Self directed behavior: Self modification for personal adjustment

Vaughan, Margaret

doi:10.1016/0005-7967(73)90028-4

Cited by 3 publications

(5 citation statements)

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“…19 The STRIDE lifestyle intervention was developed for persons with SMI. In turn, STRIDE was based on prior research, ie, the PREMIER clinical trial, 20 behavior change theories, such as the transtheoretical model, 21,22 and motivational theory. [23][24][25] In the SMILE study, the session content of the STRIDE intervention program materials was used (eMethods in Supplement 2).…”

Section: Lifestyle Interventionmentioning

confidence: 99%

“…During the 12-month intervention period, participants attended a median (IQR) of 16 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) of the 30 sessions offered. A total of 45 participants (36%) had low attendance, 34 (27%) had medium attendance, and 47 (37%) had high attendance.…”

Section: Weight Change and Attendance At Intervention Sessionsmentioning

confidence: 99%

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Effectiveness of a Lifestyle Intervention for People With a Severe Mental Illness in Dutch Outpatient Mental Health Care

et al. 2023

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ImportancePeople with a severe mental illness (SMI) have a life expectancy reduced by 10 to 20 years compared with the general population, primarily attributable to cardiometabolic disorders. Lifestyle interventions for people with SMI can improve health and reduce cardiometabolic risk.ObjectiveTo evaluate the effectiveness of a group-based lifestyle intervention among people with SMI in outpatient treatment settings compared with treatment as usual (TAU).Design, Setting, and ParticipantsThe Severe Mental Illness Lifestyle Evaluation (SMILE) study is a pragmatic cluster randomized clinical trial performed in 8 mental health care centers with 21 flexible assertive community treatment teams in the Netherlands. Inclusion criteria were SMI, age of 18 years or older, and body mass index (calculated as weight in kilograms divided by height in meters squared) of 27 or greater. Data were collected from January 2018 to February 2020, and data were analyzed from September 2020 to February 2023.InterventionsWeekly 2-hour group sessions for 6 months followed by monthly 2-hour group sessions for another 6 months, delivered by trained mental health care workers. The intervention targeted overall lifestyle changes, emphasizing establishing a healthy diet and promoting physical activity. TAU (control) did not include structured interventions or advice on lifestyle.Main Outcomes and MeasuresCrude and adjusted linear mixed models and multivariable logistic regression analyses were performed. The main outcome was body weight change. Secondary outcomes included changes in body mass index, blood pressure, lipid profiles, fasting glucose level, quality of life, self-management ability, and lifestyle behaviors (physical activity and health, mental health, nutrition, and sleep).ResultsThe study population included 11 lifestyle intervention teams (126 participants) and 10 TAU teams (98 participants). Of 224 included patients, 137 (61.2%) were female, and the mean (SD) age was 47.6 (11.1) years. From baseline to 12 months, participants in the lifestyle intervention group lost 3.3 kg (95% CI, −6.2 to −0.4) more than those in the control group. In the lifestyle intervention group, people with high attendance rates lost more weight than participants with medium and low rates (mean [SD] weight loss: high, −4.9 [8.1] kg; medium, −0.2 [7.8] kg; low, 0.8 [8.3] kg). Only small or no changes were found for secondary outcomes.Conclusions and RelevanceIn this trial, the lifestyle intervention significantly reduced weight from baseline to 12 months in overweight and obese adults with SMI. Tailoring lifestyle interventions and increasing attendance rates might be beneficial for people with SMI.Trial RegistrationNetherlands Trial Register Identifier: NTR6837

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Section: Lifestyle Interventionmentioning

confidence: 99%

Section: Weight Change and Attendance At Intervention Sessionsmentioning

confidence: 99%

Effectiveness of a Lifestyle Intervention for People With a Severe Mental Illness in Dutch Outpatient Mental Health Care

et al. 2023

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“…Over the past 50 years or so the CBTs have accumulated a wide range of procedures and techniques aimed at increasing self‐regulatory behaviour. A perusal of research reviews suggests that many of these procedures and techniques can be categorized into four principal components (Dimidjian & Linehan, 2008; Duckworth et al, 2016; Febbraro & Clum, 1998; Kanfer & Gaelick‐Buys, 1991; Logue, 1998; Watson & Tharp, 2012): (1) self‐monitoring with various techniques for increasing mindfulness, awareness, and redirecting attention to other behaviours and events in one's immediate setting, (2) doing functional analyses for acquiring knowledge of causes or contributing conditions, (3) specifying values, goals, and treatment‐plans with procedures and techniques such as role‐playing, cognitive defusion and restructuring, rule‐following, ERP, behavioural contracting, acquiring new social skills, and so on and (4) generating feedback on treatment‐progress and satisfaction. Each principal component contains various and flexible procedures and techniques adaptable to clients and circumstances; for example, when identifying values and goals (Component 3) various procedures such as questionnaires, historical information, interviewing significant others, or trying various social activities can be used depending on clients' cognitive competencies and motivation.…”

