Behavior Therapy Techniques Research Articles

Telemedicine for mental disorders: Presentation and initial results of a telephone-based care approach

A telephone-based health program for people with depressive and anxiety disorders as well as stress, already implemented in the standard care of a private health insurance company, as well as the initial evaluation results will be presented. The program, based on several months of telephone support for patients from medical professionals, focuses on teaching psychoeducational content, behavioral therapy techniques, and emotional support. In the current program, the German version of the DASS 21 questionnaire was used, which detects distress in the dimensions of depression, anxiety and stress as well as overall psychological stress. The demographic data and the questionnaire results of all participants from the first eleven months of the program, who completed questionnaires at two time points, are presented. The reductions in the DASS 21 (sub)scores after five months of coaching were defined as the primary endpoints. The basis for calculation was the t-test for dependent samples (α=0.05). Two completed questionnaires were available from 86 of 199 participants (43.2%). The population was on average 49.5 years old and predominantly female (61.6%). In total, coaching lasted 170 (SD=58) days and 200 (81) minutes. On average, these minutes were distributed over 5.6 (1.9) calls. At baseline, there were increased scores in all subcategories (depression: 7.13 [4.99]; anxiety: 4.49 [4.07]; stress: 9.85 [4.16]; total: 21.47 [11.54]). After five months, a reduction in each parameter was measured (depression: - 2.14 [3.99], Cohen's d=0.54; anxiety: - 1.65 [3.36], d=0.49; stress: - 2.24 [4.81], d=0.47; total: - 6.03 [10.70]; d=0.56; p < 0.001 for each). Broken down by severity of stress at the start of care, several subcategories showed an increase in score reduction with increasing severity, with medium to large effect sizes. The telephone program described is promising as an accompanying approach to treatment of mental illness. Due to the pre-post study design, the results presented do not allow a final statement to be made about the effectiveness of the program. However, based on the significant improvements in psychological stress shown over the course of the program, including relevant effect sizes, a further evaluation of this setting under controlled conditions is recommended.

Navigating the complexity of User Engagement: need for normative evaluations in digital interventions

Abstract Digital behavioral change interventions (DBCI), leveraging digital technology to promote cognitive behavioral therapy or positive psychology techniques, can potentially revolutionize health promotion. With applications across a spectrum of health behaviors-from managing common mental health disorders to enhancing physical activity, addressing smoking cessation, alcohol use, and weight management-these interventions offer promise for both healthy and clinical populations. However, their effectiveness hinges significantly on user engagement. Digital interventions are prone to attrition due to their self-help and unguided nature, which impedes their translation from research to real-life settings. This talk discusses the findings of a scoping review to shed light on these complexities. Firstly, we explore the various methodologies used to evaluate engagement across studies, hindering effective comparison and understanding. Secondly, we address the lack of systematic assessment of engagement strategies, advocating for experimental research to fill this gap. Lastly, we emphasize the need to establish an optimal level of engagement for desired outcomes, noting that continuous engagement may not always be conducive to behavioral change interventions, which aim to instill lasting changes in individuals. This underscores the importance of comprehensive assessment using both objective and subjective measures. In conclusion, engagement with digital interventions encompasses both quantitative usage metrics and qualitative subjective experiences, highlighting the need for comprehensive assessment beyond the mere evaluation of frequency or duration. Contrary to common belief, increased engagement does not always lead to better outcomes. Too much engagement can lead to exhaustion, while too little can result in inefficiency. Therefore, designing a DBCI that encourages optimal use is essential, fostering a balance that maximizes effectiveness while minimizing adverse effects.

