No differences were observed in clinical outcomes or satisfaction ratings. Age did not affect outcomes.ConclusionsCarefully developed iCBT interventions may significantly reduce symptoms of anxiety and depression in older adults when delivered in either clinician-guided or self-guided formats.

scholarly journals O005 Cognitive behavioural therapy and light dark therapy for postpartum insomnia symptoms: a randomised controlled trial

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A2-A3
Author(s):  
S Verma ◽  
N Quin ◽  
L Astbury ◽  
C Wellecke ◽  
J Wiley ◽  
...  
Keyword(s):  
Sleep Disturbance ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Future Research ◽  
Depression And Anxiety ◽  
Post Intervention ◽  
Cognitive Behavioural ◽  
Randomised Controlled ◽  
Insomnia Symptoms

Abstract Introduction Symptoms of postpartum insomnia are common however interventions remain scarce. Cognitive Behavioural Therapy (CBT) and Light Dark Therapy (LDT) target distinct mechanisms to improve sleep. This randomised controlled superiority trial compared CBT and LDT against treatment-as-usual (TAU) in reducing maternal postpartum insomnia symptoms. Methods Nulliparous females 4–12 months postpartum with self-reported symptoms of insomnia (Insomnia Severity Index scores >7) were included; excluded were those at risk or with high medical/psychiatric needs. Eligible participants were randomised 1:1:1 to 6 weeks of CBT, LDT (gaining light upon awakening, night-time light avoidance) or TAU. Interventions were therapist-assisted through two telephone calls and included automated self-help emails over six weeks. Symptoms of insomnia (ISI; primary outcome), sleep disturbance, fatigue, sleepiness, depression, and anxiety were assessed at baseline, mid-intervention, post-intervention, and 1-month post-intervention. Latent growth models were used. Results 114 participants (mean age=32.2±4.6 years) were randomised. There were significantly greater reductions in insomnia and sleep disturbance in both intervention groups with very large effect sizes (d>1·4, p<0·0001) from baseline to post-intervention compared to TAU; improvements were maintained at one-month follow-up. There were greater reductions in fatigue symptoms in the CBT group (d=0.85, p<.0001) but not LDT (p=0.11) compared to TAU; gains were maintained for CBT at follow-up. Changes in sleepiness, depression and anxiety over time were non-significant compared to TAU (p-values>0.08). Conclusion Therapist-assisted CBT and LDT are both efficacious for reducing postpartum insomnia symptoms. Findings were mixed for fatigue, sleepiness and mood. Future research is needed on predictors of treatment response.

scholarly journals Sleep Treatment Outcome Predictors (STOP) Pilot Study: a protocol for a randomised controlled trial examining predictors of change of insomnia symptoms and associated traits following cognitive–behavioural therapy for insomnia in an unselected sample

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e017177 ◽  
Author(s):  
Dan Denis ◽  
Thalia C Eley ◽  
Fruhling Rijsdijk ◽  
Helena M S Zavos ◽  
Robert Keers ◽  
...  
Keyword(s):  
Pilot Study ◽  
Randomised Controlled Trial ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Ethical Approval ◽  
Unselected Sample ◽  
Randomised Controlled

IntroductionCognitive–behavioural therapy for insomnia (CBT-I) leads to insomnia symptom improvements in a substantial proportion of patients. However, not everyone responds well to this treatment, and it is unclear what determines individual differences in response. The broader aim of this work is to examine to what extent response to CBT-I is due to genetic and environmental factors. The purpose of this pilot study is to examine feasibility of a design to test hypotheses focusing on an unselected sample, that is, without selection on insomnia complaints, in order to plan a larger behavioural genetics study where most participants will likely not have an insomnia disorder.Methods and analysisA two parallel-group randomised controlled trial is being conducted across three London universities. Female students (minimum age 18 years) enrolled on a psychology programme at one of the three sites were invited to participate. The target number of participants to be recruited is 240. Following baseline assessments, participants were randomly allocated to either the treatment group, where they received weekly sessions of digital CBT-I for 6 weeks, or the control group, where they completed an online puzzle each week for 6 weeks. Follow-up assessments have taken place mid-intervention (3 weeks) and end of intervention (6 weeks). A 6-month follow-up assessment will also occur. Primary outcomes will be assessed using descriptive statistics and effect size estimates for intervention effects. Secondary outcomes will be analysed using multivariate generalised estimating equation models.Ethics and disseminationThe study received ethical approval from the Research Ethics and Integrity subcommittee, Goldsmiths, University of London (application reference: EA 1305). DNA sample collection for the BioResource received ethical approval from the NRES Committee South Central—Oxford (reference number: 15/SC/0388). The results of this work shall be published in peer-reviewed journals.Trial registration numberNCT03062891; Results.

