Tag: EST: Empirically Supported Treatments

Are E-Mental Health Applications for Depression Beneficial?

Published on by Andrew MarshallLeave a comment

Research Paper Title

E-mental health applications for depression: an evidence-based ethical analysis.

Background

E-mental health applications (apps) are an increasingly important factor for the treatment of depression.

To assess the risks and benefits for patients, an in-depth ethical analysis is necessary.

The objective of this paper is to determine the ethical implications of app-based treatment for depression.

Methods

An evidence-based ethical analysis was conducted.

The material was meta-reviews and randomised control studies (RCTs) on app-based treatment.

Based on the empirical data, an ethical analysis was conducted using the 3-ACES-approach by Thornicroft and Tansella.

Results

Apps may empower autonomy, offer an uninterrupted series of contacts over a period of time, show evidence-based benefits for patients with subclinical and mild-to-moderate-symptoms, are easily accessible, may be used for coordinating information and services within an episode of care, and are on the whole cost-effective.

Their risks are that they are not suitable for the whole range of severity of mental illnesses and patient characteristics, show severe deficits in the data privacy policy, and a big variability in quality standards.

Conclusions

The use of apps in depression treatment can be beneficial for patients as long as:

  • The usefulness of an app-based treatment is assessed for each individual patient;
  • Apps are chosen according to symptom severity as well as characteristics like the patient’s level of self-reliance, their e-literacy, and their openness vis-à-vis apps; and
  • Manufacturers improve their privacy policies and the quality of apps.

Reference

Rubeis, G. (2020) E-mental health applications for depression: an evidence-based ethical analysis. European Archives of Psychiatry and Clinical Neuroscience. doi: 10.1007/s00406-019-01093-y. [Epub ahead of print].

What is the Sustainability of a Biobehavioural Intervention Implemented by Therapists & Sustainment in Community Settings?

Published on by Andrew MarshallLeave a comment

Research Paper Title

Sustainability of a biobehavioral intervention implemented by therapists and sustainment in community settings.

Background

The ultimate aim of dissemination and implementation of empirically supported treatments (ESTs) in behavioural medicine is:

  • Sustainability of the therapist/provider’s EST usage; and
  • Sustainment of EST delivery in the setting.

Thus far, sustainability has been understudied, and the therapist and setting variables that may be influential are unclear.

The purpose of the study was to test the therapists’ sustainability of a cancer-specific EST using a prospective longitudinal design and examine its predictors.

Methods

Oncology mental health therapists (N = 134) from diverse settings (N = 110) completed training in the biobehavioural intervention (BBI) and were provided with 6 months of support for implementation, with no support thereafter. BBI usage (percent of patients treated) was reported at 2, 4, 6, and 12 months.

Using a generalised estimating equation with a logistic link function, 12-month sustainability (a non-significant change in usage from 6 to 12 months) was studied along with therapist, supervisor, and setting variables as predictors.

Results

BBI usage increased through 6 months and, importantly, usage was sustained from 6 (68.4% [95% CI = 62.2%-73.9%]) to 12 months (70.9% [95% CI = 63.6%-77.3%]), with sustainment in 66 settings (60.0%).

Predictors of implementation-to-sustainability usage were therapists’ early intentions to use the BBI (p < .001) and from the setting, supervisors’ positive attitudes toward ESTs (p = .016).

Conclusions

Adding to the DI literature, a health psychology intervention was disseminated, implemented, and found sustainable across diverse therapists and settings.

Therapists and setting predictors of usage, if modified, might facilitate future sustainability/sustainment of ESTs.

Reference

Ryba, M.M., Lo, S.B. & Andersen, B.L. (2019) Sustainability of a biobehavioral intervention implemented by therapists and sustainment in community settings. Translational Behavioral Medicine. pii: ibz175. doi: 10.1093/tbm/ibz175. [Epub ahead of print].