scholarly journals Developing and implementing an online psychotherapy program to address mental health challenges in oncology and palliative care patients: Protocol (Preprint)

2021 ◽  
Author(s):  
Nazanin Alavi ◽  
Callum Stephenson ◽  
Shadé Miller ◽  
Payam Khalafi ◽  
Israa Sinan ◽  
...  
Keyword(s):  
Mental Health ◽  
Palliative Care ◽  
Behavioural Therapy ◽  
Depression And Anxiety ◽  
Treatment As Usual ◽  
Online Delivery ◽  
Online Psychotherapy ◽  
Cognitive Behavioural ◽  
Mental Health Challenges ◽  
Psychotherapy Program

BACKGROUND The demand for mental health care, particularly for depression and anxiety, is three times greater in oncology and palliative care patients compared to the general population. This population faces unique barriers making them more susceptible to mental health challenges. Various forms of psychotherapy have been deemed effective in addressing mental health challenges in this population including supportive psychotherapy, cognitive behavioural therapy, problem-based therapy, and mindfulness. However, oncology and palliative care patient's access to traditional face-to-face psychotherapy resources is limited due to compromised immune systems making frequent visits to hospitals dangerous. Additionally, patients can face hospital fatigue from numerous appointments and investigations or may live in remote areas making commutes both physically and financially taxing. The online delivery of psychotherapy is a promising solution to address these accessibility barriers. Moreover, the online delivery of psychotherapy has been proven effective in addressing depression and anxiety in other populations and may be able to be transferred to oncology and palliative care patients. OBJECTIVE The study will investigate the feasibility and effectiveness of online delivery of psychotherapy for oncology and palliative care patients with comorbid depression or anxiety. It is hypothesized that this program will be a viable and efficacious treatment modality compared to treatment as usual in addressing depression and anxiety symptoms in this population. METHODS Participants (n = 60) with depression or anxiety will be recruited from oncology and palliative care settings in Kingston, Ontario, Canada. Participants will be randomly allocated to either receive 8 weeks of online psychotherapy plus treatment as usual (treatment arm), or treatment as usual exclusively (control arm). The online psychotherapy program will incorporate cognitive behavioural therapy, mindfulness, and problem-solving skills as well as homework assignments with personalized feedback from a therapist. All online programs will be delivered through a secure online platform specifically designed for the online delivery of psychotherapy. To evaluate treatment efficacy, all participants will complete standardized symptomology questionnaires at baseline, mid-point (week 4), and post-treatment. RESULTS The study received ethics approval in February 2021 and began recruitment in April 2021. Participant recruitment has been conducted through social media advertisements, physical advertisements, and physician referrals. To date, there have been 11 (treatment n = 5; control n = 4; drop-out n = 2) participants recruited. Data collection is expected to conclude by December 2021, and data analysis is expected to be completed by January 2022. Linear regression (for continuous outcomes) will be conducted with interpretive qualitative methods. CONCLUSIONS Findings from this study can be incorporated into clinical policy and help develop more accessible mental health treatment options for oncology and palliative care patients. The asynchronous and online delivery of psychotherapy is a more accessible, scalable, and financially feasible treatment that could have major implications on the health care system. CLINICALTRIAL ClinicalTrials.gov NCT04664270; clinicaltrials.gov/ct2/show/NCT04664270

scholarly journals Engagement and outcomes for a computerised cognitive-behavioural therapy intervention for anxiety and depression in African Americans

BJPsych Open ◽  
2017 ◽  
Vol 3 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Charles R. Jonassaint ◽  
Patrice Gibbs ◽  
Bea Herbeck Belnap ◽  
Jordan F. Karp ◽  
Kaleab Z. Abebe ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
African Americans ◽  
Cognitive Behavioural Therapy ◽  
Randomised Clinical Trial ◽  
Behavioural Therapy ◽  
Anxiety Symptoms ◽  
Primary Care Doctor ◽  
Depression And Anxiety ◽  
Cognitive Behavioural

