scholarly journals Development of an Internet-Based Cognitive Behavioral Therapy Self-Help Program for Arabic-Speaking Immigrants: Mixed-Methods Study (Preprint)

2018 ◽  
Author(s):  
Tomas Nygren ◽  
Matilda Berg ◽  
Ali Sarkohi ◽  
Gerhard Andersson
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Focus Groups ◽  
Health Care Providers ◽  
Mental Health Problems ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Cognitive Behavioral ◽  
Care Providers ◽  
Self Help ◽  
Arabic Speaking

BACKGROUND Recent years have seen an increase in Arabic-speaking immigrants in Sweden and other European countries, with research showing this group to suffer from elevated levels of various forms of psychological disorders. There is a lack of treatment options for immigrants with mild to moderate mental health problems, with barriers including lack of accessible services and concerns that problems will not be understood by health care providers. OBJECTIVE This study aims to describe the process of developing a transdiagnostic internet-based cognitive behavioral therapy self-help program in Arabic for mild to moderate symptoms of common psychological problems such as anxiety, depression, and insomnia. METHODS The iterative development process, including feedback from 105 pilot users as well as 2 focus groups, is described. RESULTS Overall, the modules were rated as acceptable by the pilot users, with overall ratings ranging from 3 to 4 points on average for the respective modules on a 5-point Likert scale. Feedback from the 2 focus groups was overall positive with regard to the content and structure of the program but also included suggestions for improving the Arabic translation as well as the usability of the material. CONCLUSIONS An internet-based self-help program that is deemed acceptable by an Arabic-speaking audience can be successfully developed, thus providing increased access to psychological help for an at-risk population. However, further research regarding the efficacy of this type of intervention is warranted.

scholarly journals Cognitive-Behavioral Therapy for Insomnia: An Effective and Underutilized Treatment for Insomnia

2019 ◽  
Vol 13 (6) ◽  
pp. 544-547 ◽  
Author(s):  
Jeffrey Rossman
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Health Care Providers ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Chronic Insomnia ◽  
Relaxation Techniques ◽  
Care Providers ◽  
Medical Problems ◽  
Sleep Medication ◽  
Falling Asleep

Sleep difficulties are an extremely prevalent health problem, with about 33% to 50% of adults reporting regular difficulty falling asleep or staying asleep. About 7% to 18% of adults meet the criteria for an insomnia disorder.1,2 Sleep disruptions contribute to a variety of medical problems, including cognitive impairment, reduced immune function, metabolic imbalance, and exacerbation of psychiatric conditions.3 The most effective nonpharmacological treatment for chronic insomnia is cognitive-behavioral therapy for insomnia (CBT-i). CBT-i produces results that are equivalent to sleep medication, with no side effects, fewer episodes of relapse, and a tendency for sleep to continue to improve long past the end of treatment. The long-term improvements seem to result from the patient learning how to support and promote the body’s natural sleep mechanism. The five key components of CBT-i are sleep consolidation, stimulus control, cognitive restructuring, sleep hygiene, and relaxation techniques. Although CBT-i is a safe and highly effective treatment for insomnia, unfortunately, it is underutilized, primarily because of two reasons: (1) There is currently a shortage of trained CBT-i practitioners. (2) Patient are much more likely to learn about sleep medication as a treatment for their insomnia (via drug advertisements and prescribing physicians) than CBT-i. Physicians and health care providers can play an important role in educating their patients about CBT-i and recommending it as a first-line treatment for chronic insomnia.

scholarly journals Addressing Anxiety and Fear during the Female Pelvic Examination

2021 ◽  
Vol 12 ◽  
pp. 215013272199219
Author(s):  
Danielle J. O’Laughlin ◽  
Brittany Strelow ◽  
Nicole Fellows ◽  
Elizabeth Kelsey ◽  
Sonya Peters ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care Providers ◽  
Negative Symptoms ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Pelvic Examination ◽  
Care Providers ◽  
Emotional Symptoms ◽  
Pelvic Examinations ◽  
Anxiety And Fear

To review the anxiety and fear risk factors, pathophysiology, symptoms, screening and diagnosis while highlighting treatment considerations for women undergoing a pelvic examination. Methods: We reviewed the literature pertaining to anxiety and fear surrounding the pelvic examination to help guide health care providers’ on available screening options and to review options for individualized patient management. Results: Anxiety and fear are common before and during the pelvic examination. In fact, the pelvic exam is one of the most common anxiety-provoking medical procedures. This exam can provoke negative physical and emotional symptoms such as pain, discomfort, anxiety, fear, embarrassment, and irritability. These negative symptoms can interfere with preventative health screening compliance resulting in delayed or avoided care and significant health consequences. Conclusion: Assessing women for anxiety related to pelvic examinations may help decrease a delay or avoidance of examinations. Risk factor and symptom identification is also a key component in this. General anxiety questionnaires can help identify women with anxiety related to pelvic examinations. Strategies to reduce anxiety, fear and pain during a pelvic examination should routinely be implemented, particularly in women with high-risk factors or those identified with screening techniques as having anxiety, fear or pain with examinations. Treatment options should be targeted at understanding the patient’s concerns, starting conversations about pelvic examinations early, educating patient’s about the examination and offering the presence of a chaperone or support person. During an examination providers should ensure the patient is comfortable, negative phrases are avoided, the correct speculum size is utilized and proper lubrication, draping, dressing and positioning are performed. Treating underlying gynecologic or mental health conditions, consideration of cognitive behavioral therapy and complementary techniques such as lavender aromatherapy and music therapy should also be considered when appropriate.