Assessment and Management of Depressive Disorder: A Case Report of an Unmarried Adult

This case study examines the psychological and social aspects impacting the mental well-being of a 32-year-old unmarried woman. Based on comprehensive clinical assessment, Client D.A. was diagnosed with Major Depressive Disorder (MDD) using Structured Clinical Interview for DSM-5 (SCID-5), Minnesota Multiphasic Personality Inventory (MMPI-2), Rotter Incomplete Sentences Blank College Form (RISB), Draw-a-Person (DAP), clinical interviews, and behavioral observations. A multifaceted treatment plan was developed, combining cognitive behavioral therapy (CBT), interpersonal therapy (IPT), pharmacotherapy, mindfulness, and relaxation techniques. This study provides insights into her experiences of depression, social isolation, societal expectations, and self-esteem. Over the course of the treatment, Client D.A. demonstrated significant improvement in her depressive symptoms. Her negative thought patterns were effectively restructured through CBT and her interpersonal relationships improved with IPT. Additionally, pharmacotherapy stabilized her mood, while mindfulness techniques helped manage anxiety and stress. This case study highlights the complex interplay of factors influencing mental health and underscores the importance of culturally sensitive, personalized treatment approaches, as evidenced by Client D.A.’s increased social engagement, reduced loneliness, and improved well-being, with regular evaluations confirming sustained progress and the efficacy of the integrated treatment plan in promoting recovery.

Efficacy of Cognitive-Behavioral Therapy in Optimizing Counseling Outcomes for Fast Remission of Social Anxiety with Panic Attacks

Aims: The case study evaluates the efficacy of Cognitive Behavioral Therapy in optimizing counseling outcomes for social anxiety and panic attacks within an academic setting. Counseling sessions were conducted with a 23-year-old female client over a four-month period at T.S Government College.&lt;br /&gt; Method: The study utilized a single case study design A-B-A. The client presented with symptoms of social anxiety and panic attacks, impacting various aspects of her life including academic performance, interpersonal relationships, social interactions and family dynamics.&lt;br /&gt; Results: Cognitive Behavioral Therapy techniques including Cognitive Restructuring, Social Skills Training, Role Play and Role Reversal, and Systematic Desensitization through Gradual Exposure, were implemented over 8 sessions. Assessment tools including pre-post ratings, behavioral observations and therapy blueprints were utilized to assess the severity of social anxiety.&lt;br /&gt; Conclusion: A significant decrease in the severity of social anxiety and panic attacks based on both subjective self-reporting and objective observations suggesting Cognitive Behavioral Therapy as an approach of counseling for individuals with social anxiety with panic attacks in educational setting.&lt;br /&gt; &lt;i&gt;Keywords: &lt;/i&gt;Cognitive Behavioral Therapy, case study, case report, social anxiety, panic attacks, cognitive restructuring, systematic desensitization, role play, role reversal, social skills training

Exploring the acceptability, and feasibility of a modified virtual reality-based AVATAR therapy in schizophrenia spectrum disorders: A case series report

Schizophrenia spectrum disorder poses a complex challenge in psychiatric treatment due to its multifaceted symptomatology. Modified AVATAR therapy, an innovative virtual reality-based intervention integrating Cognitive Behavioral Therapy (CBT) techniques such as systematic desensitization, and Acceptance and Commitment Therapy (ACT) approach offers a promising avenue for addressing auditory verbal hallucinations (AVH). This case series report investigates the acceptability and feasibility of a modified AVATAR therapy in three patients diagnosed with schizophrenia spectrum disorder who experience distressing AVH. The study provides detailed demographic and clinical information, outlines the modified AVATAR therapy protocol, and presents outcomes measured through standardized assessments.The findings indicate a decrease in the severity of AVHs, along with enhancements in overall symptomatology after modified AVATAR therapy sessions. Moreover, qualitative perspectives from patients shed light on their favorable experiences and perceptions of this adapted intervention. Nonetheless, the results exhibited inconsistency across individual cases, underscoring challenges for future research and clinical applications in this domain. Nevertheless, in light of the hurdles accompanying the rehabilitation of schizophrenia patients, along with the evaluation and subsequent measurement of parameters affecting efficacy, modified AVATAR therapy could present a valuable addition to schizophrenia patient care.

