Dropout from an internet-delivered CBT Intervention for Adults with Depression and Anxiety: A Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Kate Lawler ◽  
Caroline Earley ◽  
Ladislav Timulak ◽  
Angel Enrique ◽  
Derek Richards
Keyword(s):  
Online Communication ◽  
Structured Interview ◽  
Routine Care ◽  
Drop Out ◽  
Group Differences ◽  
Dropping Out ◽  
Completion Rates ◽  
Depression And Anxiety ◽  
Lower Treatment ◽  
Perceived Change

BACKGROUND Treatment dropout continues to be reported from iCBT interventions and lower completion rates are generally associated with lower treatment effect sizes. However, evidence is emerging to suggest that completion of a pre-defined number of modules is not always necessary for clinical benefit nor considerate of the needs of each individual patient. OBJECTIVE The study aimed to carry out a qualitative analysis of patients’ experiences of an iCBT intervention in a routine care setting in order to achieve a deeper insight into the phenomenon of dropout. METHODS Fifteen purposively sampled participants (8 female) from a larger parent RCT were interviewed via telephone using a semi-structured interview schedule that was developed from the existing literature and research on dropout in iCBT. Data was analysed using the descriptive-interpretive approach. RESULTS The experience of treatment leading to dropout can be understood in terms of ten domains: Relationship to Technology, Motivation to Start, Background Knowledge and Attitudes towards iCBT, Perceived Change in Motivation, Usage of the Programme, Changes due to the Intervention, Engagement with Content, Experience Interacting with the Supporter, Experience of Online Communication and Termination of the Supported Period. CONCLUSIONS Patients who drop out of treatment can be distinguished in terms of their change in motivation: those who felt ready to leave treatment early and those who had negative reasons for dropping out. These two groups of participants have different treatment experiences, revealing potential attributes and non-attributes of dropout. The reported between group differences should be examined further to consider those attributes that are strongly descriptive of the experience and regarded with less importance those that have become loosely affiliated.

scholarly journals Efficacy of Internet Delivered Cognitive Behaviour Therapy for People in the Depressed Phase of Bipolar Disorder

2021 ◽  
Author(s):  
Olav Nielssen ◽  
Lauren Staples ◽  
Eyal Karin ◽  
rony kayrouz ◽  
Blake Dear ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Behaviour Therapy ◽  
Bipolar Depression ◽  
Routine Care ◽  
Completion Rates ◽  
Depression And Anxiety ◽  
Behaviour Therapy ◽  
Research Reporting ◽  
Cognitive Behaviour ◽  
Patient Health

Abstract BackgroundThere is little research reporting the outcome of internet delivered cognitive behaviour therapy (iCBT) for the depressed phase of bipolar disorder as part of routine care. MethodsDemographic information, baseline scores and treatment outcomes were examined for patients of MindSpot Clinic, a national iCBT service who reported taking Lithium and their clinic records confirming the diagnosis of bipolar disorder. Outcomes were completion rates, patient satisfaction and changes in measures of psychological distress, depression and anxiety measured by the Kessler-10 item (K-10), Patient Health Questionnaire 9 Item (PHQ-9), and Generalized Anxiety Disorder Scale 7 Item (GAD-7), compared to clinic benchmarks. ResultsOut of 21,745 people completed a MindSpot assessment and enrolled in a MindSpot treatment course in a 7 year period, 83 reported taking Lithium and had a confirmed a diagnosis of bipolar disorder. Reductions in symptoms were large on all measures (effect sizes > 1.0 on all measures, percentage change between 32.4% and 40%), and lesson completion and satisfaction with the course were also high. ConclusionsMindSpot treatments were effective in treating anxiety and depression in people diagnosed with bipolar, and suggest that the routine provision of iCBT can help overcome the under-use of evidence based psychological treatments of people with bipolar depression.

scholarly journals Reasons for dropping out of internet-based problem gambling treatment, and the process of recovery – a qualitative assessment

2021 ◽  
Author(s):  
Anders Nilsson ◽  
Olivia Simonsson ◽  
Clara Hellner
Keyword(s):  
Problem Gambling ◽  
Structured Interview ◽  
Drop Out ◽  
Qualitative Assessment ◽  
Dropping Out ◽  
Gambling Problems ◽  
Need For Treatment ◽  
Concerned Significant Others ◽  
Drop Outs ◽  
Gambling Treatment

