Internet and Face-to-Face Cognitive Behavioural Therapy for Postnatal Depression Compared to Treatment-As-Usual: A Randomised Controlled Trial of MumMoodBooster (Preprint)

2020 ◽  
Author(s):  
Jeannette Milgrom ◽  
Brian G. Danaher ◽  
John R. Seeley ◽  
Christopher J. Holt ◽  
Charlene Holt ◽  
...  
Keyword(s):  
Postnatal Depression ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Treatment As Usual ◽  
Face To Face ◽  
Cognitive Behavioural ◽  
Postnatal Women ◽  
Dsm Iv ◽  
Randomised Controlled

BACKGROUND Previous research confirms that symptoms of postnatal depression (PND) can be ameliorated through internet-delivered psychological interventions. To date, no research has examined the efficacy of such interventions compared directly to face-to-face (FTF) treatment in women clinically diagnosed with PND. OBJECTIVE We aimed to compare the efficacy of one of the first Web-based cognitive behavioural therapy (internet CBT + coach calls) interventions for PND (MumMoodBooster: MMB) with FTF-CBT in a randomised controlled trial (RCT). METHODS One hundred and sixteen postnatal women with a DSM-IV diagnosis of major or minor depression were randomised to either MMB (n = 39), FTF-CBT (n = 39) or a treatment as usual control condition (TAU, n = 38). Diagnostic status was determined at baseline and at a 21-week follow-up using the Structured Clinical Interview for the DSM-IV (SCID-IV). Severity of anxious and depressive symptoms were evaluated with the Depression Anxiety Stress Scales (DASS-21) and the Beck Depression Inventory – Revised (BDI-II) at baseline, 12 weeks (post-treatment) and at 21 weeks follow-up. RESULTS Ninety two percent of participants had a diagnosis of major depression at baseline. Rates of remission from the major or minor depressive episode at 21 weeks in both the FTF-CBT and the MMB groups were superior to TAU (Relative Risk = 0.59 and 0.68 respectively) and they were not significantly different from each other. Whilst remission rates differed between TAU and FTF-CBT, growth models showed that, in terms of symptom reduction across time, the FTF-CBT treatment was not significantly better than TAU. By comparison, MMB was statistically superior to both TAU and FTF-CBT in reducing symptoms of depression, anxiety and stress from baseline to 21 weeks follow-up (large and moderate effect sizes). Thus, after 21 weeks, symptom scores for depression and anxiety in women receiving MMB were approximately 50% lower than the average scores in both TAU and FTF-CBT. CONCLUSIONS In this RCT, MMB was at least as effective as FTF-CBT in achieving remission from a diagnosed postnatal depressive episode. MMB was superior to both TAU and FTF-CBT in encouraging and maintaining reduction of symptom severity over 21 weeks follow-up for depressed postnatal women. These findings replicate results of prior studies of MMB that showed clinically significant improvements in depressive symptoms and they provide direct empirical support that internet delivered treatment for depressed postnatal women is a viable alternative to face-to-face treatment. Advantages of internet treatment include anonymity, convenience and catering for women who would prefer not to, or cannot, access face-to-face treatments. The generalisability of results needs to be examined by future research since RCTs of internet-based versus face-to-face treatments necessarily involve a subset of people who are willing to undertake either modality of treatment. CLINICALTRIAL The protocol for this trial was registered prospectively on the Australia and New Zealand Clinical Trials Registry (trial id ACTRN12613000881730); https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364683&isReview=true.

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 Assessing telephone-delivered cognitive–behavioural therapy (CBT) and web-delivered CBT versus treatment as usual in irritable bowel syndrome (ACTIB): a multicentre randomised trial

Gut ◽  
2019 ◽  
pp. gutjnl-2018-317805 ◽  
Author(s):  
Hazel Anne Everitt ◽  
Sabine Landau ◽  
Gilly O’Reilly ◽  
Alice Sibelli ◽  
Stephanie Hughes ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Social Adjustment ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Clinical Effectiveness ◽  
Behavioural Therapy ◽  
Treatment As Usual ◽  
Cognitive Behavioural ◽  
Randomised Controlled

