Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: An updated meta-analysis

Andrews, Gavin; Basu, Ashna; Cuijpers, Pim; Craske, Michelle G.; McEvoy, Peter M.; English, Christine; Newby, Jill M.

doi:10.1016/j.janxdis.2018.01.001

Cited by 768 publications

(514 citation statements)

References 73 publications

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“…This requires flexibility from healthcare professionals. Similarly to the dietitians in the present study, in a study on the experiences of implementing a blended care intervention combining face-to-face physiotherapy sessions with a web-based application, physiotherapists asked for more options to tailor the intervention to the individual patient's needs (24) . Professional autonomy appeared to be an important determinant of implementation in daily practice.…”

Section: Discussionmentioning

confidence: 99%

Facilitators and barriers to a dietitian‐implemented blended care weight‐loss intervention (SMARTsize): a qualitative study

Heideman

Rongen

Bolleurs³

et al. 2019

J Human Nutrition Diet

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Background Dietitians play an important role in the intervention and prevention of being overweight and obesity. More and more blended care interventions are being implemented. The present study aimed to evaluate the delivery by Dutch dietitians of a multicomponent, evidence‐based weight‐loss programme ( SMART size), including counselling for relapse prevention. The aim of this qualitative study was to identify facilitators and barriers to the delivery of SMART size. Methods Nine semi‐structured interviews were conducted with 10 dietitians who participated in a larger implementation study. Each interview was recorded and transcribed verbatim. Determinants of theory of implementation, including characteristics of the user, the innovation, organisational context and setting, and innovation strategy guided interviews and analysis. Data were coded and analysed using the framework approach. Results According to dietitians, the SMART size intervention had a positive influence on patients. The main implementation facilitators were the availability of implementation materials, such as a manual, training in relapse prevention and social support from other dietitians. The main barriers to implementation were organisation and financial reimbursement of cooking classes, the belief that patients need more individual counselling in the starting phase, and the unsuitability for people with low levels of health literacy. Conclusions Most dietitians considered that implementation of the SMART size intervention consisting of e‐health, written information and cooking classes and face‐to‐face counselling is challenging but feasible. Further development of the SMART size intervention and implementation tools is needed to lower experienced barriers. It is also recommended that a version of the intervention to be developed that is suitable for patients with lower levels of health literacy.

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Section: Discussionmentioning

confidence: 99%

Facilitators and barriers to a dietitian‐implemented blended care weight‐loss intervention (SMARTsize): a qualitative study

Heideman

Rongen

Bolleurs³

et al. 2019

J Human Nutrition Diet

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“…Whether to offer guided or unguided interventions in routine care has been a debated issue in the literature since internet-based self-help has emerged. This discussion has since predominately focused on potential differences in adherence, effects and costs [22,[82][83][84]. Meta-analytic findings clearly indicate that stand-alone guided self-help interventions can be effective in the prevention and treatment of a range of mental health problems, including depression [68], anxiety [72] and stress [78].…”

Section: Providing Asynchronous Treatment Formats To Increase Health mentioning

confidence: 99%

Public Attitudes Toward Guided Internet-Based Therapies: Web-Based Survey Study (Preprint)

Apolinário-Hagen¹,

Harrer²,

Kählke³

et al. 2018

Preprint

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Background: Internet interventions have been proposed to improve the accessibility and utilization of evidence-based psychological treatments. However, little is known about attitudes toward such treatments, which can be an important barrier to their utilization. Objective: This study aimed to (1) determine attitudes toward guided internet interventions, to (2) assess its acceptability compared to other internet-based formats, and to (3) explore predictors of acceptance. Methods: A web-based survey (N=646) assessed attitudes toward guided internet therapies (i.e. "perceived usefulness/helpfulness", "relative advantage compared to face-to face therapy"), preferences for delivery modes ("e-preference": guided Internet interventions, unguided internet interventions, video conferencing psychotherapy (VCP)) as well as potential predictors of attitudes and preferences, including socio-demographics, help seeking-related variables, attachment style, perceived stress. Results: Although most participants perceived internet interventions as useful or helpful (65.9%, 426/646), the minority indicated their relative advantage compared to face-to-face therapy (8.7%, 56/646). Most participants preferred guided internet interventions (39.0%, 252/646) over VCP (22.8%, 147/646), unguided internet interventions (19.2%, 124/646) and not using internet interventions (18.8%, 121/646; missing: 0.2%). Attachment avoidance and stress were related to epreference (all P<.05). Moreover, preference for therapist-guided internet interventions was higher for individuals aware of internet-based treatment (χ