AbstractProblem gambling (PG) is a condition affecting the economy, mental health, and relationships of both the individuals with gambling problems, and concerned significant others (CSOs). While PG is treatable, few individuals with gambling problems seek treatment, and many drop out of treatment. This qualitative study aims to investigate a) the reasons for individuals with gambling problems to drop-out from Internet-based PG treatment, and b) what individuals with gambling problems and CSOs find helpful and unhelpful processes in PG recovery. A total of 16 participants (8 individuals with gambling problems and 8 CSOs) who had participated in an Internet-based PG treatment were interviewed over the telephone in a semi-structured interview. The interviews were analyzed using thematic analysis. Drop-out from treatment was one aspect of an overarching theme identified as unstable path to recovery, where alternating periods of progress and setbacks delineate several aspects of PG. Relapses, negative emotions, and changing life circumstances were identified to separately, and in combination, contribute to drop-out. Drop-outs were also explained by participants’ experiences of a reduced need for treatment. Openness and a support from CSOs and peers were identified as themes important for recovery. The results suggest that PG treatments should consider the emotional state, and comorbidities of the patients, in order to reduce drop-out and improve chances of recovery.

Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and meta-analysis of comparative outcome studies

2010 ◽  
Vol 40 (12) ◽  
pp. 1943-1957 ◽  
Author(s):  
P. Cuijpers ◽  
T. Donker ◽  
A. van Straten ◽  
J. Li ◽  
G. Andersson
Keyword(s):  
Anxiety Disorders ◽  
Meta Analysis ◽  
Routine Care ◽  
Drop Out ◽  
Depression And Anxiety ◽  
Face To Face ◽  
Self Help ◽  
Significant Difference ◽  
Post Test ◽  
The Difference

BackgroundAlthough guided self-help for depression and anxiety disorders has been examined in many studies, it is not clear whether it is equally effective as face-to-face treatments.MethodWe conducted a meta-analysis of randomized controlled trials in which the effects of guided self-help on depression and anxiety were compared directly with face-to-face psychotherapies for depression and anxiety disorders. A systematic search in bibliographical databases (PubMed, PsycINFO, EMBASE, Cochrane) resulted in 21 studies with 810 participants.ResultsThe overall effect size indicating the difference between guided self-help and face-to-face psychotherapy at post-test was d=−0.02, in favour of guided self-help. At follow-up (up to 1 year) no significant difference was found either. No significant difference was found between the drop-out rates in the two treatments formats.ConclusionsIt seems safe to conclude that guided self-help and face-to-face treatments can have comparable effects. It is time to start thinking about implementation in routine care.

scholarly journals Clinical Use of Surface Electromyography to Track Acute Upper Extremity Muscle Recovery after Stroke: A Descriptive Case Study of a Single Patient

2021 ◽  
Vol 4 (2) ◽  
pp. 32
Author(s):  
Heather A. Feldner ◽  
Christina Papazian ◽  
Keshia M. Peters ◽  
Claire J. Creutzfeldt ◽  
Katherine M. Steele
Keyword(s):  
Muscle Activity ◽  
Surface Electromyography ◽  
Inpatient Rehabilitation ◽  
Stroke Survivor ◽  
Structured Interview ◽  
Routine Care ◽  
Stroke Recovery ◽  
Descriptive Case Study ◽  
Sensing Technology

Arm recovery varies greatly among stroke survivors. Wearable surface electromyography (sEMG) sensors have been used to track recovery in research; however, sEMG is rarely used within acute and subacute clinical settings. The purpose of this case study was to describe the use of wireless sEMG sensors to examine changes in muscle activity during acute and subacute phases of stroke recovery, and understand the participant’s perceptions of sEMG monitoring. Beginning three days post-stroke, one stroke survivor wore five wireless sEMG sensors on his involved arm for three to four hours, every one to three days. Muscle activity was tracked during routine care in the acute setting through discharge from inpatient rehabilitation. Three- and eight-month follow-up sessions were completed in the community. Activity logs were completed each session, and a semi-structured interview occurred at the final session. The longitudinal monitoring of muscle and movement recovery in the clinic and community was feasible using sEMG sensors. The participant and medical team felt monitoring was unobtrusive, interesting, and motivating for recovery, but desired greater in-session feedback to inform rehabilitation. While barriers in equipment and signal quality still exist, capitalizing on wearable sensing technology in the clinic holds promise for enabling personalized stroke recovery.

scholarly journals Service Use, Drop-Out Rate and Clinical Outcomes: A Comparison Between High and Low Intensity Treatments in an IAPT Service