BackgroundComputerised cognitive-behavioural therapy (CCBT) helps improve mental health outcomes in White populations. However, no studies have examined whether CCBT is acceptable and beneficial for African Americans.AimsWe studied differences in CCBT use and self-reported change in depression and anxiety symptoms among 91 African Americans and 499 White primary care patients aged 18–75, enrolled in a randomised clinical trial of collaborative care embedded with an online treatment for depression and anxiety.MethodPatients with moderate levels of mood and/or anxiety symptoms (PHQ-9 or GAD-7≥10) were randomised to receive either care-manager-guided access to the proven-effective Beating the Blues® CCBT programme or usual care from their primary care doctor.ResultsCompared with White participants, African Americans were less likely to start the CCBT programme (P=0.01), and those who did completed fewer sessions and were less likely to complete the full programme (P=0.03). Despite lower engagement, however, African Americans who started the CCBT programme experienced a greater decrease in self-reported depressive symptoms (estimated 8-session change: −6.6 v. −5.5; P=0.06) and similar decrease in anxiety symptoms (−5.3 v. −5.6; P=0.80) compared with White participants.ConclusionsCCBT may be an efficient and scalable first-step to improving minority mental health and reducing disparities in access to evidence-based healthcare.

scholarly journals Crisis-focused Cognitive Behavioural Therapy for Psychosis (CBTp) vs Treatment as Usual in Acute Mental Health Inpatient Settings (The CRISIS Study): Protocol For a Feasibility Randomised Controlled Trial

2021 ◽  
Author(s):  
Lisa Wood ◽  
Claire Williams ◽  
Vanessa Pinfold ◽  
Fiona Nolan ◽  
Anthony P Morrison ◽  
...  
Keyword(s):  
Mental Health ◽  
Randomised Controlled Trial ◽  
Inpatient Care ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Treatment As Usual ◽  
Feasibility Randomised Controlled Trial ◽  
Cognitive Behavioural ◽  
Randomised Controlled ◽  
Feasibility Rct

Abstract Background Cognitive Behavioural Therapy for psychosis (CBTp) is a psychological therapy which should be offered during the acute phases of psychosis. However, few research studies have examined the efficacy of CBTp interventions specifically adapted for the acute mental health inpatient context with most research trials being conducted with white European community populations. Aims The aim of this study is to conduct a feasibility Randomised Controlled Trial (RCT) of a crisis-focused CBTp intervention adapted for an ethnically diverse acute mental health inpatient population. The study will examine the feasibility of undertaking the trial, the acceptability and safety of the intervention, and the suitability of chosen outcome measures. This will inform the planning of a future, fully powered RCT. Methods A single-site, parallel group, feasibility RCT will be conducted examining the intervention. Drawing on principles of coproduction, the intervention has been adapted in partnership with key stakeholders; service users with lived experience of psychosis and of inpatient care (including those from ethnic minority backgrounds), carers, multidisciplinary inpatient clinicians, and researchers. Sixty participants with experience of psychosis and in current receipt of acute mental health inpatient care will be recruited. Participants will be randomly allocated to either the crisis-focused CBTp intervention or Treatment as Usual (TAU). Discussion Findings of this feasibility RCT will indicate whether a larger multi-site RCT is needed to investigate the efficacy of the intervention. If the initial results demonstrate that this trial is feasible and the intervention is acceptable, it will provide evidence that a full-scale effectiveness trial may be warranted. Trial registration: This trial has been prospectively registered on the ISRCTN registry (ISRCTN59055607) on the 18th February 2021 https://www.isrctn.com/ISRCTN59055607

scholarly journals Cognitive Behavioural Therapy through PowerPoint: Efficacy in an Adolescent Clinical Population with Depression and Anxiety

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Nazanin Alavi ◽  
Matthew Stefanoff ◽  
Alyssa Hirji ◽  
Sarosh Khalid-Khan
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Help Seeking ◽  
Behavioural Therapy ◽  
Self Concept ◽  
Clinical Population ◽  
Depression And Anxiety ◽  
Cognitive Behavioural ◽  
Final Treatment ◽  
Attending Physician