scholarly journals Recovery-focused cognitive–behavioural therapy for recent-onset bipolar disorder: Randomised controlled pilot trial

2015 ◽  
Vol 206 (1) ◽  
pp. 58-66 ◽  
Author(s):  
Steven H. Jones ◽  
Gina Smith ◽  
Lee D. Mulligan ◽  
Fiona Lobban ◽  
Heather Law ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Behavioural Therapy ◽  
Personal Recovery ◽  
Recent Onset ◽  
Cognitive Behavioural ◽  
Randomised Controlled

BackgroundDespite evidence for the effectiveness of structured psychological therapies for bipolar disorder no psychological interventions have been specifically designed to enhance personal recovery for individuals with recent-onset bipolar disorder.AimsA pilot study to assess the feasibility and effectiveness of a new intervention, recovery-focused cognitive–behavioural therapy (CBT), designed in collaboration with individuals with recent-onset bipolar disorder intended to improve clinical and personal recovery outcomes.MethodA single, blind randomised controlled trial compared treatment as usual (TAU) with recovery-focused CBT plus TAU (n = 67).ResultsRecruitment and follow-up rates within 10% of pre-planned targets to 12-month follow-up were achieved. An average of 14.15 h (s.d. = 4.21) of recovery-focused CBT were attended out of a potential maximum of 18 h. Compared with TAU, recovery-focused CBT significantly improved personal recovery up to 12-month follow-up (Bipolar Recovery Questionnaire mean score 310.87, 95% CI 75.00–546.74 (s.e. = 120.34), P = 0.010, d=0.62) and increased time to any mood relapse during up to 15 months follow-up (χ2 = 7.64, P<0.006, estimated hazard ratio (HR) = 0.38, 95% CI 0.18–0.78). Groups did not differ with respect to medication adherence.ConclusionsRecovery-focused CBT seems promising with respect to feasibility and potential clinical effectiveness. Clinical- and cost-effectiveness now need to be reliably estimated in a definitive trial.

scholarly journals One-day cognitive–behavioural therapy self-confidence workshops for people with depression: randomised controlled trial

2014 ◽  
Vol 204 (3) ◽  
pp. 222-233 ◽  
Author(s):  
Linda Horrell ◽  
Kimberley A. Goldsmith ◽  
André T. Tylee ◽  
Ulrike H. Schmidt ◽  
Caroline L. Murphy ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Randomised Controlled Trial ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Self Esteem ◽  
Behavioural Therapy ◽  
Self Confidence ◽  
Cognitive Behavioural ◽  
Randomised Controlled

BackgroundDespite its high prevalence, help-seeking for depression is low.AimsTo assess the effectiveness and cost-effectiveness of 1-day cognitive–behavioural therapy (CBT) self-confidence workshops in reducing depression. Anxiety, self-esteem, prognostic indicators as well as access were also assessed.MethodAn open randomised controlled trial (RCT) waiting list control design with 12-week follow-up was used (trial registration: ISRCTN26634837). A total of 459 adult participants with depression (Beck Depression Inventory (BDI) scores of 14) self-referred and 382 participants (83%) were followed up.ResultsAt follow-up, experimental and control participants differed significantly on the BDI, with an effect size of 0.55. Anxiety and self-esteem also differed. Of those who participated, 25% were GP non-consulters and 32% were from Black and minority ethnic groups. Women benefited more than men on depression scores. The intervention has a 90% chance of being considered cost-effective if a depression-free day is valued at £14.ConclusionsSelf-confidence workshops appear promising in terms of clinical effectiveness, cost-effectiveness and access by difficult-to-engage groups.

