How can technology enhance cognitive behavioral therapy: the case of pediatric obsessive compulsive disorder

Wolters, Lidewij H.; Beek, Vivian op de; Weidle, Bernhard; Skokauskas, Norbert

doi:10.1186/s12888-017-1377-0

Cited by 17 publications

(17 citation statements)

References 62 publications

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“…First, we used the umbrella term digital, as it covers the full spectrum of digital technology, such as the internet, electronic devices, and mobile phones [ 39 ]. Second, we referred to the definition of technology-empowered CBT outlined by Wolters et al [ 40 ]: “CBT-based interventions integrating technology varying from basic online bibliotherapy to online self-help therapy, therapist-supported computerized CBT, smartphone applications (apps), traditional CBT delivered via telephone or videoconferencing, and combinations of these forms.” We only included interventions that began during pregnancy, but some of them also provided follow-up support during the postnatal period. We included any depression symptom intervention across the Institute of Medicine’s spectrum of interventions for mental health based on the risk of the target population: prevention (universal, selective, indicated), treatment (case identification, standard treatment for known disorders), and maintenance (compliance with long-term treatment, aftercare) [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

Digitalized Cognitive Behavioral Interventions for Depressive Symptoms During Pregnancy: Systematic Review

Yunus¹,

Matinolli²,

Waris³

et al. 2022

J Med Internet Res

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Background Studies have shown a high prevalence of depression during pregnancy, and there is also evidence that cognitive behavioral therapy (CBT) is one of the most effective psychosocial interventions. Emerging evidence from randomized controlled trials (RCTs) has shown that technology has been successfully harnessed to provide CBT interventions for other populations. However, very few studies have focused on their use during pregnancy. This approach has become increasingly important in many clinical areas due to the COVID-19 pandemic, and our study aimed to expand the knowledge in this particular clinical area. Objective Our systematic review aimed to bring together the available research-based evidence on digitalized CBT interventions for depression symptoms during pregnancy. Methods A systematic review of the Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE, Embase, PsycINFO, Scopus, ClinicalTrials.gov, and EBSCO Open Dissertations databases was carried out from the earliest available evidence to October 27, 2021. Only RCT studies published in English were considered. The PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-analyses) guidelines were followed, and the protocol was registered on the Prospective Register of Systematic Reviews. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials. Results The review identified 7 studies from 5 countries (the United States, China, Australia, Norway, and Sweden) published from 2015 to 2021. The sample sizes ranged from 25 to 1342 participants. The interventions used various technological elements, including text, images, videos, games, interactive features, and peer group discussions. They comprised 2 guided and 5 unguided approaches. Using digitalized CBT interventions for depression during pregnancy showed promising efficacy, with guided intervention showing higher effect sizes (Hedges g=1.21) than the unguided interventions (Hedges g=0.14-0.99). The acceptability of the digitalized CBT interventions was highly encouraging, based on user feedback. Attrition rates were low for the guided intervention (4.5%) but high for the unguided interventions (22.1%-46.5%). A high overall risk of bias was present for 6 of the 7 studies. Conclusions Our search only identified a small number of digitalized CBT interventions for pregnant women, despite the potential of this approach. These showed promising evidence when it came to efficacy and positive outcomes for depression symptoms, and user feedback was positive. However, the overall risk of bias suggests that the efficacy of the interventions needs to be interpreted with caution. Future studies need to consider how to mitigate these sources of biases. Digitalized CBT interventions can provide prompt, effective, evidence-based interventions for pregnant women. This review increases our understanding of the importance of digitalized interventions during pregnancy, including during the COVID-19 pandemic. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020216159; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216159

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Section: Methodsmentioning

confidence: 99%

Digitalized Cognitive Behavioral Interventions for Depressive Symptoms During Pregnancy: Systematic Review