Background. Limited help-seeking behaviours, among adolescents with mental health concerns and many barriers to accessing mental health services, make innovative approaches to administering mental health therapies crucial. Therefore, this study evaluated the efficacy of e-CBT given via PowerPoint slides to treat adolescents with anxiety and/or depression. Method. 15 adolescents referred to an outpatient adolescent psychiatry clinic to treat a primary DSM-IV diagnosis of anxiety and/or depression chose between 8 weeks of e-CBT (n=7) or 7 weeks of live CBT (n=8). The e-CBT modules were presented using PowerPoint delivered weekly through email by either a senior psychiatry resident or an attending physician. Within each session, participants in both groups had personalized feedback on their mandatory weekly homework assignment from the previous week’s module. BYIs were completed before treatment and and after final treatment within both groups to assess changes in depression, anxiety, anger, disruption, and self-concept. Findings. Before treatment, BYI scores did not sig. differ between groups. After treatment, e-CBT participants reported sig. improved depression, anger, anxiety, and self-concept BYI scores while live CBT participants did not report any sig. changes. Only the Beck Anxiety Inventory sig. differed between groups after CBT. Conclusion. Despite the low sample size within this study, using email to deliver e-CBT PowerPoint slides and individualized homework feedback shows promise as an alternate method of CBT delivery that reduces barriers to receiving mental health treatment that occur internationally.

scholarly journals Addressing concerns about smoking cessation and mental health: theoretical review and practical guide for healthcare professionals

2020 ◽  
pp. 1-11
Author(s):  
Gemma M. J. Taylor ◽  
Amanda L. Baker ◽  
Nadine Fox ◽  
David S. Kessler ◽  
Paul Aveyard ◽  
...  
Keyword(s):  
Mental Health ◽  
Smoking Cessation ◽  
Healthcare Professionals ◽  
Mental Health Problems ◽  
Behavioural Therapy ◽  
Routine Care ◽  
Evidence Based ◽  
Depression And Anxiety ◽  
Stop Smoking ◽  
Cognitive Behavioural

SUMMARY Smoking rates in people with depression and anxiety are twice as high as in the general population, even though people with depression and anxiety are motivated to stop smoking. Most healthcare professionals are aware that stopping smoking is one of the greatest changes that people can make to improve their health. However, smoking cessation can be a difficult topic to raise. Evidence suggests that smoking may cause some mental health problems, and that the tobacco withdrawal cycle partly contributes to worse mental health. By stopping smoking, a person's mental health may improve, and the size of this improvement might be equal to taking antidepressants. In this article we outline ways in which healthcare professionals can compassionately and respectfully raise the topic of smoking to encourage smoking cessation. We draw on evidence-based methods such as cognitive–behavioural therapy (CBT) and outline approaches that healthcare professionals can use to integrate these methods into routine care to help their patients stop smoking.

scholarly journals Treating Depression and Anxiety with Digital Cognitive Behavioural Therapy for Insomnia: A Real World NHS Evaluation Using Standardized Outcome Measures

2016 ◽  
Vol 45 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Annemarie I. Luik ◽  
Sophie Bostock ◽  
Leanne Chisnall ◽  
Simon D. Kyle ◽  
Nicky Lidbetter ◽  
...  
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Cognitive Behavioural Therapy ◽  
Generalized Anxiety Disorder ◽  
Behavioural Therapy ◽  
Generalized Anxiety ◽  
Depression And Anxiety ◽  
Psychological Therapies ◽  
Self Help ◽  
Cognitive Behavioural

Background: Evidence suggests that insomnia may be an important therapeutic target to improve mental health. Aims: Evaluating changes in symptoms of depression and anxiety after supported digital cognitive behavioural therapy (dCBT) for insomnia delivered via a community-based provider (Self Help Manchester) of the Improving Access to Psychological Therapies (IAPT) service. Method: Supported dCBT for insomnia was delivered to 98 clients (mean age 44.9 years, SD 15.2, 66% female) of Self Help Manchester. All clients received six support calls from an eTherapy coordinator to support the self-help dCBT. During these calls levels of depression (Patient Health Questionnaire, PHQ-9) and anxiety (Generalized Anxiety Disorder, GAD-7) were determined. Results: Depression (Mdifference-5.7, t(70) = 12.5, p < .001) and anxiety [Generalized Anxiety Disorder-7 (GAD-7), Mdifference-4.1, t(70) = 8.0, p < .001] were reduced following supported dCBT for insomnia. This translated into an IAPT recovery rate of 68% for depression and anxiety. Conclusions: These results suggest that dCBT for insomnia alleviates depression and anxiety in clients presenting with mental health complaints in routine healthcare.