Cognitive Behavioral Therapy (CBT) in Reducing Symptoms of Self Injury in Adolescents with Depression Major Disorder

Self injury is the behavior of self injuring in various ways regardless of whether or not there is an intention and desire to die. Self injury behavior in adolescents can have a long-term impact on adulthood. The purpose of this study is to reduce the behavior of adolescents who injure their hands with major depressive disorder using Cognitive Behavior Therapy (CBT) techniques. To achieve this goal, CBT therapy was conducted for 3 weeks with 3 times a week. This study uses CBT theory helping clients to examine the validity of their thinking and to see how they interpret or evaluate something that happens and its effect on emotional and behavioral experiences. The subjects in this study were junior high school students. The data analysis process used visual graph techniques. The results of this study showed that CBT therapy was able to reduce self-harm behavior in adolescents with major depressive disorder.

P11 - The effect of motivational interviewing and/ or cognitive behaviour therapy techniques on gestational weight gain – a systematic review and meta‑analysis

P11 - The effect of motivational interviewing and/ or cognitive behaviour therapy techniques on gestational weight gain – a systematic review and meta‑analysis

Chronic pain after traumatic brain injury: a collaborative care approach.

Chronic pain is common after traumatic brain injury (TBI), frequently limits daily activities, and is associated with negative outcomes such as decreased community participation. Despite the negative impact of chronic pain, few people with TBI receive effective treatment. This paper describes a collaborative care (CC) intervention, TBI Care, adapted specifically to treat chronic pain in people living with TBI, emphasizing expert clinician input, cognitive behavioral therapy (CBT) techniques, and other non-pharmacological approaches for decreasing pain interference. 79 participants engaged in the CC intervention from two academic medical rehabilitation clinics with weekly assessments of pain intensity, interference, and medication use. Participant feedback on the intervention was gathered by interview with the care manager (CM) at the last treatment session and/or booster session. Provider feedback was gathered by a confidential survey post intervention. Ninety percent of participants received at least 11 of the target 12 sessions with a care manager (CM), the majority occurring over the phone. Participants endorsed an average of 7 pain locations. All participants received pain education, skills in self-monitoring, goal setting/behavioral activation and relaxation training. Pain interference scores (impact on activity and enjoyment), tracked weekly by the CM, significantly decreased across sessions. 89% of participants received recommendations for CBT skills, 65% received referrals for additional treatments targeting pain interference, and 43% received care coordination. 75% of participants reported 6 or more medications/supplements at both the first and last session, with changes recommended primarily for headache treatment. Feedback from participants and providers was positive. TBI Care, a novel patient-centered CC approach, was flexibly delivered, tailored to the needs of those living with TBI and chronic pain, with a high level of participant engagement, and satisfaction among participants and providers. This approach, prioritizing pain self-management strategies and other non-pharmacological approaches, along with optimizing pharmacological treatment, led to significant reductions in self-reported pain interference and intensity during the intervention. Using a CC model in TBI is feasible and successfully improved access to evidence-based treatments for chronic pain as well as outcomes for pain interference and intensity. ClinicalTrials.gov, identifier NCT03523923.

Enhancing quality of life in epilepsy with a digital intervention (emyna): Results of the ELAINE randomized controlled trial.