Yunus¹,

Matinolli²,

Waris³

et al. 2022

J Med Internet Res

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“…The use of modern technologies in health interventions can offer the possibility to bridge this gap (Wolters et al 2017 ) and help young patients to get the therapy they need. There is a wide range of treatments that can be subsumed under the generic term of digital health interventions (Hollis et al 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Internet-based cognitive behavioral therapy in children and adolescents with obsessive compulsive disorder: a feasibility study

et al. 2021

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Cognitive behavioral therapy (CBT) is the first choice of treatment of obsessive–compulsive disorder (OCD) in children and adolescents. However, there is often a lack of access to appropriate treatment close to the home of the patients. An internet-based CBT via videoconferencing could facilitate access to state-of-the-art treatment even in remote areas. The aim of this study was to investigate feasibility and acceptability of this telemedical approach. A total of nine children received 14 sessions of CBT. The first session took place face-to-face, the remaining 13 sessions via videoconference. OCD symptoms were recorded with a smartphone app and therapy materials were made accessible in a data cloud. We assessed diagnostic data before and after treatment and obtained measures to feasibility, treatment satisfaction and acceptability. Outcomes showed high acceptance and satisfaction on the part of patients with online treatment (89%) and that face-to-face therapy was not preferred over an internet-based approach (67%). The majority of patients and their parents classified the quality of treatment as high. They emphasized the usefulness of exposures with response prevention (E/RP) in triggering situations at home. The app itself was rated as easy to operate and useful. In addition to feasibility, a significant decrease in obsessive–compulsive symptoms was also achieved. Internet-based CBT for pediatric OCD is feasible and well received by the patients and their parents. Furthermore, obsessive–compulsive symptomatology decreased in all patients. The results of this study are encouraging and suggest the significance of further research regarding this technology-supported approach, with a specific focus on efficacy.Trial registration number: Clinical trials AZ53-5400.1-004/44.

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“…Still, CBT for pediatric OCD has not reached its full potential, with response rates ranging between 40 and 65% [11, 12]. In addition, stigma about mental health treatment in general and OCD in particular, limited access to high-quality CBT, and the high costs of CBT may reduce treatment uptake [13]. Sixty to 90% of adults with OCD from Western countries and China are not seeking treatment for OCD [14].…”

Section: Introductionmentioning

confidence: 99%

Acceptability, feasibility, and efficacy of Internet cognitive behavioral therapy (iCBT) for pediatric obsessive-compulsive disorder: a systematic review

et al. 2019

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BackgroundObsessive-compulsive disorder (OCD) is a chronic mental health disorder characterized by recurring obsessions and compulsions affecting 1–3% of children and adolescents. Current treatment options are limited by accessibility, availability, and quality of care. New technologies provide opportunities to address at least some of these challenges. This paper aims to investigate the acceptability, feasibility, and efficacy of traditional cognitive behavioral therapy with Internet cognitive behavioral therapy (iCBT) for pediatric OCD according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.MethodWe searched EMBASE, Medline, PsycINFO, CENTRAL, LILACS, CINAHL, and Scopus. Results include articles from 1987 to March 2018. Main inclusion criteria were patients aged 4–18, primary diagnosis of OCD, and iCBT.ResultsOf the 2323 unique articles identified during the initial search, six studies with a total of 96 participants met our inclusion criteria: three randomized controlled trials, one single-case multiple-baseline design, one open-label trial, and one case series. Four studies reported a significant decrease in OCD severity on the Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) following iCBT, one study reported significant decrease in CY-BOCS scores for iCBT relative to waitlist, and the case series reported (some) symptom reduction in all participants. Six studies reported high rates of feasibility, and five studies reported good acceptability of iCBT.ConclusionAt present, evidence regarding acceptability, feasibility, and efficacy of iCBT for pediatric OCD is limited. Results are promising but need to be confirmed and refined in further research.Systematic review registrationPROSPERO CRD4201808587

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How can technology enhance cognitive behavioral therapy: the case of pediatric obsessive compulsive disorder

Cited by 17 publications

References 62 publications

Digitalized Cognitive Behavioral Interventions for Depressive Symptoms During Pregnancy: Systematic Review

Digitalized Cognitive Behavioral Interventions for Depressive Symptoms During Pregnancy: Systematic Review

Internet-based cognitive behavioral therapy in children and adolescents with obsessive compulsive disorder: a feasibility study

Acceptability, feasibility, and efficacy of Internet cognitive behavioral therapy (iCBT) for pediatric obsessive-compulsive disorder: a systematic review

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