scholarly journals Tips and Traps: Lessons From Codesigning a Clinician E-Monitoring Tool for Computerized Cognitive Behavioral Therapy

2020 ◽  
Author(s):  
Frederick Sundram ◽  
Susan J Hawken ◽  
Karolina Stasiak ◽  
Mathijs FG Lucassen ◽  
Theresa Fleming ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Focus Groups ◽  
Therapeutic Relationship ◽  
Electronic Monitoring ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Youth Workers ◽  
Monitoring Tool ◽  
Additional Time ◽  
Registration Process

Background Computerized cognitive behavioral therapy (cCBT) is an acceptable and promising treatment modality for adolescents with mild-to-moderate depression. Many cCBT programs are standalone packages with no way for clinicians to monitor progress or outcomes. We sought to develop an electronic monitoring (e-monitoring) tool in consultation with clinicians and adolescents to allow clinicians to monitor mood, risk, and treatment adherence of adolescents completing a cCBT program called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts). Objective The objectives of our study were as follows: (1) assess clinicians’ and adolescents’ views on using an e-monitoring tool and to use this information to help shape the development of the tool and (2) assess clinician experiences with a fully developed version of the tool that was implemented in their clinical service. Methods A descriptive qualitative study using semistructured focus groups was conducted in New Zealand. In total, 7 focus groups included clinicians (n=50) who worked in primary care, and 3 separate groups included adolescents (n=29). Clinicians were general practitioners (GPs), school guidance counselors, clinical psychologists, youth workers, and nurses. Adolescents were recruited from health services and a high school. Focus groups were run to enable feedback at 3 phases that corresponded to the consultation, development, and postimplementation stages. Thematic analysis was applied to transcribed responses. Results Focus groups during the consultation and development phases revealed the need for a simple e-monitoring registration process with guides for end users. Common concerns were raised in relation to clinical burden, monitoring risk (and effects on the therapeutic relationship), alongside confidentiality or privacy and technical considerations. Adolescents did not want to use their social media login credentials for e-monitoring, as they valued their privacy. However, adolescents did want information on seeking help and personalized monitoring and communication arrangements. Postimplementation, clinicians who had used the tool in practice revealed no adverse impact on the therapeutic relationship, and adolescents were not concerned about being e-monitored. Clinicians did need additional time to monitor adolescents, and the e-monitoring tool was used in a different way than was originally anticipated. Also, it was suggested that the registration process could be further streamlined and integrated with existing clinical data management systems, and the use of clinician alerts could be expanded beyond the scope of simply flagging adolescents of concern. Conclusions An e-monitoring tool was developed in consultation with clinicians and adolescents. However, the study revealed the complexity of implementing the tool in clinical practice. Of salience were privacy, parallel monitoring systems, integration with existing electronic medical record systems, customization of the e-monitor, and preagreed monitoring arrangements between clinicians and adolescents.

A Systematic Meta-Review of Internet-Based Cognitive Behavioral Therapy (ICBT)

2018 ◽  
Author(s):  
Quincy J. J. Wong ◽  
Alison L. Calear ◽  
Helen Christensen
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Is Implementation ◽  
Treatment And Prevention ◽  
Meta Review ◽  
Adolescents And Adults ◽  
Meta Analyses

Internet-based cognitive behavioral therapy (ICBT) is the provision of cognitive behavioral therapy (CBT) using the Internet as a platform for delivery. The advantage of ICBT is its ability to overcome barriers to treatment associated with traditional face-to-face CBT, such as poor access, remote locations, stigmas around help-seeking, the wish to handle the problem alone, the preference for anonymity, and costs (time and financial). A large number of randomized controlled trials (RCTs) have tested the acceptability, efficacy, and cost-effectiveness of ICBT for anxiety disorders, mood disorders, and associated suicidality. A meta-review was conducted by searching PsycINFO and PubMed for previous systematic reviews and meta-analyses of ICBT programs for anxiety, depression, and suicidality in children, adolescents, and adults. The results of the meta-review indicated that ICBT is effective in the treatment and prevention of mental health problems in adults and the treatment of these problems in youth. Issues of adherence and privacy have been raised. However, the major challenge for ICBT is implementation and uptake in the “real world.” The challenge is to find the best methods to embed, deliver, and implement ICBT routinely in complex health and education environments.

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