Predictors of outcome in guided self-help cognitive behavioural therapy for common mental disorders in primary care

Abstract

Cognitive behavioural therapy (CBT) can effectively treat common mental disorders (CMDs), but access to treatment is insufficient. Guided self-help (GSH) CBT has shown effects comparable to face-toface CBT and may be a resource-efficient treatment alternative. However, not all patients respond to GSH. Learning more about predictors of outcome may increase knowledge regarding which patients respond to GSH. The aim of this study was to investigate predictors of outcome for GSH CBT for patients with CMDs in primary care. Consecutive patients (N = 396) with a principal disorder of depression, anxiety, insomnia or stress-related disorders were included. All patients received GSH CBT. Outcomes were remission status, reliable change and post-treatment depression ratings. Predictors investigated were clinical, demographic and therapyrelated variables. Analyses were conducted using logistic and linear regression. Higher educational level predicted remission, higher quality of life ratings predicted remission and decreased depression, and higher age at onset predicted reliable change. Therapy-related variables, i.e. patient adherence to treatment and patients' and clinicians' estimation of treatment response, were all related to outcome. More large-scale studies are needed, but the present study points at the importance of therapy-related variables such as monitoring and supporting treatment adherence for an increased chance of remission.

Telehealth mental health services during COVID-19: summary of evidence and clinical practice

“…Furthermore, there is growing evidence indicating that 'second-generation' self-guided treatments, with enhanced engagement features, can produce clinical benefits similar to clinician-guided treatments. 16,17 There has been a call to integrate internet-delivered services with traditional mental health services using a stepped care model. Clients identified as being suitable for online interventions could be directed to self-guided or therapist-guided programs, whilst those deemed unsuitable, or have not responded, are provided with face-to-face interventions 15 or a hybrid approach.…”

Predicting treatment failure in regular care Internet-Delivered Cognitive Behavior Therapy for depression and anxiety using only weekly symptom measures.

“…There are several examples of adherence predicting good outcomes El Alaoui et al, 2016;Mojtabai, 2017;Nordgreen et al, 2012;Salomonsson et al, 2019), though adherence is often operationalized with a rough proxy such as number of modules completed or messages sent. In stark contrast, Kraepelien, Blom, Lindefors, Johansson, and Kaldo (2019) did a high resolution operationalization where they assessed both quantity and quality of component specific compliance and overall compliance.…”

Efektifitas Cognitive Behaviour Therapy di Sekolah: Meta Analisis Review

“…Sejak awal, sejumlah protokol CBT khusus gangguan telah dikembangkan yang secara khusus menangani berbagai faktor pemeliharaan kognitif (Jongerden & Bögels, 2015)dan perilaku dari berbagai gangguan. Meskipun protokol perawatan khusus-gangguan ini menunjukkan perbedaan besar dalam beberapa teknik perawatan khusus (Asbrand, Heinrichs, Nitschke, Wolf, Schmidtendorf, et al, 2019;Alladin, 2015;Salomonsson et al, 2019), mereka semua memiliki model inti yang sama dan pendekatan umum untuk perawatan.…”