Despite the availability of pharmacological treatment for seizures, people with epilepsy (PwE) commonly experience impairments in quality of life (QoL). Given the limited access to psychosocial treatments for PwE, digital interventions could bridge treatment gaps and help improve QoL. The objective of this study was to examine the effectiveness of emyna, a fully automated digital intervention based on cognitive behavioral therapy (CBT) techniques, in improving health-related QoL among PwE who reported impairments in QoL. A previous trial showed that emyna was effective in improving depressive symptoms among PwE with a comorbid depressive disorder, but its effects on QoL among PwE without comorbid depression remain unknown. A pragmatic randomized controlled trial was conducted with N = 438 PwE (mean age = 37.5, 70.3% women, physician-verified diagnoses) who were assigned to the intervention group (n = 216), which used emyna alongside treatment as usual (TAU), or the control group (n = 222), which received TAU only. QoL and secondary outcomes such as general self-efficacy, medication adherence, general distress, and epilepsy-related work and social adjustment were assessed at baseline, 3 months, and 6 months. The primary outcome was QoL assessed with the Quality of Life in Epilepsy [QOLIE-31] total score at 3 months post-randomization. Findings from the intent-to-treat analyses showed that after 3 months, participants in the intervention group experienced significant and clinically relevant improvements in health-related QoL compared to the control group (baseline-adjusted group difference = 4.5; 95% CI = [2.0, 6.9], p < 0.001; Cohen's d = 0.32). Effects on secondary outcomes did not reach statistical significance. This study extends previous research by demonstrating that emyna facilitates improvements in QoL in a diverse group of PwE treated in routine care settings. This CBT-based digital intervention therefore presents a convenient and cost-effective addition to healthcare providers' treatment repertoire. In our study, we tested a digital program called emyna, which conveys cognitive behavioral therapy (CBT) techniques to help improve the quality of life for people living with epilepsy. We found that those who used emyna alongside their usual treatments felt better about their quality of life compared to those who did not use the program. Emyna offers a new, convenient way for people with epilepsy to manage their condition, which can be used alongside currently available treatments.

Assessment of the outcomes of an intervention combining cognitive behavioral therapy techniques and hypnosis for the therapy of obesity

Assessment of the outcomes of an intervention combining cognitive behavioral therapy techniques and hypnosis for the therapy of obesity

Effectiveness of Unguided Internet-Based Cognitive Behavioral Therapy for Subthreshold Social Anxiety Disorder in Adolescents and Young Adults: Multicenter Randomized Controlled Trial.

Social anxiety disorder (SAD) is a common mental disorder in adolescents and young adults. Early intervention and support could help prevent the development of full-blown SAD. Considering that adolescents with social anxiety symptoms do not prefer face-to-face sessions due to their fear of communicating with therapists, internet-based cognitive behavioral therapy (ICBT) was implemented. This study aimed to examine the effectiveness of complete self-help ICBT for subthreshold SAD in high school and college students with no history of mental disorders. A multicenter randomized controlled trial designed to demonstrate the objective was conducted from December 2022 to October 2023. Participants were students enrolled at 6 universities and 1 high school. The intervention was a complete self-help ICBT and consisted of 10 text-based sessions that taught cognitive behavioral therapy techniques for social anxiety in youths and young adults. The comparison was a no-treatment condition (control group), which was randomly assigned in a 1:1 ratio by a computer program. A total of 2 psychological scales were used to assess the severity of social anxiety, and 1 psychological scale each was used to measure symptoms of depression, general anxiety, and quality of life. In total, 77 students were enrolled as study participants. Through the randomization procedure, 38 participants were included in the intervention group, and 39 patients were included in the control group. Results from the analysis of covariance with depression as covariates showed that the participants in the intervention group had significantly reduced symptoms of social anxiety, depression, and general anxiety compared to the control group. The response rate was 61% (19/31) in the intervention group and 24% (9/38) in the control group: odds ratio (OR) 4.97 (95% CI 1.61-16.53; P=.003) in the Fisher exact test. The recovery rate was 68% (21/31) in the intervention group and 34% (13/38) in the control group: OR 3.95 (95% CI 1.32-12.56; P=.008). The OR for the remission ratio was 2.01 (95% CI 0.64-6.60; P=.20) and for the risk of worsening was 0.23 (95% CI 0.002-1.33; P=.10), but no significant difference was observed. The results of this randomized controlled trial show that fully unguided ICBT improves subthreshold SAD in adolescents and young adults. Interpretation of the effectiveness in preventing SAD that meets the diagnostic criteria is limited by sample size and the follow-up period. Future studies should include more extended observations and larger sample sizes in high-risk populations. UMIN-CTR UMIN000050064; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000057035.

