Effects of Internet-Based Guided Self-Help Problem-Solving Therapy for Adolescents with Depression and Anxiety: A Randomized Controlled Trial

ABSTRACTBackground: Elderly people living in residential homes are at high risk for developing major depressive and anxiety disorders, and therefore deserve attention in terms of preventive interventions. We evaluated the feasibility and effectiveness of a guided self-help intervention for the prevention of depression and anxiety in these residents.Methods: We conducted a pragmatic randomized controlled trial in two parallel groups comparing the intervention with usual care in 14 residential homes in and surrounding the city of Amsterdam in the Netherlands. A total of 129 residents with a score of 8 or more on the Centre for Epidemiologic Studies Depression Scale (CES-D) screening instrument, who did not meet the full diagnostic criteria for disorders, and were not suffering from cognitive impairment were recruited between April 2007 and December 2008. Participants were randomized to a guided self-help intervention (n = 67) or to usual care (n = 62). The main outcome measures were improvement in the level of symptoms of depression and anxiety. The secondary outcome was improvement in participation in organized activities in the residential homes. The study is registered in de Dutch Cochrane Centre, under number ISRCTN27540731.Results: Only 21% of the participants (mean age 84.0 years (SD 6.7), 72.1% suffering from two or more chronic illnesses) completed the intervention. Although we found some large positive effect sizes on the CES-D, none of these effects was statistically significant.Conclusion: Although guided self-help may be promising in the prevention of depression and anxiety, it proved to be difficult to apply in this very old and vulnerable group of people living in residential homes.

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The effectiveness of problem solving therapy for stroke patients: study protocol for a pragmatic randomized controlled trial

BMC Neurology ◽

10.1186/1471-2377-13-67 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 6

Author(s):

Marieke M Visser ◽

Majanka H Heijenbrok-Kal ◽

Adriaan van ’t Spijker ◽

Gerard M Ribbers ◽

Jan JV Busschbach

Keyword(s):

Randomized Controlled Trial ◽

Problem Solving ◽

Study Protocol ◽

Controlled Trial ◽

Stroke Patients ◽

Problem Solving Therapy ◽

Pragmatic Randomized Controlled Trial ◽

Randomized Controlled

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Efficacy of brief guided self-help cognitive behavioral treatment for perfectionism in reducing perinatal depression and anxiety: a randomized controlled trial

Cognitive Behaviour Therapy ◽

10.1080/16506073.2018.1490810 ◽

2018 ◽

Vol 48 (2) ◽

pp. 106-120 ◽

Cited By ~ 3

Author(s):

Talitha A. Lowndes ◽

Sarah J. Egan ◽

Peter M. McEvoy

Keyword(s):

Randomized Controlled Trial ◽

Behavioral Treatment ◽

Perinatal Depression ◽

Controlled Trial ◽

Cognitive Behavioral ◽

Cognitive Behavioral Treatment ◽

Depression And Anxiety ◽

Randomized Controlled ◽

Self Help

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The BEACON Study: Protocol for a cluster randomized controlled trial of a service to deliver smartphone-assisted problem-solving therapy compared to usual care in men who present with intentional self-harm to Emergency Departments in Ontario

10.21203/rs.2.21009/v1 ◽

2020 ◽

Author(s):

Simon Hatcher ◽

Marnin Heisel ◽

Oyedeji Ayonrinde ◽

Julie Kathleen Campbell ◽

Ian Colman ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Problem Solving ◽

Health System ◽

Usual Care ◽

Emergency Departments ◽

Controlled Trial ◽

Problem Solving Therapy ◽

Randomized Controlled ◽

Self Harm ◽

Cluster Randomized

Abstract Background Patients who present to Emergency Departments (ED) after intentional self-harm receive variable levels care in Ontario. Many are not assessed by a mental health professional following discharge from ED and do not receive psychological services available in the community as many of these services are not covered by the provincial health insurance. Patients who present with intentional self-harm to hospital are more likely to die by suicide and premature death by other means compared to the general population. This risk is elevated in men, who represent two-thirds of those who die by suicide in Ontario. One way of potentially addressing this gap is to offer problem-solving therapy (PST) designed specifically for men, facilitated by the use of a patient facing smartphone application and a clinician facing dashboard. This attempts to blend the use of face to face therapy and technology to create an effective intervention after self-harm.Methods This is a pragmatic, multicentre pre- and post-design cluster randomized controlled trial (cRCT) comparing the provision of a suicide prevention intervention to usual care, in men who present to the ED with self-harm. The study intervention is composed of: 1) staff education; 2) resource materials for men who present to the ED with self-harm; and, 3) the option to refer patients to a blended PST service for the treatment of self-harm. The primary outcome to be assessed is a composite of the incidence of suicides and/or re-presentations to any ED in Ontario for self-harm in the year after presentation with self-harm. Secondary outcome measures include: total number of suicides; re-presentations to any ED in Ontario for the repetition of self-harm; re-presentations to any ED in Ontario for any reason; other health system use including use of primary care and hospital outpatient appointments; mortality not related to suicide; and, health system costs over one year. All outcomes will be measured from provincial health administrative databases available at the Institute for Clinical and Evaluative Sciences (IC/ES).

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