scholarly journals Effectiveness of Usual-Care Cognitive-Behavioral Therapy for Adolescents with Depressive Disorders Rated by Parents and Patients

2020 ◽  
Author(s):  
Daniel Walter ◽  
Jana Buschsieweke ◽  
Lydia Dachs ◽  
Hildegard Goletz ◽  
Anja Goertz-Dorten ◽  
...  

Abstract BackgroundDepressive disorders are common in adolescence and are associated with a wide range of negative long-term outcomes. Highly controlled randomized controlled trials (RCT) provide considerable evidence for the efficacy of cognitive-behavioral therapy (CBT) as a treatment for depression, but the effectiveness of CBT under routine care conditions remains unproven.MethodsIn the present observational study, the changes achieved through routine CBT in adolescents with depressive disorders treated in a university outpatient clinic were analyzed, and compared to a historical control group of adolescents with depressive disorders who had received treatment as usual. At the start and end of treatment (pre- and post-assessment), parent and self-ratings of the German versions of the Youth Self-Report (YSR), the Child Behavior Checklist (CBCL) and rating scales for depressive symptoms (FBB-DES, SBB-DES) were assessed. A total of 331 adolescents aged 11–18 years with complete data were assessed for the main analysis.ResultsThe analysis yielded small to large pre-post effect sizes (Cohen’s d) for the total sample (d = 0.33 to d = 0.82) and large effect sizes for adolescents who were rated in the clinical range on each (sub)scale at the start of treatment (d = 0.85 to d = 1.30). When comparing patients in the clinical range with historical controls, medium to large net effect sizes (d = 0.53 to d = 2.09) emerged for the total scores in self- and parent rating. However, a substantial proportion of the sample remained in the clinical range at the end of treatment.ConclusionsThese findings suggest that CBT is effective for adolescents with depressive disorders when administered under routine care conditions, but the results must be interpreted with caution due to the lack of a direct control condition.Trial registrationDRKS, DRKS00021518. Registered 27 April 2020 - Retrospectively registered, http://drks.de

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Walter ◽  
Jana Buschsieweke ◽  
Lydia Dachs ◽  
Hildegard Goletz ◽  
Anja Goertz-Dorten ◽  
...  

Abstract Background Depressive disorders are common in adolescence and are associated with a wide range of negative long-term outcomes. Highly controlled randomized controlled trials (RCT) provide considerable evidence for the efficacy of cognitive-behavioral therapy (CBT) as a treatment for depression, but studies examining the effectiveness of CBT in clinical settings are very rare . Methods In the present observational study, the changes achieved through routine CBT in adolescents with depressive disorders treated in a clinical setting in terms of a university outpatient clinic were analyzed, and compared to a historical control group of adolescents with depressive disorders who had received treatment as usual. At the start and end of treatment (pre- and post-assessment), parent and self-ratings of the German versions of the Youth Self-Report (YSR), the Child Behavior Checklist (CBCL) and rating scales for depressive symptoms (FBB-DES, SBB-DES) were assessed. A total of 331 adolescents aged 11–18 years with complete data were assessed for the main analysis. Results The analysis yielded small to large pre-post effect sizes (Cohen’s d) for the total sample (d = 0.33 to d = 0.82) and large effect sizes for adolescents who were rated in the clinical range on each (sub) scale at the start of treatment (d = 0.85 to d = 1.30). When comparing patients in the clinical range with historical controls, medium to large net effect sizes (d = 0.53 to d = 2.09) emerged for the total scores in self- and parent rating. However, a substantial proportion of the sample remained in the clinical range at the end of treatment. Conclusions These findings suggest that CBT is effective for adolescents with depressive disorders when administered under routine care conditions, but the results must be interpreted with caution due to the lack of a direct control condition. Trial registration DRKS, DRKS00021518. Registered 27 April 2020 - Retrospectively registered, http://drks.de


Author(s):  
Nasrin Jaberghaderi ◽  
Mansour Rezaei ◽  
Mitra Kolivand ◽  
Azita Shokoohi

Objective: This study was conducted to examine and compare the effectiveness of cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) in child victims of domestic violence (child physical abuse and/or witnessing parents’ conflicts). Method: A total of 139 girls and boys, aged 8-12 years, were randomly assigned into CBT (n = 40), EMDR (n = 40), or control groups (n=59). All children received up to 12 individual treatment sessions over 4–12 weeks. Blind assessment was done before and 2 weeks after the treatment and on a variety of teacher-parent-rated and self-report measures of posttraumatic symptomatology, depression, anxiety, and behavior problems. Results: CBT and EMDR were effective in ameliorating psychological sequelae of victims of domestic violence on the measured variables (p =.001). Comparison of the treatment and control groups suggested moderate to high practical significance in treatment groups vs controls. Conclusion: Both CBT and EMDR can help children to greatly recover from the outcomes of domestic violence in comparison with control group. Moreover, structured trauma treatments are strongly recommended and can be used for children


2020 ◽  
Author(s):  
Anne Etzelmueller ◽  
Christiaan Vis ◽  
Eirini Karyotaki ◽  
Harald Baumeister ◽  
Nickolai Titov ◽  
...  