2014 ◽  
Vol 42 (6) ◽  
pp. 747-759 ◽  
Author(s):  
Stella W. Y. Chan ◽  
Malcolm Adams
Keyword(s):  
Clinical Outcomes ◽  
High Intensity ◽  
Recovery Rate ◽  
Service Use ◽  
Evaluation Study ◽  
Drop Out ◽  
Stepped Care ◽  
Depression And Anxiety ◽  
Low Intensity ◽  
Drop Out Rate

Background: The IAPT services provide high and low intensity psychological treatments for adults suffering from depression and anxiety disorders using a stepped care model. The latest national evaluation study reported an average recovery rate of 42%. However, this figure varied widely between services, with better outcomes associated with higher “step-up” rates between low and high intensity treatments. Aims: This study aimed to compare the two intensity groups in an IAPT service in Suffolk. Method: This study adopted a between groups design. A sample of 100 service users was randomly selected from the data collected from an IAPT service in Suffolk between May 2008 and February 2011. The treatment outcomes, drop-out rate, and other characteristics were compared between those who received high and low intensity treatments. Results: The high intensity group received, on average, more sessions and contact time. They received more CBT sessions and less guided self-help. There were no group differences in terms of the drop-out and appointment cancellation rates. Analyses on clinical outcomes suggested no group difference but demonstrated an overall recovery rate of 52.6% and significant reduction in both depression and anxiety symptoms. Conclusions: Despite methodological limitations, this study concludes that the service as a whole achieved above-average clinical outcomes. Further research building upon the current study in unpacking the relative strengths and weaknesses for the high and low intensity treatments would be beneficial for service delivery.

scholarly journals Depression and anxiety in a community sample with epilepsy in Brazil

2011 ◽  
Vol 69 (2b) ◽  
pp. 342-348 ◽  
Author(s):  
S Stefanello ◽  
L Marín-Léon ◽  
P T Fernandes ◽  
L M Li ◽  
N J Botega
Keyword(s):  
Suicide Attempts ◽  
Community Sample ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Psychiatric Evaluation ◽  
Depression And Anxiety ◽  
Community Based ◽  
Cross Sectional ◽  
The Social

OBJECTIVE: To estimate the frequency of depression/anxiety and to establish the social, epilepsy and psychiatric characteristics in individuals with epilepsy. METHOD: A cross-sectional study was employed to evaluate 153 subjects with epilepsy who were identified in a previous community-based survey. First, a structured interview was conducted, followed by a psychiatric evaluation. Subjects with depression were compared to those without, and subjects with anxiety were compared to those without. RESULTS: The prevalence of anxiety and depression was 39.4 and 24.4%, respectively. Both were associated with low schooling (OR 3.8, 95% CI 1.6 to 9.0 and OR 2.8, 95% CI 1.2 to 6.5 for depression and anxiety, respectively), lifetime suicidal thoughts (OR 4.4, 95% CI 1.9 to 10.3 and OR 3.6, 95% CI 1.7 to 7.7) and lifetime suicide attempts (OR 9.3, 95% CI 2.6 to 32.8 and OR 6.9, 95% CI 1.8 to 26.4). CONCLUSION: The high rates of depression and anxiety reinforced the need for recognition and treatment of mental disorders in epilepsy.

scholarly journals School dropout among female learners in rural Mpumalanga, South Africa

2021 ◽  
Vol 41 (3) ◽  
pp. 1-9
Author(s):  
Prince Mokoena ◽  
Adrian D. van Breda
Keyword(s):  
South Africa ◽  
High School ◽  
Rural Community ◽  
High School Dropout ◽  
School Dropout ◽  
Drop Out ◽  
Health Policies ◽  
Dropping Out ◽  
Secondary Schooling ◽  
Out Of School

South Africa, like many countries, has high numbers of learners who do not complete secondary schooling. This reduces these young people’s chances of finding work or of earning a better salary. It is thus important to understand the factors that contribute to high school dropout. In the study reported on here we investigated the factors that caused a number of female learners to drop out and return to high school in a rural community in Mpumalanga. The learners provided 3 reasons for dropping out of school: pregnancy, illness and immigration. The analysis of these factors suggests 3 underlying themes that influence the ability of children to remain in school, viz. health, policies and structures, and poverty. The implications of these and recommendations to address them are discussed. The authors argue that greater interdepartmental efforts are required to support vulnerable girls to remain in school.

scholarly journals Ride through testing of variable speed drive due to voltage sag types (types I, II and III)

2019 ◽  
Vol 10 (2) ◽  
pp. 690
Author(s):  
Surya Hardi ◽  
R. Harahap ◽  
S. Ahmad ◽  
M. Isa
Keyword(s):  
Drop Out ◽  
Dropping Out ◽  
Voltage Sag ◽  
Type I ◽  
Voltage Sags ◽  
Test Results ◽  
Variable Speed ◽  
Variable Speed Drives ◽  
Standard Curve ◽  
Test Points

