Online CBT Using a Waitlist Method

Research Paper Title

Online cognitive-behavioural therapy for traumatically bereaved people: study protocol for a randomised waitlist-controlled trial.

Background

The traumatic death of a loved one, such as death due to a traffic accident, can precipitate persistent complex bereavement disorder (PCBD) and comorbid post-traumatic stress disorder (PTSD) and depression. Waitlist-controlled trials have shown that grief-specific cognitive-behavioural therapy (CBT) is an effective treatment for such mental health problems. This is the first study that will examine the effectiveness of online CBT (vs waitlist controls) in a sample exclusively comprised of people bereaved by a traumatic death.

The primary hypothesis is that people allocated to the online CBT condition will show larger reductions in PCBD, PTSD and depression symptom levels at post-treatment than people allocated to a waitlist. We further expect that reductions in symptom levels during treatment are associated with reductions of negative cognitions and avoidance behaviours and the experience of fewer accident-related stressors. Moreover, the effect of the quality of the therapeutic alliance on treatment effects and drop-out rates will be explored.

Methods

A two-arm (online CBT vs waiting list) open-label parallel randomised controlled trial will be conducted. Participants will complete questionnaires at pre-treatment and 12 and 20 weeks after study enrolment. Eligible for participation are Dutch adults who lost a loved one at least 1 year earlier due to a traffic accident and report clinically relevant levels of PCBD, PTSD and/or depression. Multilevel modelling will be used.

Discussion

This study will provide new insights in the effectiveness of online CBT for traumatically bereaved people. If the treatment is demonstrated to be effective, it will be made publicly accessible. Findings will be disseminated among:

  • Lay people (e.g. through newsletters and media performances);
  • Research collaborators (e.g. through presentations at support organisations); and
  • Clinicians and researchers (e.g. through conference presentations and scientific journal articles).

Reference

Lenferink, L., de Keijser, J., Eisma, M., Smid, G. & Boelen, P. (2020) Online cognitive-behavioural therapy for traumatically bereaved people: study protocol for a randomised waitlist-controlled trial. BMJ Open. 10(9), pp.e035050. doi: 10.1136/bmjopen-2019-035050.

Online CBT and Bereaved Persons

Research Paper Title

Online cognitive-behavioural therapy for traumatically bereaved people: study protocol for a randomised waitlist-controlled trial.

Background

The traumatic death of a loved one, such as death due to a traffic accident, can precipitate persistent complex bereavement disorder (PCBD) and comorbid post-traumatic stress disorder (PTSD) and depression.

Waitlist-controlled trials have shown that grief-specific cognitive-behavioural therapy (CBT) is an effective treatment for such mental health problems.

This is the first study that will examine the effectiveness of online CBT (vs waitlist controls) in a sample exclusively comprised of people bereaved by a traumatic death.

The primary hypothesis is that people allocated to the online CBT condition will show larger reductions in PCBD, PTSD and depression symptom levels at post-treatment than people allocated to a waitlist. The researchers further expect that reductions in symptom levels during treatment are associated with reductions of negative cognitions and avoidance behaviours and the experience of fewer accident-related stressors. Moreover, the effect of the quality of the therapeutic alliance on treatment effects and drop-out rates will be explored.

Methods

A two-arm (online CBT vs waiting list) open-label parallel randomised controlled trial will be conducted. Participants will complete questionnaires at pretreatment and 12 and 20 weeks after study enrolment.

Eligible for participation are Dutch adults who lost a loved one at least 1 year earlier due to a traffic accident and report clinically relevant levels of PCBD, PTSD and/or depression. Multilevel modelling will be used.

Ethics and Dissemination

Ethics approval has been received by the Medical Ethics Review Board of the University Medical Center Groningen (METc UMCG: M20.252121). This study will provide new insights in the effectiveness of online CBT for traumatically bereaved people.

If the treatment is demonstrated to be effective, it will be made publicly accessible.

Findings will be disseminated among:

  • Lay people (eg, through newsletters and media performances);
  • Our collaborators (eg, through presentations at support organisations); and
  • Clinicians and researchers (eg, through conference presentations and scientific journal articles).