BACKGROUND Although there is evidence for the efficacy of internet-based cognitive behavioral therapy (iCBT), the generalizability of results to routine care is limited. OBJECTIVE This study systematically reviews effectiveness studies of guided iCBT interventions for the treatment of depression or anxiety. METHODS The acceptability (uptake, participants’ characteristics, adherence, and satisfaction), effectiveness, and negative effects (deterioration) of nonrandomized pre-post designs conducted under routine care conditions were synthesized using systematic review and meta-analytic approaches. RESULTS A total of 19 studies including 30 groups were included in the analysis. Despite high heterogeneity, individual effect sizes of investigated studies indicate clinically relevant changes, with effect sizes ranging from Hedges’ g=0.42-1.88, with a pooled effect of 1.78 for depression and 0.94 for anxiety studies. Uptake, participants’ characteristics, adherence, and satisfaction indicate a moderate to high acceptability of the interventions. The average deterioration across studies was 2.9%. CONCLUSIONS This study provides evidence supporting the acceptability and effectiveness of guided iCBT for the treatment of depression and anxiety in routine care. Given the high heterogeneity between interventions and contexts, health care providers should select interventions that have been proven in randomized controlled clinical trials. The successful application of iCBT may be an effective way of increasing health care in multiple contexts.


2020 ◽  
Author(s):  
Kyong-Mee Chung ◽  
Yung Jae Suh ◽  
Siyung Chin ◽  
Eun-Seung Yu ◽  
Hyun Jeong Lee ◽  
...  

UNSTRUCTURED Objective: To develop and evaluate an app-based cognitive behavioral therapy program for cancer patients with sleep problems. Method: Sixty participants who met the inclusion criteria were randomly assigned to the app-based cognitive behavioral therapy program (HARUToday Sleep) (N = 15), an app-based attentional control program (HARUCard Sleep) (N = 15), or a waitlist control group (N = 15). HARUToday Sleep consists of 48 sessions separated into five zones (psycho-education, behavioral activation, relaxation training, cognitive restructuring, and problem solving). Each participant was required to complete one 10- to 15-minute session per day on weekdays for 10 weeks. In the HARUCard Sleep, participants received one card per day, which provided information about cancer, hobbies, and activities. Participants were evaluated before and after the completion of the program using self-report questionnaires and a dot-probe computer task that measured attentional bias. Results: The intensity of sleep problems decreased significantly after the intervention for the HARUToday Sleep group compared to the other two groups, whereas there were no significant changes in the quality of life score and the attentional bias scores of the patients. Conclusion: The HARUToday Sleep app may be an effective intervention for reducing sleep problems in cancer patients.


10.2196/18100 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e18100 ◽  
Author(s):  
Anne Etzelmueller ◽  
Christiaan Vis ◽  
Eirini Karyotaki ◽  
Harald Baumeister ◽  
Nickolai Titov ◽  
...  

Background Although there is evidence for the efficacy of internet-based cognitive behavioral therapy (iCBT), the generalizability of results to routine care is limited. Objective This study systematically reviews effectiveness studies of guided iCBT interventions for the treatment of depression or anxiety. Methods The acceptability (uptake, participants’ characteristics, adherence, and satisfaction), effectiveness, and negative effects (deterioration) of nonrandomized pre-post designs conducted under routine care conditions were synthesized using systematic review and meta-analytic approaches. Results A total of 19 studies including 30 groups were included in the analysis. Despite high heterogeneity, individual effect sizes of investigated studies indicate clinically relevant changes, with effect sizes ranging from Hedges’ g=0.42-1.88, with a pooled effect of 1.78 for depression and 0.94 for anxiety studies. Uptake, participants’ characteristics, adherence, and satisfaction indicate a moderate to high acceptability of the interventions. The average deterioration across studies was 2.9%. Conclusions This study provides evidence supporting the acceptability and effectiveness of guided iCBT for the treatment of depression and anxiety in routine care. Given the high heterogeneity between interventions and contexts, health care providers should select interventions that have been proven in randomized controlled clinical trials. The successful application of iCBT may be an effective way of increasing health care in multiple contexts.