변증법적행동치료 기술을 적용한 무용동작치료 프로그램이 학교 부적응 청소년의 자아존중감 향상에 미치는 영향

This study was conducted to examine qualitative changes in self-esteem and movement of research participants by providing a dance movement program applying dialectical behavior therapy techniques to school maladjusted adolescents. 12 first-year middle school students from Suwon were divided into an experimental group and a control group, with 6 students in each group. A short-term program was implemented twice a week for a total of 8 sessions. The program of this study applies the common factor of Dance Movement Therapy (DMT) and Dialectical Behaviour Therapy (DBT), which use a body-based therapeutic approach. The research question analyzed self-esteem and its subfactors, and a movement observation analysis was conducted accordingly to examine qualitative changes in the movements of the experimental group. As a result of the study, first, the dance movement therapy program applying dialectical behavior therapy techniques had a positive effect on improving the self-esteem of School maladjusted adolescents. Second, changes in movement showed improved social skills. This study has confirmed that a positive impact on the self-esteem of School-maladjusted adolescents, and it is hoped that future research will be encouraged using different treatment methods.

Analisis Teknik-Teknik CBT (Cognitive Behavior Therapy) dalam Mengatasi Masalah Siswa di Sekolah

The purpose of this study is to examine the various methods used in cognitive behavior therapy theory used in guidance and counseling. So, this can help BK teachers and counselors conduct individual, guidance, and group counseling using a cognitive behavior therapy (CBT) approach. These CBT techniques have proven to be effective in dealing with a wide range of issues that students face in school. Data is collected through literature research, which uses various reference sources such as articles, source books, and other supporting documents. A good understanding of how CBT techniques can be used in counseling can help guidance and counseling teachers better understand how to use cognitive behavior therapy techniques in their counseling practices.

Effectiveness of Group Guidance Using Behavioral Therapy Techniques to Prevent Bullying Problems in Santri

The rise of bullying that occurs in the school environment today is very worrying. One of the impacts is targeting the perpetrator, namely aggressive behavior. This research aims to determine the bullying behavior of students, both seniors and juniors, in Islamic boarding school environments. The main perpetrators in this research were female students and female students who were involved in bullying at Islamic boarding schools. The method used in this research is a qualitative method and literature study. The data collection techniques used in this research were interviews with bullying victims directly and literature studies through journals and books. The results of the discussion from this research are that bullying behavior is rampant in Islamic boarding school environments, both direct and indirect bullying. Bullying not only often occurs due to factors in the Islamic boarding school environment, parents are also very influential in the perpetrators of bullying which often occurs in the Islamic boarding school environment. The impact of bullying is also very bad for the health of the victims, quite a few victims experience depression, excessive fear and worry easily.

Efficacy of deep brain stimulation for Tourette syndrome and its comorbidities: A meta-analysis

Tourette Syndrome (TS) is a neurodevelopmental disorder characterized by multiple motor and vocal tics, often accompanied by comorbid disorders. Optional treatments for patients with TS include behavioral therapy, pharmacotherapy, and neurostimulation techniques. Deep brain stimulation (DBS) has been considered a therapeutic approach for refractory TS and its comorbid symptoms. However, systematic comparison is necessary to understand the therapeutic effect of DBS among patients with TS with various comorbid symptoms, demographic characteristics, or stimulation targets. Consequently, our research aimed to assess the clinical efficacy of DBS in alleviating the symptoms of TS and its comorbidities. A systematic literature search was conducted across five databases: PubMed, Web of Science, MEDLINE, Embase, and PsycINFO. The primary outcome was the mean change in the global score of the Yale Global Tic Severity Scale (YGTSS), which assesses the severity of tics. The secondary outcomes included mean improvement of comorbid symptoms, such as obsessive-compulsive behaviors (OCB), depression symptoms and anxiety symptoms. In total, 51 studies with 673 participants were included in this meta-analysis. Overall, the DBS led to a significant improvement in tic symptoms (p ​< ​0.001), as well as the comorbid obsessive-compulsive, depression, and anxiety symptoms with effect sizes of 1.88, 0.88, 1.04, and 0.76 accordingly. In the subgroup analysis, we found that striatum stimulation led to a more significant improvement in OCB in patients with TS compared to that observed with thalamic stimulation (p ​= ​0.017). The relationship between sex, age, and target with the improvement of tics, depression, and anxiety was not statistically significant (p ​= ​0.923, 0.438, 0.591 for different male proportions; p ​= ​0.463, 0.425, 0.105 for different age groups; p ​= ​0.619, 0.113, 0.053 for different targets). In conclusion, DBS is an efficient treatment option for TS, as well as the comorbid OCB, depression symptoms, and anxiety symptoms. It is important to highlight that stimulating the striatum is more effective in managing obsessive-compulsive symptoms compared to stimulating the thalamus.