Reference

Lenferink, L., de Keijser, J., Eisma, M., Smid, G. & Boelen, P. (2020) Online cognitive-behavioural therapy for traumatically bereaved people: study protocol for a randomised waitlist-controlled trial. BMJ Open. doi: 10.1136/bmjopen-2019-035050.

The Challenges & Opportunities for Counselling & Psychotherapy in the Aftermath of COIV-19.

Research Paper Title

Counselling and psychotherapy post-COVID-19.

Background

The researchers consider how the prolonged, complex and uncertain aftermath of the COVID-19 crisis will present challenges and opportunities for counselling and psychotherapy.

Increased mental strain on populations, individuals and professionals is likely to be compounded by further constraints in therapeutic resources.

Nevertheless, emerging needs and priorities will offer ground for systems thinking in linking the application of a range of therapeutic frameworks, theories to address global challenges, integration of counselling and psychotherapy into new sectors, service models for the most vulnerable, use of digital approaches, support mechanisms for professionals and interdisciplinary research.

Reference

Vostanis, P & Bell, C.A. (2020) Counselling and psychotherapy post-COVID-19. Counselling and Psychotherapy Research. doi: 10.1002/capr.12325. Online ahead of print.

CBT: Is It Remotely Effective!

Perhaps because cognitive behavioural therapy (CBT) is effective in such a wide range of conditions, availability is often limited.

However, it is beginning to look as if CBT works equally well when delivered remotely.

In a three month trial in a primary care setting in Sweden, internet delivered CBT was no worse than face-to-face CBT for patients with high levels of anxiety about their health.

Regardless of how it was delivered, CBT produced benefits not only for hypochondriasis but for general anxiety and depression too.

Can Internet-Based CBT be used to Treat Young People with OCD?

Research Paper Title

Online Obsessive-Compulsive Disorder Treatment: Preliminary Results of the “OCD? Not Me!” Self-Guided Internet-Based Cognitive Behavioral Therapy Program for Young People.

Background

The development and evaluation of Internet-delivered cognitive behavioral therapy (iCBT) interventions provides a potential solution for current limitations in the acceptability, availability, and accessibility of mental health care for young people with obsessive-compulsive disorder (OCD).

Preliminary results support the effectiveness of therapist-assisted iCBT for young people with OCD; however, no previous studies have examined the effectiveness of completely self-guided iCBT for OCD in young people.

The researches aimed to conduct a preliminary evaluation of the effectiveness of the OCD? Not Me! program for reducing OCD-related psychopathology in young people (12-18 years). This programme is an eight-stage, completely self-guided iCBT treatment for OCD, which is based on exposure and response prevention.

Methods

These data were early and preliminary results of a longer study in which an open trial design is being used to evaluate the effectiveness of the OCD? Not Me!

Participants were required to have at least subc-linical levels of OCD to be offered the online program. Participants with moderate-high suicide/self-harm risk or symptoms of eating disorder or psychosis were not offered the programme. OCD symptoms and severity were measured at pre- and post-test, and at the beginning of each stage of the programme. Data was analysed using generalised linear mixed models.

Results

A total of 334 people were screened for inclusion in the study, with 132 participants aged 12 to 18 years providing data for the final analysis.

Participants showed significant reductions in OCD symptoms (P<.001) and severity (P<.001) between pre- and post-test.

Conclusions

These preliminary results suggest that fully automated iCBT holds promise as a way of increasing access to treatment for young people with OCD; however, further research needs to be conducted to replicate the results and to determine the feasibility of the programme.

Reference

Rees, C.S., Anderson, R.A., Kane, R.T. & Finaly-Jones, A.L. (2016) Online Obsessive-Compulsive Disorder Treatment: Preliminary Results of the “OCD? Not Me!” Self-Guided Internet-Based Cognitive Behavioral Therapy Program for Young People. JMIR Mental Health. 3(3):e29. doi: 10.2196/mental.5363.