scholarly journals Cognitive behavioural therapy in virtual reality treatments across mental health conditions: a systematic review

2020 ◽  
Vol 1 (1) ◽  
pp. 30-46
Author(s):  
M. Dilgul ◽  
J. Martinez ◽  
N. Laxhman ◽  
S. Priebe ◽  
V. Bird
2021 ◽  
Vol 20 ◽  
pp. 627-631
Author(s):  
Yash Joshi ◽  
Austin Mardon

Many organizations around the world are pursuing space exploration with hopes of going further and further away from Earth. Spaceflight itself has significant implications on humans, meaning that it is important to understand the magnitude of effects that astronauts would feel during these missions. Some pressing concerns are the increased isolation due to social interactions as well as situational factors, which would lead to a decline in mental and physical health. Additionally, the possibility of substance abuse due to stress and access to medications can lead to significant reductions in mental health. To deal with these issues, virtual reality has presented itself as a unique solution that would help provide better overall mental health. The technology is frequently used in various clinical settings to deal with anxiety and depression, through techniques such as exposure therapy and cognitive behavioural therapy. Exposure therapy for anxiety with virtual reality targets anxiety-causing stimulus and works towards changing the patient’s response, in a controlled setting. Cognitive behavioural therapy immerses the patient into a simulated world to provide them with experiences that mitigate the depression they are feeling. On the mission, exposure therapy would potentially be available to deal with stimulants of anxiety, while cognitive behavioural therapy would provide a happiness break. With further research in the field, virtual reality thus presents itself as a feasible opportunity to plan longer duration human space missions. This review compiles and investigates sources from literary research done in the respective fields.


Author(s):  
Wenxuan Wang ◽  
Sean Wong

Anxiety disorders are the most prevalent mental health condition, affecting one-third of the population during their lifetime. Patient with anxiety may experience overwhelming fear to an irrational fear that can impair  everyday functioning. Current treatment for anxiety disorders include pharmacological (i.e. selective serotonin reuptake inhibitors) and psychological (i.e. cognitive behavioural therapy) intervention. Cognitive behavioural therapy is an effective exposure-based therapy utilizing repetitive exposure to the feared stimulus to develop desensitization and tolerance but holds high dropout rates due to unbearable anxiety for patients. Recognizing this challenge, virtual reality technology is emerging as a promising tool for patients to challenge their fear in a simulated environment based on individual progression. This article explores the new development of virtual reality technology as an effective treatment modality for anxiety disorders to enhance current approaches in mental health care.


Author(s):  
Katie Lawton ◽  
Angela Spencer

AbstractGlobal conflict in 2019 created record numbers of displaced children. These children have experienced multiple traumas and subsequently suffer high levels of mental health symptoms. Cognitive-behavioural therapy (CBT) is commonly used for post-traumatic stress disorder (PTSD), depression and anxiety, however the current evidence-base of CBT in child refugees is sparse, with mixed results. This study aimed to assess the effects of CBT on symptoms of PTSD, depression and anxiety in child refugees/AS. Ethics were reviewed and granted by the University of Manchester ethics committee. Medline, Embase, Cochrane, PsycINFO and CINAHL were systematically searched. Studies were included if CBT was delivered to refugee/AS children with pre and post-intervention measures of symptoms. Sixteen studies fulfilled criteria. In all studies, mental health symptom scores post-intervention had reduced, suggesting an improvement in mental health following CBT. This reduction was statistically significant in twelve studies (p < 0.001–0.5), clinically significant in eight studies and maintained at follow-up periods. No adverse effects of CBT were identified. This is the first systematic review to focus solely on CBT in child refugee populations, with unanimously positive results. Its use is cautiously recommended, however the need for more methodologically rigorous studies in this population is highlighted.


Author(s):  
Harry Banyard ◽  
Alex J. Behn ◽  
Jaime Delgadillo

Abstract Background Previous reviews indicate that depressed patients with a comorbid personality disorder (PD) tend to benefit less from psychotherapies for depression and thus personality pathology needs to be the primary focus of treatment. This review specifically focused on studies of Cognitive Behavioural Therapy (CBT) for depression examining the influence of comorbid PD on post-treatment depression outcomes. Methods This was a systematic review and meta-analysis of studies identified through PubMed, PsychINFO, Web of Science, and Scopus. A review protocol was pre-registered in the PROSPERO database (CRD42019128590). Results Eleven eligible studies (N = 769) were included in a narrative synthesis, and ten (N = 690) provided sufficient data for inclusion in random effects meta-analysis. All studies were rated as having “low” or “moderate” risk of bias and there was no significant evidence of publication bias. A small pooled effect size indicated that patients with PD had marginally higher depression severity after CBT compared to patients without PD (g = 0.26, [95% CI: 0.10, 0.43], p = .002), but the effect was not significant in controlled trials (p = .075), studies with low risk of bias (p = .107) and studies that adjusted for intake severity (p = .827). Furthermore, PD cases showed symptomatic improvements across studies, particularly those with longer treatment durations (16–20 sessions). Conclusions The apparent effect of PD on depression outcomes is likely explained by higher intake severity rather than treatment resistance. Excluding these patients from evidence-based care for depression is unjustified, and adequately lengthy CBT should be routinely offered.


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e050661
Author(s):  
Håvard Kallestad ◽  
Simen Saksvik ◽  
Øystein Vedaa ◽  
Knut Langsrud ◽  
Gunnar Morken ◽  
...  

IntroductionInsomnia is highly prevalent in outpatients receiving treatment for mental disorders. Cognitive–behavioural therapy for insomnia (CBT-I) is a recommended first-line intervention. However, access is limited and most patients with insomnia who are receiving mental healthcare services are treated using medication. This multicentre randomised controlled trial (RCT) examines additional benefits of a digital adaptation of CBT-I (dCBT-I), compared with an online control intervention of patient education about insomnia (PE), in individuals referred to secondary mental health clinics.Methods and analysisA parallel group, superiority RCT with a target sample of 800 participants recruited from treatment waiting lists at Norwegian psychiatric services. Individuals awaiting treatment will receive an invitation to the RCT, with potential participants undertaking online screening and consent procedures. Eligible outpatients will be randomised to dCBT-I or PE in a 1:1 ratio. Assessments will be performed at baseline, 9 weeks after completion of baseline assessments (post-intervention assessment), 33 weeks after baseline (6 months after the post-intervention assessment) and 61 weeks after baseline (12 months after the post-intervention assessment). The primary outcome is between-group difference in insomnia severity 9 weeks after baseline. Secondary outcomes include between-group differences in levels of psychopathology, and measures of health and functioning 9 weeks after baseline. Additionally, we will test between-group differences at 6-month and 12-month follow-up, and examine any negative effects of the intervention, any changes in mental health resource use, and/or in functioning and prescription of medications across the duration of the study. Other exploratory analyses are planned.Ethics and disseminationThe study protocol has been approved by the Regional Committee for Medical and Health Research Ethics in Norway (Ref: 125068). Findings from the RCT will be disseminated via peer-reviewed publications, conference presentations, and advocacy and stakeholder groups. Exploratory analyses, including potential mediators and moderators, will be reported separately from main outcomes.Trial registration numberClinicalTrials.gov Registry (NCT04621643); Pre-results.


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.


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