Development of a Mobile application for Effective Mental Health Intervention

The global surge in depression and anxiety, intensified by challenges such as cost and stigma, emphasizes the pressing need for accessible, evidence-based digital solutions. The research centers on the creation of a mobile application specifically designed to address mental health challenges. By integrating cognitive behavioral therapy techniques and features like appointment bookings and mindfulness feedback tools, the app is positioned to improve user outcomes. Utilizing platforms like React Native and React, combined with NestJS for enhanced back-end security, the application adheres to the rigorous standards required for mental health interventions. Collaborative efforts with experts, notably the counseling unit of IIUM, ensure the app's alignment with contemporary best practices and research. Preliminary findings indicate a promising tool with the potential to address the global mental health treatment disparity.

Therapeutic Chatbots as Cognitive-Affective Artifacts

Conversational Artificial Intelligence (CAI) systems (also known as AI “chatbots”) are among the most promising examples of the use of technology in mental health care. With already millions of users worldwide, CAI is likely to change the landscape of psychological help. Most researchers agree that existing CAIs are not “digital therapists” and using them is not a substitute for psychotherapy delivered by a human. But if they are not therapists, what are they, and what role can they play in mental health care? To answer these questions, we appeal to two well-established and widely discussed concepts: cognitive and affective artifacts. Cognitive artifacts are artificial devices contributing functionally to the performance of a cognitive task. Affective artifacts are objects which have the capacity to alter subjects’ affective state. We argue that therapeutic CAIs are a kind of cognitive-affective artifacts which contribute to positive therapeutic change by (i) simulating a (quasi-)therapeutic interaction, (ii) supporting the performance of cognitive tasks, and (iii) altering the affective condition of their users. This sheds new light on why virtually all existing mental health CAIs implement principles and techniques of Cognitive Behavioral Therapy — a therapeutic orientation according to which affective change and, ultimately, positive therapeutic change is mediated by cognitive change. Simultaneously, it allows us to conceptualize better the potential and limitations of applying these technologies in therapy.

Virtual Reality as Exposure Therapy in the Treatment of Blood-Injection-Injury Phobias

Introduction Virtual Reality (VR) is a transformative technology that facilitates the development of immersive virtual environments. Its application is steadily growing within Cognitive Behavioral Therapy (CBT) techniques, notably in virtuo exposure therapy. This is particularly evident in the treatment of specific phobias, with a specific focus on addressing blood-injection-injury phobias.ObjectivesThe objective of our study is to design a treatment protocol for patients suffering from blood phobia based on VR.MethodsWe used the following scales: -Fear Survey Schedule-III (FSS-III) and the Injection Phobia Scale (IPS) for psychometric evaluation of the intensity of avoidance fear.-Questionnaire on cybersickness: to identify potential adverse effects of exposure to virtual reality.To conduct a functional analysis of phobias, we used the SECCA grid and the SORC grid.ResultsThe therapeutic protocol stages of VR for a patient suffering from Blood-Injection-Injury Phobia (BIIP) are as follows:1.Collection of sociodemographic and clinical data.2.Functional analysis to identify triggering factors, contributing factors, and consequences of behavior. The SECCA or SORC grid can help in conducting this functional analysis.3.Psychometric evaluation of the intensity of avoidance fear using the three scales: FSS-III, IPS, and the cybersickness scale.4.Patient education on the mechanisms of the phobia.5.Setting of objectives.6.Therapeutic contract.7.The Protocol :8.Cognitive approach: identification of automatic thoughts and replacement with more rational thoughts.9.Behavioral approach: Progressive exposure, controlled immersion of the patient in virtual environments corresponding to situations that trigger their phobia. This exposure is coupled with relaxation.The treatment continues with regular follow-up to ensure the consolidation of progress and to adjust strategies.For relapse prevention, simple measures ,like personalized exercises to be done by the patient, can favor the long-term maintenance of the acquired skills.Conclusions Virtual reality exposure therapies (in virtuo) are as effective as in-vivo therapies. Besides, they offer a significant advantage over the latter as they facilitate access to stimuli or anxiety-provoking situations that are difficult to access or control in the real world.Disclosure of InterestNone Declared