Section: A Component Analysis Of Self‐regulation: Directions For Rese...mentioning

confidence: 99%

Toward a synthesis of cognitive behaviour therapy via component analysis of self‐regulation

Arco

2023

Clin Psychology and Psychoth

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The cognitive behavioural therapies (CBTs) are the choice psychotherapies for many clinicians treating a wide range of adult psychological disorders including various anxieties, mood, substance use, eating, schizophrenia and personality‐related. Empirical research in the CBTs is ever increasing, and the accumulating evidence supporting efficacious treatments is substantial and well documented. However, with prolific research comes a seemingly accelerating and worrying trend of purportedly different therapies, and numerous hybrids and combinations of therapies and techniques. For many clinicians this is increasingly confusing and not helpful in clinical practice. This article is a critique of current trends and directions in clinical research, which show signs of limited effectiveness, fragmentation, and obfuscation. An alternative strategy is proposed—examining transdiagnostic therapeutic effects, which appear related to treating pervasive dysregulated emotions, with component analyses of four principal self‐regulation components (viz., self‐monitoring; functional analysis; identifying values, goals and treatment‐plans; and feedback). Such a strategy is likely to lead to a more coherently synthesized and effective CBT.

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“…In 2015, results of the STRIDE study were published (31). The STRIDE lifestyle intervention was developed for people with SMI (31) and was based on the prior PREMIER clinical trial (32), on behaviour change theories such as the transtheoretical model (33,34), and on motivational theory (35)(36)(37). The results of the STRIDE study were that intervention participants lost on average 2.6 kg more than did control participants, from baseline to 12 months (95% CI=-5.14 kg to -0.07 kg).…”

Section: The Smile Interventionmentioning

confidence: 99%

“…The STRIDE lifestyle intervention is modified for persons with SMI and is based on the PREMIER lifestyle intervention with the DASH (Dietary Approaches to Stop Hypertension) dietary pattern (18)(19)(20)(21)(22)(23)(24), both developed for people without mental illnesses. It incorporates behaviour change theories such as the trans theoretical model (33,34) and motivational theory (35)(36)(37). The SMILE intervention primarily aims at a healthy diet and increased physical activity.…”

Section: Interventionmentioning

confidence: 99%

The SMILE lifestyle intervention for people with a severe mental illness: feasibility and (cost-)effectiveness

Walburg¹

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In this thesis, we present a pragmatic RCT evaluating the effectiveness of an intervention (SMILE) targeting lifestyle changes in people with SMI. Alongside, we performed three sub-studies: a process evaluation to gain insight into the feasibility of the intervention in FACT-care practice; a qualitative study on the experiences of people with SMI and their health care professionals with the SMILE intervention; and finally an economic evaluation of the cost-effectiveness of the intervention. We included patients with overweight or obesity, as they were expected to make the greatest health gains from the SMILE intervention. The SMILE intervention is a feasible way to contribute to the physical health through weight loss of people with SMI in a group setting in Dutch ambulatory mental health care. The intervention was well-perceived by both mental health care professionals and clients who participated in the intervention. The intervention was generally well implemented during the trial and showed positive effects for weight change. In addition, the SMILE intervention was found to be cost-effective for weight loss but not for increased QALYs. Physical health and lifestyle behaviours should be integrated into treatments in this population and the SMILE intervention seems to be a promising way to offer clients with SMI support in improving their lifestyle.

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Self directed behavior: Self modification for personal adjustment

Cited by 3 publications

References 0 publications

Effectiveness of a Lifestyle Intervention for People With a Severe Mental Illness in Dutch Outpatient Mental Health Care

Effectiveness of a Lifestyle Intervention for People With a Severe Mental Illness in Dutch Outpatient Mental Health Care

Toward a synthesis of cognitive behaviour therapy via component analysis of self‐regulation

The SMILE lifestyle intervention for people with a severe mental illness: feasibility and (cost-)effectiveness

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