ObjectiveTo evaluate the clinical effectiveness of two modes of cognitive–behavioural therapy (CBT) for IBS compared with treatment as usual (TAU) in refractory IBS.DesignA three-arm randomised controlled trial assessing telephone-delivered CBT (TCBT), web-based CBT (WCBT) with minimal therapist support, and TAU. Blinding participants and therapists was not possible. Chief investigator, assessors and statisticians were blinded. Participants were adults with refractory IBS (clinically significant symptoms for ≥12 months despite first-line therapies), recruited by letter and opportunistically from 74 general practices and three gastroenterology centres in London and South of England between May 2014 to March 2016. Co-primary outcomes were IBS Symptom Severity Score (IBS-SSS) and Work and Social Adjustment Scale (WSAS) at 12 months.Results558/1452 (38.4%) patients screened for eligibility were randomised: 76% female: 91% white: mean age 43 years. (391/558) 70.1% completed 12 months of follow-up. Primary outcomes: Compared with TAU (IBS-SSS 205.6 at 12 months), IBS-SSS was 61.6 (95% CI 33.8 to 89.5) points lower (p<0.001) in TCBT and 35.2 (95% CI 12.6 to 57.8) points lower (p=0.002) in WCBT at 12 months. Compared with TAU (WSAS score 10.8 at 12 months) WSAS was 3.5 (95% CI 1.9 to 5.1) points lower (p<0.001) in TCBT and 3.0 (95% CI 1.3 to 4.6) points lower (p=0.001) in WCBT. All secondary outcomes showed significantly greater improvement (p≤0.002) in CBT arms compared with TAU. There were no serious adverse reactions to treatment.ConclusionBoth CBT interventions were superior to TAU up to 12 months of follow-up.Trial registration numberISRCTN44427879.

scholarly journals Computerised cognitive–behavioural therapy for adults with intellectual disability: randomised controlled trial

2017 ◽  
Vol 211 (2) ◽  
pp. 95-102 ◽  
Author(s):  
Patricia Cooney ◽  
Catherine Jackman ◽  
David Coyle ◽  
Gary O'Reilly
Keyword(s):  
Intellectual Disability ◽  
Randomised Controlled Trial ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Primary Outcome Measure ◽  
Cognitive Behavioural ◽  
Randomised Controlled

BackgroundDespite the evidence base for computer-assisted cognitive–behavioural therapy (CBT) in the general population, it has not yet been adapted for use with adults who have an intellectual disability.AimsTo evaluate the utility of a CBT computer game for adults who have an intellectual disability.MethodA 2 × 3 (group × time) randomised controlled trial design was used. Fifty-two adults with mild to moderate intellectual disability and anxiety or depression were randomly allocated to two groups: computerised CBT (cCBT) or psychiatric treatment as usual (TAU), and assessed at pre-treatment, post-treatment and 3-month follow-up. Forty-nine participants were included in the final analysis.ResultsA significant group x time interaction was observed on the primary outcome measure of anxiety (Glasgow Anxiety Scale for people with an Intellectual Disability), favouring cCBT over TAU, but not on the primary outcome measure of depression (Glasgow Depression Scale for people with a Learning Disability). A medium effect size for anxiety symptoms was observed at post-treatment and a large effect size was observed after follow-up. Reliability of Change Indices indicated that the intervention produced clinically significant change in the cCBT group in comparison with TAU.ConclusionsAs the first application of cCBT for adults with intellectual disability, this intervention appears to be a useful treatment option to reduce anxiety symptoms in this population.

scholarly journals Influence of age on outcome of psychological treatments in first-episode psychosis

2006 ◽  
Vol 188 (3) ◽  
pp. 250-254 ◽  
Author(s):  
Gillian Haddock ◽  
Shôn Lewis ◽  
Richard Bentall ◽  
Graham Dunn ◽  
Richard Drake ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Behavioural Therapy ◽  
First Episode ◽  
Treatment As Usual ◽  
Psychological Treatments ◽  
Treatment Providers ◽  
Cognitive Behavioural ◽  
Episode Psychosis ◽  
Supportive Counselling ◽  
Randomised Controlled

BackgroundPsychological treatments have been shown to be effective in patients with psychosis. However, the studies published to date have included participants across wide age ranges, so few conclusions can be reached about the effectiveness of such treatments in relation to age.AimsTo evaluate outcomes by age in a randomised controlled trial designed to evaluate the effectiveness of cognitive-behavioural therapy (CBT), supportive counselling and treatment as usual.MethodOutcomes were evaluated in terms of symptoms, social functioning, insight and therapeutic alliance according to age at 3- and 18-month follow-up.ResultsYounger participants responded better to supportive counselling than to treatment as usual and CBTover 3 months. Older participants responded better to CBT than to supportive counselling over 18 months. Younger participants showed a greater increase in insight after CBT compared with treatment as usual and supportive counselling, and were more difficult to engage in therapy.ConclusionsYoung people may have different needs with regard to engagement in psychological treatments. Treatment providers need to take age-specific factors into account.