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“…Across 144 low-and middle-income countries, a shortage of over 1 million mental health care workers has been estimated (WHO, 2011). In comparison, antidepressants are cheaper, more available and administering them requires considerably fewer resources (Andrews et al, 2018). It has been estimated that of the primary care patients treated for depression, about 70% are treated with antidepressants (Olfson, Blanco & Marcus, 2016;Sleath, Rubin & Huston, 2001;Verhaak, van Dijk, Nuijen, Verheij & Schellevis, 2012).…”

Section: Treatment Gapmentioning

confidence: 99%

“…ICBT with clinician guidance has been found to be effective for depression and other common mental disorders (e.g., Andersson, Cuijpers, Carlbring, Riper & Hedman, 2014;Cuijpers, Donker, van Straten & Andersson, 2010;Kuester, Niemeyer & Knaevelsrud, 2016: O'Mahen et al, 2014, insomnia (Trockel, Karlin, Taylor & Manber, 2014) as well as a range of somatic conditions (e.g., Andersson, 2016;Cuijpers et al, 2010;Cuijpers, van Straten & Andersson, 2008). In one of the more recent reviews, the overall treatment effect for ICBT for depression, based on 32 trials and 5642 patients, was estimated to g = 0.67 (Andrews et al, 2018).…”

Section: Clinical Effect and Attritionmentioning

confidence: 99%

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Blended cognitive behavior therapy : efficacy and acceptability for treating depression in the adult and adolescent population

Topooco¹

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Depression is the most burdensome disorder worldwide in terms of health loss. The potential of internet and technologies to scale up psychological treatment resources is substantial. A blended treatment approach, reducing therapist time and combining sessions with online self-help components, could enhance availability of psychological treatment, while maintaining and possibly enhancing effect of treatment. The aim of this thesis was to develop and investigate the blended treatment approach, in terms of acceptance among key stakeholders, and clinical effect in treatment of depression in the adult and adolescent population.Study I investigated acceptance of the blended treatment approach among mental health care stakeholders by means of a European survey. The results demonstrated that the majority readily accepted blended treatment for management of mild and moderate depression.Study II evaluated blended treatment compared to standard face-toface psychotherapy in treatment of adult depression in a controlled non-inferiority trial. The results showed a similar decrease in depression from both interventions at post-treatment, with decreased levels maintained over six months. Non-inferiority for the blended treatment could not be statistically established.Study III was a controlled non-inferiority trial evaluating blended treatment compared to treatment as usual. The results indicated superiority for the blended treatment at post-treatment and partly at six months. After twelve months the outcomes in the two conditions were similar.Study IV evaluated blended treatment for adolescent depression in a controlled superiority trial, where the therapist time was not reduced, but sessions delivered via chat for improved reach and efficiency. Compared to attention control, the blended treatment significantly reduced depression symptoms, with effects indicated to be maintained over six months.Study V was a controlled superiority trial, evaluating an improved version of the blended treatment used in Study IV to similar methods and in a similar population. In comparison to minimal attention control, the blended treatment significantly reduced depression symptoms at post-treatment, corresponding to a large treatment effect.Across Study II to V, estimates indicated that the amount of therapist time that could be saved in blended treatment, compared to standard psychological treatment, was around 40%.In conclusion, a gradual, blended integration of technology into psychological treatment i) performed well in treatment of adult and adolescent populations, ii) could substantially reduce therapist time in comparison to standard face-to-face psychological treatment, and iii) was accepted by patients as well as other mental health care stakeholders.The thesis demonstrates the potentials of technology-assisted blended treatment models to deliver treatment of depression in the young and adult population in accordance with the current, urgent need to increase availability of psychological treatment as well as increase acceptance ...

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Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: An updated meta-analysis

Abstract: The conclusions drawn in the original meta-analysis are now supported: iCBT for the anxiety and depressive disorders is effective, acceptable and practical health care.

Cited by 768 publications

References 73 publications

Facilitators and barriers to a dietitian‐implemented blended care weight‐loss intervention (SMARTsize): a qualitative study

Facilitators and barriers to a dietitian‐implemented blended care weight‐loss intervention (SMARTsize): a qualitative study

Public Attitudes Toward Guided Internet-Based Therapies: Web-Based Survey Study (Preprint)

Blended cognitive behavior therapy : efficacy and acceptability for treating depression in the adult and adolescent population

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