Variable speed drives (VSDs) are widely used in various applications mainly in process industry need constant rotational speed. It is developed from power electronic components thus saving energy in its operation. Unfortunately it is susceptible against power quality problem for example voltage sags. The VSD may be disruption or drop out when it is supplied by voltage sags and it is determined by sag characteristics. This study is to investigate effect of voltage sags Types I, II and III on VSD through laboratory testing. The voltage sags characteristics are generated from voltage sag generator (Shaffner 2100 EMC).  The effects are presented in susceptibility curves in disruption and drop out conditions. The curves resulted are evaluated by standard curve recommended. Test results show that voltage sag Type I cause the VSD disruption only, whereas two types sag other result in the VSD disruption and also drop out. Evaluation results explain  a few test points are in operation area for disruption condition whereas test points for dropping out far below the threshold recommended. Hence the VSD has good quality to voltage sags.

scholarly journals No effect of gamification on attrition from a longitudinal cognitive testing study

2017 ◽  
Author(s):  
Jim Alexander Lumsden ◽  
Andy Skinner ◽  
David Coyle ◽  
Natalia Lawrence ◽  
Marcus Robert Munafo
Keyword(s):  
Cognitive Task ◽  
Stop Signal ◽  
Cognitive Testing ◽  
Drop Out ◽  
Stop Signal Task ◽  
Dropping Out ◽  
Repeated Testing ◽  
Balance Task ◽  
Health Practitioners ◽  
Gamelike Features

The prospect of assessing cognition longitudinally is attractive to researchers, health practitioners and pharmaceutical companies alike. However, such repeated-testing regimes place a considerable burden on participants, and with cognitive tasks typically being regarded as effortful and unengaging, these studies may experience high levels of participant attrition. One potential solution is to gamify these tasks to make them more engaging: increasing participant willingness to take part and reducing attrition. However, such an approach must balance task validity with introducing entertaining gamelike elements.We investigated the effects of gamelike features on participant attrition using a between-subjects, longitudinal online testing study. We used three variants of a common cognitive task, the stop signal task, with a single gamelike feature in each: one variant where points were rewarded for performing optimally, another where the task was given a graphical theme, and a third variant which was a standard stop signal task and served as a control condition. Participants completed four compulsory test sessions over four consecutive days before entering a six-day voluntary testing period where they faced a daily decision to either drop out or continue taking part. Participants were paid for each session they completed.We saw no evidence for an effect of gamification on attrition, with participants dropping out of each variant at equal rates. Our findings raise doubts about the ability of gamification to increase engagement with cognitive testing studies.

scholarly journals Socijalna integracija mladih u riziku od ispadanja iz sustava obrazovanja: rezultati slovenskog programa Projektno učenje mladih odraslih

2020 ◽  
Vol 27 (3) ◽  
pp. 287-308
Author(s):  
Miloslav Poštrak ◽  
Natalija Žalec ◽  
Gordana Berc
Keyword(s):  
Young Adults ◽  
Education System ◽  
Social Inclusion ◽  
Team Work ◽  
Drop Out ◽  
Dropping Out ◽  
Project Learning ◽  
Self Confidence ◽  
Social Fund ◽  
The Republic

SOCIAL INTEGRATION OF YOUNG PERSONS AT RISK OF DROPPING OUT OF THE EDUCATION SYSTEM: RESULTS OF THE SLOVENIAN PROGRAMME PROJECT LEARNING FOR YOUNG ADULTS In order to understand the phenomenon of dropping out of the education system, it is important to direct scientific and professional interest on understanding the lifestyle of these young persons from their perspective. The concept of social vulnerability of the youth is useful for that purpose, as it explores risk factors in various life circumstances of young persons, based on which approaches and programmes focused on prevention of dropping out, solving the problems of droputs and unemployed young persons are developed. The programme Project Learning for Young Adults combines both approaches and is based on an individualised, holistic and structured way of working with vulerable young persons. It consists of three levels of project activities: elective, individual and interest based with the aim of developing working habits, team work, self-confidence and career interests in order to reintegrate young adults in the education system and promote their entering the labour market and social inclusion. The programme has been active for 25 years in the Republic of Slovenia and it has included over 1,370 young adults. It has been financed by the European Social Fund. Key words: vulnerable youth, drop-out, NEET population, project learning for young adults.

Sign in / Sign up

Export Citation Format

Share Document