Comparative Evaluation of the Effectiveness of Innovative Periorbital Eye Massager and Virtual Reality Eyeglasses for Reducing Dental Anxiety during Dental Restorative Procedures in Children.

Many behavior management techniques are employed to reduce the anxiety associated with dental procedures in children. One of the most commonly used methods comprises audiovisual distraction using virtual reality (VR) eyeglasses. In this study, an innovative device, a periorbital eye massager (PEM), is compared with VR to evaluate dental anxiety in children. in this study, 22 children were divided into two groups, that is, group I consisting of PEM and group II consisting of VR. The participants were instructed to wear the device and then subjected to dental restorative procedures. After completion of the procedure, anxiety was measured using a validated questionnaire by the children and by using the modified behavior pain scale by the second investigator. Also, physiological parameters like heart rate and oxygen saturation were evaluated before and after a dental procedure. The results were statistically insignificant for group I and group II when a validated questionnaire and modified behavior pain scale were used to measure the dental anxiety of children. Also, the data also shows no significant difference in heart rate and oxygen saturation between the two groups. The innovative PEM can also be used as an effective behavior management tool in managing dental anxiety in children, as there was no statistically significant difference between PEM and VR. As a pediatric dentist, the methods for administering a patient present a novel challenge because behavior management varies from patient to patient. As a result, the prospects for augmenting various techniques of behavior therapy for pediatric patients are limitless. Gala UP, Kalaskar R. Comparative Evaluation of the Effectiveness of Innovative Periorbital Eye Massager and Virtual Reality Eyeglasses for Reducing Dental Anxiety during Dental Restorative Procedures in Children. Int J Clin Pediatr Dent 2024;17(1):48-53.

Pain Care at Home to Amplify Function: Protocol Article.

Guidelines recommend strategies to optimize opioid medication safety, including frequent reassessment of the benefits and harms of long-term opioid therapy. Prescribers, who are predominantly primary care providers (PCPs), may lack the training or resources to implement these guideline-concordant practices. Two interventions have been designed to assist PCPs and tested within the Veterans Health Administration (VHA). Telemedicine Collaborative Management (TCM) provides primarily medication management support via care manager-prescriber teams. Cooperative Pain Education and Self-Management (COPES) promotes self-management strategies for chronic pain via cognitive behavior therapy techniques. Each intervention has been shown to improve prescribing and/or patient outcomes. The added value of combining these interventions is untested. With funding and central coordination by the Integrative Management of Chronic Pain and Opioid Use Disorder for Whole Recovery (IMPOWR) Network of the National Institutes of Health Helping to End Addiction Long-term (HEAL) Initiative, we will conduct a multisite patient-level randomized hybrid II effectiveness-implementation trial within VHA to compare TCM to TCM + COPES on the primary composite outcome of pain interference and opioid safety, secondary outcomes of alcohol use, anxiety, depression, and sleep, and other consensus IMPOWR Network measures. Implementation facilitation strategies informed by interviews with healthcare providers will target site-specific needs. The impact of these strategies on TCM implementation will be assessed via established formative and summative evaluation techniques. Economic analyses will evaluate intervention cost-effectiveness.