Health-related quality of life in patients with chronic fatigue syndrome: group cognitive behavioural therapy and graded exercise versus usual treatment. A randomised controlled trial with 1 year of follow-up

2011 ◽  
Vol 30 (3) ◽  
pp. 381-389 ◽  
Author(s):  
Montserrat Núñez ◽  
Joaquim Fernández-Solà ◽  
Esther Nuñez ◽  
José-Manuel Fernández-Huerta ◽  
Teresa Godás-Sieso ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
Related Quality ◽  
Health Related ◽  
Randomised Controlled

scholarly journals Cognitive Behavioural Therapy for Nightmares for Patients with Persecutory Delusions (Nites): An Assessor-Blind, Pilot Randomized Controlled Trial

2019 ◽  
pp. 070674371984742 ◽  
Author(s):  
Bryony Sheaves ◽  
Emily A. Holmes ◽  
Stephanie Rek ◽  
Kathryn M. Taylor ◽  
Alecia Nickless ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Behavioural Therapy ◽  
Serious Adverse Events ◽  
Persecutory Delusions ◽  
Treatment As Usual ◽  
Cognitive Behavioural

Objective:Nightmares are relatively common in patients experiencing psychosis but rarely assessed or treated. Nightmares may maintain persecutory delusions by portraying fears in sensory-rich detail. We tested the potential benefits of imagery-focused cognitive behavioural therapy (CBT) for nightmares on nightmare severity and persecutory delusions.Method:This assessor-blind parallel-group pilot trial randomized 24 participants with nightmares and persecutory delusions to receive CBT for nightmares delivered over 4 weeks in addition to treatment as usual (TAU) or TAU alone. Assessments were at 0, 4 (end of treatment), and 8 weeks (follow-up). Feasibility outcomes assessed therapy uptake, techniques used, satisfaction, and attrition. The primary efficacy outcome assessed nightmare severity at week 4. Analyses were intention to treat, estimating treatment effect with 95% confidence intervals (CIs).Results:All participants offered CBT completed therapy (mean [SD], 4.8 [0.6] sessions) with high satisfaction, and 20 (83%) participants completed all assessments. Compared with TAU, CBT led to large improvements in nightmares (adjusted mean difference = −7.0; 95% CI, –12.6 to –1.3; d = –1.1) and insomnia (6.3; 95% CI, 2.6 to 10.0; d = 1.4) at week 4. Gains were maintained at follow-up. Suicidal ideation was not exacerbated by CBT but remained stable to follow-up, compared with TAU, which reduced at follow-up (6.8; 95% CI, 0.3 to 3.3; d = 0.7). CBT led to reductions in paranoia (–20.8; 95% CI, –43.2 to 1.7; d = –0.6), although CIs were wide. Three serious adverse events were deemed unrelated to participation (CBT = 2, TAU = 1).Conclusions:CBT for nightmares is feasible and may be efficacious for treating nightmares and comorbid insomnia for patients with persecutory delusions. It shows promise on paranoia but potentially not on suicidal ideation.

scholarly journals Cognitive–behavioural therapy for anxiety in dementia: pilot randomised controlled trial

2015 ◽  
Vol 206 (6) ◽  
pp. 509-516 ◽  
Author(s):  
Aimee Spector ◽  
Georgina Charlesworth ◽  
Michael King ◽  
Miles Lattimer ◽  
Susan Sadek ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Behavioural Therapy ◽  
Treatment As Usual ◽  
Pilot Randomised Controlled Trial ◽  
Cognitive Behavioural ◽  
Randomised Controlled ◽  
Effective Treatments

BackgroundAnxiety is common and problematic in dementia, yet there is a lack of effective treatments.AimsTo develop a cognitive–behavioural therapy (CBT) manual for anxiety in dementia and determine its feasibility through a randomised controlled trial.MethodA ten-session CBT manual was developed. Participants with dementia and anxiety (and their carers) were randomly allocated to CBT plus treatment as usual (TAU) (n= 25) or TAU (n= 25). Outcome and cost measures were administered at baseline, 15 weeks and 6 months.ResultsAt 15 weeks, there was an adjusted difference in anxiety (using the Rating Anxiety in Dementia scale) of (–3.10, 95% CI −6.55 to 0.34) for CBT compared with TAU, which just fell short of statistical significance. There were significant improvements in depression at 15 weeks after adjustment (–5.37, 95% CI −9.50 to −1.25). Improvements remained significant at 6 months. CBT was cost neutral.ConclusionsCBT was feasible (in terms of recruitment, acceptability and attrition) and effective. A fully powered RCT is now required.

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