2016 ◽  
Vol 27 (7) ◽  
pp. 789-801 ◽  
Author(s):  
Allen Rubin ◽  
Micki Washburn ◽  
Christine Schieszler

Purpose: This article provides benchmark data on within-group effect sizes from published randomized clinical trials (RCTs) supporting the efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) for traumatized children. Methods: Within-group effect-size benchmarks for symptoms of trauma, anxiety, and depression were calculated via the Glass approach and adjusted for sample size using Hedges’ g. Results: Overall TF-CBT and control group benchmarks are presented, as well as specific benchmarks for sexual abuse and mixed trauma, and whether included studies utilized intent-to-treat analysis. Discussion: Community practitioners can use these benchmarks as a comparison tool to evaluate whether the way they are adopting or adapting the TF-CBT intervention is satisfactory, needs to be modified, or should be replaced by a different intervention approach. These benchmarks also have potential utility for future implementation research on TF-CBT assessing which service provision conditions are associated with effect sizes approximating benchmarks provided in this article.


2021 ◽  
Vol 10 (16) ◽  
pp. 3544
Author(s):  
Estela María Pardos-Gascón ◽  
Lucas Narambuena ◽  
César Leal-Costa ◽  
Antonio Jesús Ramos-Morcillo ◽  
María Ruzafa-Martínez ◽  
...  

The objective of this study is to evaluate the differential efficacy between Mindfulness-Based Cognitive Therapy (MBCT) and Cognitive Behavioral Therapy (CBT). A quasi-experimental design of repeated measures before and after the test (n = 57) was used with a non-equivalent control group from a previous cohort treated with CBT (n = 105). The t-test revealed significant differences in subjective quality of life for the MBCT group, and in quantity, optimum, and adequate sleep for the CBT group. The pre–post effect size comparison mostly showed slightly larger effect sizes in the MBCT group. CBT and MBCT had comparable efficacies, although a slight trend towards larger effect sizes in MBCT was found. Likewise, CBT seemed to improve sleep-related variables, while MBCT was associated with improvements in pain and quality of life.


2021 ◽  
Vol 8 ◽  
Author(s):  
Eldre W. Beukes ◽  
Gerhard Andersson ◽  
Vinaya Manchaiah

Introduction: An internet-based cognitive behavioral therapy (ICBT) offers a way to increase access to evidence-based tinnitus care. To increase the accessibility of this intervention, the materials were translated into Spanish to reach Spanish as well as English speakers. A clinical trial indicated favorable outcomes of ICBT for tinnitus for the population of the United States. In view of later dissemination, a way to increase the applicability of this intervention is required. Such understanding is best obtained by considering the perspectives and experiences of participants of an intervention. This study aimed to identify the processes that could facilitate or hinder the clinical implementation of ICBT in the United States.Methods: This study evaluated the processes regarding enrolment, allocation, intervention delivery, the outcomes obtained, and the trial implementation. The study sample consisted of 158 participants who were randomly assigned to the experimental and control group.Results: Although the recruitment was sufficient for English speakers, recruiting the Spanish participants and participants belonging to ethnic minority groups was difficult despite using a wide range of recruitment strategies. The allocation processes were effective in successfully randomizing the groups. The intervention was delivered as planned, but not all the participants chose to engage with the materials provided. Compliance for completing the outcome measures was low. The personal and intervention factors were identified as barriers for the implementation whereas the facilitators included the support received, being empowering, the accessibility of the intervention, and its structure.Conclusion: An understanding regarding the factors contributing to the outcomes obtained, the barriers and facilitators of the results, engagement, and compliance were obtained. These insights will be helpful in preparing for the future dissemination of such interventions.Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT04004260. Registered on 2 July 2019.


2011 ◽  
pp. 13-19
Author(s):  
Nhu Minh Hang Tran ◽  
Huu Cat Nguyen ◽  
Dang Doanh Nguyen ◽  
Van Luong Ngo ◽  
Vu Hoang Nguyen ◽  
...  

Objectives: To determine factors impact on the relapse in depressed patients treated with Cognitive Behavioral Therapy (CBT) during one year follow-up. Materials and Methods: 80 depressed patients divided into two groups, group 1: included 40 patients treated with CBT; group 2: 40 patients on amitriptyline. Non-randomized controlled clinical trial, opened, longiditual and prospective research. Results and Conclusions: relapse rate after CBT during 1 year follow-up is 10% (compared to 25% in control group), related factors to relapse rate in depression after CBT are age and education. Shared predictors between 2 groups are severity and recurrence of depression. Key words: Depression, relapse, Cognitive Behavioral Therapy (CBT)


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