scholarly journals Increasing access to cognitive–behavioural therapy for patients with psychosis by evaluating the feasibility of a randomised controlled trial of brief, targeted cognitive–behavioural therapy for distressing voices delivered by assistant psychologists: the GiVE2 trial

BJPsych Open ◽  
2021 ◽  
Vol 7 (5) ◽  
Author(s):  
Mark Hayward ◽  
Katherine Berry ◽  
Stephen Bremner ◽  
Anna-Marie Jones ◽  
Sam Robertson ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Post Treatment ◽  
Treatment As Usual ◽  
Cognitive Behavioural ◽  
Supportive Counselling ◽  
Randomised Controlled

Background Cognitive–behavioural therapy (CBT) is recommended for all patients with psychosis, but is offered to only a minority. This is attributable, in part, to the resource-intensive nature of CBT for psychosis. Responses have included the development of CBT for psychosis in brief and targeted formats, and its delivery by briefly trained therapists. This study explored a combination of these responses by investigating a brief, CBT-informed intervention targeted at distressing voices (the GiVE intervention) administered by a briefly trained workforce of assistant psychologists. Aims To explore the feasibility of conducting a randomised controlled trial to evaluate the clinical and cost-effectiveness of the GiVE intervention when delivered by assistant psychologists to patients with psychosis. Method This was a three-arm, feasibility, randomised controlled trial comparing the GiVE intervention, a supportive counselling intervention and treatment as usual, recruiting across two sites, with 1:1:1 allocation and blind post-treatment and follow-up assessments. Results Feasibility outcomes were favourable with regard to the recruitment and retention of participants and the adherence of assistant psychologists to therapy and supervision protocols. For the candidate primary outcomes, estimated effects were in favour of GiVE compared with supportive counselling and treatment as usual at post-treatment. At follow-up, estimated effects were in favour of supportive counselling compared with GiVE and treatment as usual, and GiVE compared with treatment as usual. Conclusions A definitive trial of the GiVE intervention, delivered by assistant psychologists, is feasible. Adaptations to the GiVE intervention and the design of any future trials may be necessary.

scholarly journals Chat- and internet-based cognitive–behavioural therapy in treatment of adolescent depression: randomised controlled trial

BJPsych Open ◽  
2018 ◽  
Vol 4 (4) ◽  
pp. 199-207 ◽  
Author(s):  
Naira Topooco ◽  
Matilda Berg ◽  
Sofie Johansson ◽  
Lina Liljethörn ◽  
Ella Radvogin ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Behavioural Therapy ◽  
Adolescent Depression ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Access To Treatment ◽  
For Profit ◽  
Symptoms Of Depression ◽  
Cognitive Behavioural ◽  
Randomised Controlled

BackgroundDepression is a major contributor to the burden of disease in the adolescent population. Internet-based interventions can increase access to treatment.AimsTo evaluate the efficacy of internet-based cognitive–behavioural therapy (iCBT), including therapist chat communication, in treatment of adolescent depression.MethodSeventy adolescents, 15–19 years of age and presenting with depressive symptoms, were randomised to iCBT or attention control. The primary outcome was the Beck Depression Inventory II (BDI-II).ResultsSignificant reductions in depressive symptoms were found, favouring iCBT over the control condition (F(1,67) = 6.18, P < 0.05). The between-group effect size was Cohen's d = 0.71 (95% CI 0.22–1.19). A significantly higher proportion of iCBT participants (42.4%) than controls (13.5%) showed a 50% decrease in BDI-II score post-treatment (P < 0.01). The improvement for the iCBT group was maintained at 6 months.ConclusionsThe intervention appears to effectively reduce symptoms of depression in adolescents and may be helpful in overcoming barriers to care among young people.Declaration of interestN.T. and G.A. designed the programme. N.T. authored the treatment material. The web platform used for treatment is owned by Linköping University and run on a non-for-profit basis. None of the authors receives any income from the programme.

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