scholarly journals A Full Systematic Review on the Effects of Cognitive Behavioural Therapy for Mental Health Symptoms in Child Refugees

2021 ◽  
Author(s):  
Katie Lawton ◽  
Angela Spencer
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Current Evidence ◽  
Depression And Anxiety ◽  
Mental Health Symptoms ◽  
Post Intervention ◽  
Health Symptoms ◽  
Cognitive Behavioural

AbstractGlobal conflict in 2019 created record numbers of displaced children. These children have experienced multiple traumas and subsequently suffer high levels of mental health symptoms. Cognitive-behavioural therapy (CBT) is commonly used for post-traumatic stress disorder (PTSD), depression and anxiety, however the current evidence-base of CBT in child refugees is sparse, with mixed results. This study aimed to assess the effects of CBT on symptoms of PTSD, depression and anxiety in child refugees/AS. Ethics were reviewed and granted by the University of Manchester ethics committee. Medline, Embase, Cochrane, PsycINFO and CINAHL were systematically searched. Studies were included if CBT was delivered to refugee/AS children with pre and post-intervention measures of symptoms. Sixteen studies fulfilled criteria. In all studies, mental health symptom scores post-intervention had reduced, suggesting an improvement in mental health following CBT. This reduction was statistically significant in twelve studies (p < 0.001–0.5), clinically significant in eight studies and maintained at follow-up periods. No adverse effects of CBT were identified. This is the first systematic review to focus solely on CBT in child refugee populations, with unanimously positive results. Its use is cautiously recommended, however the need for more methodologically rigorous studies in this population is highlighted.

scholarly journals Cultural adaptation of cognitive behavioural therapy (CBT) for patients with depression and anxiety in Saudi Arabia and Bahrain: a qualitative study exploring views of patients, carers, and mental health professionals

2019 ◽  
Vol 12 ◽  
Author(s):  
Haifa Mohammad Saleh Algahtani ◽  
Abdullah Almulhim ◽  
Fatema Ali AlNajjar ◽  
Mazen Khalil Ali ◽  
Muhammad Irfan ◽  
...  
Keyword(s):  
Mental Health ◽  
Saudi Arabia ◽  
Cognitive Behavioural Therapy ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Cultural Adaptation ◽  
Behavioural Therapy ◽  
Depression And Anxiety ◽  
Arab Population ◽  
Cognitive Behavioural

AbstractWestern values influence cognitive behavioural therapy (CBT) as it was primarily developed and practised in the West. As understanding the cultural context has been linked to better therapy outcomes, it has been suggested that CBT might need modification to non-Western clients’ cultural backgrounds. Previously we developed a cost-effective approach to adapt CBT for clients in China and Pakistan. In this study, we applied the same methodology for local clients suffering from depression and anxiety in the Kingdom of Saudi Arabia and Bahrain. This study aimed to understand the views of patients with depression and anxiety, caregivers and mental health professionals about CBT to develop guidelines for culturally adapting CBT for depression and anxiety. We conducted semi-structured interviews with the patients (n = 42), caregivers (n = 11), and psychiatrists and psychologists (n = 16). The data were analysed using a thematic framework analysis by identifying emerging themes and categories. The themes emerging from the analyses of interviews by each interviewer were compared and contrasted with those of other interviewers. The results highlighted barriers of access to and strengths of CBT while working with these patient groups. Patients and their caregivers in both countries use a bio-psycho-spiritual-social model of illness and seek help from multiple sources. Therapists emphasized the need for using local idioms, culturally appropriate translation and minor adjustments in therapy. There were no thematic differences between the two sites. These findings will be used to culturally adapt a CBT manual, which will be tested in a randomized controlled trial.Key learning aimsAfter reading this article, readers will be able to:(1)Understand the need for cultural adaptation of CBT.(2)Identify the necessary steps to adapt CBT for the Muslim Arab population.(3)Understand the modifications required to deliver culturally adapted CBT for the Muslim Arab population.

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