scholarly journals Effects of Internet-Based Cognitive Behavioral Therapy in Routine Care for Adults in Treatment for Depression and Anxiety: Systematic Review and Meta-Analysis (Preprint)

2020 ◽  
Author(s):  
Anne Etzelmueller ◽  
Christiaan Vis ◽  
Eirini Karyotaki ◽  
Harald Baumeister ◽  
Nickolai Titov ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Routine Care ◽  
Cognitive Behavioral ◽  
Effect Sizes ◽  
Depression And Anxiety ◽  
Care Providers ◽  
Treatment Of Depression

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.

scholarly journals Effects of Internet-Based Cognitive Behavioral Therapy in Routine Care for Adults in Treatment for Depression and Anxiety: Systematic Review and Meta-Analysis

10.2196/18100 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e18100 ◽  
Author(s):  
Anne Etzelmueller ◽  
Christiaan Vis ◽  
Eirini Karyotaki ◽  
Harald Baumeister ◽  
Nickolai Titov ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Routine Care ◽  
Cognitive Behavioral ◽  
Effect Sizes ◽  
Depression And Anxiety ◽  
Care Providers ◽  
Treatment Of Depression

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.

Integrating Motivational Interviewing and Cognitive Behavioral Therapy in the Treatment of Depression and Anxiety

2004 ◽  
Vol 18 (4) ◽  
pp. 337-350 ◽  
Author(s):  
Hal Arkowitz ◽  
Henny A. Westra
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Motivational Interviewing ◽  
Clinical Experience ◽  
Behavioral Activation ◽  
Behavioral Therapy ◽  
Readiness For Change ◽  
Cognitive Behavioral ◽  
Depression And Anxiety ◽  
Treatment Of Depression

Many clients engaging in Cognitive Behavioral Therapy (CBT) for depression and anxiety are ambivalent about change, and about taking necessary actions to bring about change such as exposure or behavioral activation exercises. Given the focus of motivational interviewing (MI) on enhancing readiness for change, it is of great interest to investigate applications of MI to prevalent disorders such as depression and anxiety. After exploring the rationale for integrating MI with CBT for these disorders, we outline unique features of MI that may render it a useful complement to CBT, such as its focus on resolving ambivalence for change and specific strategies for responding to resistance. We suggest several possible ways in which MI may be combined with CBT. Finally, we discuss our clinical experience with adapting MI to the treatment of depression and anxiety, including case illustrations of each, and discuss some of the unique issues arising in generalizing MI for use with these populations.

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 ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Depressive Disorders ◽  
Behavioral Therapy ◽  
Routine Care ◽  
Self Report ◽  
Cognitive Behavioral ◽  
Effect Sizes ◽  
Control Group ◽  
Parent Rating ◽  
Wide Range

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

scholarly journals Guided Internet-Based Cognitive Behavioral Therapy for Adult Depression and Anxiety in Routine Secondary Care: Observational Study (Preprint)

2018 ◽  
Author(s):  
Kim Mathiasen ◽  
Heleen Riper ◽  
Tonny E Andersen ◽  
Kirsten K Roessler
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Secondary Care ◽  
Odds Ratio ◽  
Large Scale ◽  
Behavioral Therapy ◽  
Routine Care ◽  
Cognitive Behavioral ◽  
Depression And Anxiety ◽  
High Baseline ◽  
Baseline Severity

BACKGROUND Internet-based cognitive behavioral therapy (iCBT) is a promising new treatment method for depression and anxiety. However, it is important to determine whether its results can be replicated in routine care before its implementation on a large scale. Although many studies have demonstrated the efficacy of iCBT under controlled conditions, only a few studies have investigated its effectiveness in routine care. Furthermore, several effects of iCBT such as treatment effects in routine care are unclear. OBJECTIVE This study aimed to evaluate the clinical effectiveness of iCBT for depression and anxiety in routine secondary care. METHODS n a retrospective cohort study, we analysed patients treated for depression or anxiety in a dedicated iCBT clinic in secondary care in Denmark. Patients were examined before treatment and weekly thereafter by using the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7 scales for the diagnoses of depression and anxiety, respectively. Primary analyses were conducted using a linear mixed-effects model with random slope and intercept. Secondary analyses were conducted using baseline characteristics as predictors (gender, age, highest level of education, occupational status, marital status, psychotropic medication use, consumption of alcohol, and leisure drugs). Additionally, logistic regression analyses were used to predict noncompletion of treatment. RESULTS A total of 203 (depression, N=60; anxiety, N=143) patients were included. Participants were mainly female (78.3% with depression and 65.7% with anxiety), with a mean age of 36.03 (SD 10.97) years (range, 19-67 years) for patients with depression and 36.80 (SD 13.55) years (range, 19-69 years) for patients with anxiety. The completion rates were 62% (37) and 40% (57) for depression and anxiety treatments, respectively. The primary analyses revealed large and significant reductions in the symptom levels of depression (beta=-6.27, SE 0.83, P<.001, d=1.0) and anxiety (beta=-3.78, SE 0.43, P<.001, d=1.1). High baseline severity of the primary disorder was associated with high treatment gains (r=-0.31 for depression; r=-0.41 for anxiety). In patients with anxiety, high baseline severity also predicted a high risk of noncompletion (odds ratio=1.08, CI=1.01-1.16, P=.03). An increase in the baseline severity of the comorbid disorder slightly increased the risk of noncompletion for both disorders (depression: odds ratio=1.03, CI=1.01-1.06, P=.02; anxiety: odds ratio=1.08, CI=1.01-1.16, P=.03). CONCLUSIONS iCBT can be clinically effective in routine care. Since depression and anxiety are costly and debilitating disorders that are vastly undertreated, this finding is important. Additionally, iCBT may help bridge the gap between the need for treatment and its provision. Our results are comparable to the within-group results of efficacy and effectiveness studies. Our noncompletion rates are similar to those observed in psychotherapy but are higher than those reported in similar clinics. Multiple factors predicted outcome and noncompletion. However, all predictor effects were statistically weak.

Treatment of depression and anxiety in infertile women: Cognitive behavioral therapy versus fluoxetine

2008 ◽  
Vol 108 (1-2) ◽  
pp. 159-164 ◽  
Author(s):  
Mahbobeh Faramarzi ◽  
Ahmad Alipor ◽  
Seddigheh Esmaelzadeh ◽  
Farzan Kheirkhah ◽  
Karamolah Poladi ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Depression And Anxiety ◽  
Infertile Women ◽  
Treatment Of Depression

scholarly journals Possibilities of Using Cognitive Behavioral Therapy for the Treatment of Depression and Anxiety after Stroke

2018 ◽  
Vol 26 (1) ◽  
pp. 95-111 ◽  
Author(s):  
D.A. Zakharchenko ◽  
S.S. Petrikov
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Depression And Anxiety ◽  
Flow Disturbance ◽  
Common Structure ◽  
Treatment Of Depression ◽  
Therapy Sessions

The paper presents the review of studies of cognitive behavioral therapy efficacy for patients with depression and anxiety after acute cerebral blood flow disturbance. The possibilities of adapting and modifying cognitive behavior methods of intervention to suit the needs and specific features of these patients are discussed. Organization of therapy sessions for patients with cognitive and emotional impairments during rehabilitation after acute cerebral blood flow disturbance is described. The common structure of the psychotherapeutic process and the peculiarities of behavioral and cognitive interventions are considered.

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