Internet-based cognitive behavior therapy for depression, social anxiety disorder, and panic disorder: Effectiveness and predictors of response in a teaching clinic

Niles, Andrea N.; Axelsson, Erland; Andersson, Erik; Hedman‐Lagerlöf, Erik; Carlbring, Per; Andersson, Gerhard; Widén, Sara; Driessen, Jens; Santoft, Fredrik; Ljótsson, Brjánn

doi:10.1016/j.brat.2020.103767

Cited by 19 publications

(12 citation statements)

References 82 publications

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“…To estimate symptom reduction as a function of time, we fit piecewise multilevel models in R (version 4.0.2; The R Foundation for Statistical Computing) using the package "lmerTest" (version 3.1-2) [41]. Consistent with prior work, we selected a piecewise approach to capture a typical pattern of symptom reduction observed in treatment studies where symptoms initially decrease sharply and then level out as time progresses [42][43][44][45][46][47]. In these models, we regressed the symptom outcome measure (GAD-7 score or PHQ score) onto the number of days since subscribing to the app.…”

Section: Aim 2: Effectivenessmentioning

confidence: 99%

Acceptability and Effectiveness of Artificial Intelligence Therapy for Anxiety and Depression (Youper): Longitudinal Observational Study

Mehta¹,

Niles²,

Vargas³

et al. 2021

J Med Internet Res

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Background Youper is a widely used, commercially available mobile app that uses artificial intelligence therapy for the treatment of anxiety and depression. Objective Our study examined the acceptability and effectiveness of Youper. Further, we tested the cumulative regulation hypothesis, which posits that cumulative emotion regulation successes with repeated intervention engagement will predict longer-term anxiety and depression symptom reduction. Methods We examined data from paying Youper users (N=4517) who allowed their data to be used for research. To characterize the acceptability of Youper, we asked users to rate the app on a 5-star scale and measured retention statistics for users’ first 4 weeks of subscription. To examine effectiveness, we examined longitudinal measures of anxiety and depression symptoms. To test the cumulative regulation hypothesis, we used the proportion of successful emotion regulation attempts to predict symptom reduction. Results Youper users rated the app highly (mean 4.36 stars, SD 0.84), and 42.66% (1927/4517) of users were retained by week 4. Symptoms decreased in the first 2 weeks of app use (anxiety: d=0.57; depression: d=0.46). Anxiety improvements were maintained in the subsequent 2 weeks, but depression symptoms increased slightly with a very small effect size (d=0.05). A higher proportion of successful emotion regulation attempts significantly predicted greater anxiety and depression symptom reduction. Conclusions Youper is a low-cost, completely self-guided treatment that is accessible to users who may not otherwise access mental health care. Our findings demonstrate the acceptability and effectiveness of Youper as a treatment for anxiety and depression symptoms and support continued study of Youper in a randomized clinical trial.

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Section: Aim 2: Effectivenessmentioning

confidence: 99%

Acceptability and Effectiveness of Artificial Intelligence Therapy for Anxiety and Depression (Youper): Longitudinal Observational Study

Mehta¹,

Niles²,

Vargas³

et al. 2021

J Med Internet Res

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show abstract

“…Even so, some interventions have been evaluated and published on the effectiveness of internet-based interventions for common mental-health disorders within routine practice, including chronic stress (Andersson, Titov, et al, 2019;Niles et al, 2020). For example, an uncontrolled trial of 470 general practitioner referred patients treated at a Dutch online mental health clinic for burnout, found positive and large within-group effects of a therapist-assisted iCBT intervention (Ruwaard et al, 2012).…”

Section: Dissemination and Implementationmentioning

confidence: 99%

Learning how to recover from stress-related disorders via internet-based interventions

Asplund

2021

Linköping Studies in Behavioural Science

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Gerhard Andersson, my main supervisor. We first met at Uppsala university in 1999-2000, when I was a student looking for a scientific project in psychology. From that day on, you have always shown such kindness and openness to new ideas. Your supervision has been very wise and gentle, pushing me when I need to, and generously and trustfully letting me explore and grow as a researcher. And thank you for all the laughs and mischievous pranks (mixing up signs, titles, roles, mugs etcetera). To my delight, I have also noticed that you have picked up some recovery activities during these years.Brjánn Ljótsson, my co-supervisor. I am very grateful for all your valuable support and encouragement during these years. You have really inspired me in testing and applying various statistical methods. And thank you for sharing your experiences and knowledge on becoming a PhD.George Vlaescu (a.k.a. G or Speedy), IT-System developer. Thank you for your quick, invaluable and sometimes crucial support regarding the IT-platform iterapy. Without your quick and methodical work, this research would not have been possible.Per Carlbring, professor and fellow grant applicant. Thank you for your enthusiastic, and super quick responses, and for your helpful and thorough comments on our studies.Master level psychology students and psychotherapy students. Without your commitment and hard work, this would never have been possible. I have enjoyed reading all the comments from grateful participants regarding the importance of your guidance in their treatment. Study I,

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“…Furthermore, public health measures and the closure of healthcare services during the pandemic restrict access to traditional mental health services. Internet-based interventions have been found to be effective for a range of mental health conditions [ 12 ], including life-stressor-related adjustment disorders [ 13 ] as well as burnout among HCWs [ 14 ]. Moreover, especially during the COVID-19 pandemic, online therapies are particularly relevant for HCWs because of their flexibility, access to a large-scale number of medical staff, and the possibility to provide psychosocial care for HCWs from isolated regions [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Internet-based stress recovery intervention FOREST for healthcare staff amid COVID-19 pandemic: study protocol for a randomized controlled trial

Jovarauskaitė

Dumarkaitė

Truskauskaitė‐Kunevičienė

et al. 2021

Trials

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Background The demand for care during the COVID-19 pandemic has affected the mental health of healthcare workers (HCWs), thus increasing the need for psychosocial support services. Internet-based interventions have previously been found to reduce occupational stress. The study aims to test the effects of an Internet-based stress recovery intervention—FOREST—among HCWs. Methods A randomized controlled trial (RCT) parallel group design with three measurement points will be conducted to assess the efficacy of an Internet-based stress recovery intervention FOREST for nurses. The FOREST intervention is a 6-week Internet-based CBT and mindfulness-based program which comprises of six modules: (1) Introduction, (2) Detachment (relaxation and sleep), (3) Distancing, (4) Mastery (challenge), (5) Control, and (6) Keeping the change alive. We will compare the intervention against a waiting list group at pre-test, post-test, and follow-up. Stress recovery, PTSD, complex PTSD, moral injury, the level of stress, depression, anxiety, and psychological well-being will be measured. Discussion The study will contribute to the development of mental healthcare programs for the HCWs. Based on the outcomes of the study, the FOREST intervention can be further developed or offered to healthcare staff as a tool to cope with occupational stress. Trial registration ClinicalTrials.gov NCT04817995. Registered on 30 March 2021

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Internet-based cognitive behavior therapy for depression, social anxiety disorder, and panic disorder: Effectiveness and predictors of response in a teaching clinic

Cited by 19 publications

References 82 publications

Acceptability and Effectiveness of Artificial Intelligence Therapy for Anxiety and Depression (Youper): Longitudinal Observational Study

Acceptability and Effectiveness of Artificial Intelligence Therapy for Anxiety and Depression (Youper): Longitudinal Observational Study

Learning how to recover from stress-related disorders via internet-based interventions

Internet-based stress recovery intervention FOREST for healthcare staff amid COVID-19 pandemic: study protocol for a randomized controlled trial

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