Cognitive Behavioral Therapy Program Research Articles

Combining procedural and behavioral treatments for chronic low back pain: A pilot feasibility randomized controlled trial.

Individual treatments for chronic low back pain (CLBP) have small magnitude effects. Combining different types of treatments may produce larger effects. To (1) assess feasibility of conducting a factorial randomized controlled trial of these treatments; and (2) estimate individual and combined treatment effects of (a) lumbar radiofrequency ablation (LRFA) of the dorsal ramus medial branch nerves (vs. a simulated LRFA control procedure) and (b) Activity Tracker-Informed Video-Enabled Cognitive Behavioral Therapy program for CLBP (AcTIVE-CBT) (vs. an educational control treatment) on back-related disability at 3 months post-randomization. Participants (n = 13) were randomized in a 1:1:1:1 ratio in a 2 × 2 factorial randomized controlled trial. Feasibility goals included an enrollment proportion ≥ 30%, a randomization proportion ≥ 80%, and a ≥ 80% proportion of randomized participants completing the 3-month Roland-Morris Disability Questionnaire (RMDQ) primary outcome end point. An intent-to-treat analysis was used. The enrollment proportion was 62%, the randomization proportion was 81%, and all randomized participants completed the primary outcome. Though not statistically significant, there was a beneficial, moderate-magnitude effect of LRFA versus control on 3-month RMDQ (-3.25 RMDQ points [95% confidence interval [CI], -10.18 to 3.67]). There was a significant, beneficial, large-magnitude effect of AcTIVE-CBT versus control (-6.29 [95% CI, -10.97 to -1.60]). Though not statistically significant, there was a beneficial, large effect of LRFA+AcTIVE-CBT versus control (-8.37 [95% CI: -21.47, 4.74]). We conclude that it is feasible to conduct a randomized controlled trial combining procedural and behavioral treatments for CLBP. gov Registration: https://clinicaltrials.gov/ct2/show/NCT03520387.

Effects of a Procrastination Intervention for Japanese University Students With Attention-Deficit/Hyperactivity Disorder Tendencies: An Interrupted Time Series Analysis.

University students, especially those with attention-deficit/hyperactivity disorder (ADHD), experience distress due to procrastination. However, the existing treatment for adult ADHD does not adequately address procrastination. A brief procrastination-focused cognitive behavioral therapy program was developed for the current study, and its effects on procrastination, depression, and life satisfaction were assessed. Using a single-case AB design, procrastination behaviors and mood during the baseline and intervention periods were recorded. Data from 24 students with ADHD symptoms (mean age = 20.42 years, SD = 1.50) were analyzed using interrupted time series and counterfactual analyses. The effects of the program on the depressive symptoms and life satisfaction were also examined. The intervention changed the trajectory of the students' procrastination behaviors, significantly reducing them compared with baseline. They also reported improved life satisfaction following the intervention. This novel intervention appears effective in reducing procrastination among university students with ADHD symptoms.

Effectiveness of Digital Mental Health Interventions in the Workplace: Umbrella Review of Systematic Reviews.

There is potential for digital mental health interventions to provide affordable, efficient, and scalable support to individuals. Digital interventions, including cognitive behavioral therapy, stress management, and mindfulness programs, have shown promise when applied in workplace settings. The aim of this study is to conduct an umbrella review of systematic reviews in order to critically evaluate, synthesize, and summarize evidence of various digital mental health interventions available within a workplace setting. A systematic search was conducted to identify systematic reviews relating to digital interventions for the workplace, using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). The review protocol was registered in the Open Science Framework. The following databases were searched: PubMed, Web of Science, MEDLINE, PsycINFO, and Cochrane Library. Data were extracted using a predefined extraction table. To assess the methodological quality of a study, the AMSTAR-2 tool was used to critically appraise systematic reviews of health care interventions. The literature search resulted in 11,875 records, which was reduced to 14 full-text systematic literature reviews with the use of Covidence to remove duplicates and screen titles and abstracts. The 14 included reviews were published between 2014 and 2023, comprising 9 systematic reviews and 5 systematic reviews and meta-analyses. AMSTAR-2 was used to complete a quality assessment of the reviews, and the results were critically low for 7 literature reviews and low for the other 7 literature reviews. The most common types of digital intervention studied were cognitive behavioral therapy, mindfulness/meditation, and stress management followed by other self-help interventions. Effectiveness of digital interventions was found for many mental health symptoms and conditions in employee populations, such as stress, anxiety, depression, burnout, and psychological well-being. Factors such as type of technology, guidance, recruitment, tailoring, and demographics were found to impact effectiveness. This umbrella review aimed to critically evaluate, synthesize, and summarize evidence of various digital mental health interventions available within a workplace setting. Despite the low quality of the reviews, best practice guidelines can be derived from factors that impact the effectiveness of digital interventions in the workplace. OSF Registries osf.io/rc6ds; https://doi.org/10.17605/OSF.IO/RC6DS.

P0635 Degree of interest in using a cognitive-behavioral therapy application for fatigue management and related factors among outpatients with inflammatory bowel disease

Abstract Background Fatigue is a common symptom in patients with inflammatory bowel disease (IBD) and is associated with a diminished quality of life. Previous research has demonstrated the effectiveness of fatigue management programmes that use cognitive behavioural therapy (CBT) or other psychotherapies. CBT is often face-to-face and individually time consuming, and there are personnel challenges in its implementation in real-world clinical settings. This study aimed to understand the needs of Japanese patients with IBD regarding fatigue management and explore the characteristics of those willing to use CBT applications (apps). Methods This study involved secondary analysis of data from 488 patients treated at a specialised IBD clinic in Japan. Patient characteristics, such as sex, age, disease duration, interest in CBT programmes, and interest in CBT apps for fatigue management (each assessed on a 7-point ordinal scale from 0 for not interested to 6 for very interested), and the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F) scale score were included in the survey. Data on blood parameters and disease activity, as determined by Crohn’s activity index and the partial Mayo score, were obtained from medical records. Results Among the participants, 85% were in clinical remission, 58% had Crohn’s disease (CD), and 66% were male. Forty-five percent of the patients were affected by moderate or high levels of fatigue (FACIT-F score > 40). The mean score for interest in the CBT programme was 3.3 ± 1.9, with 69% expressing moderate or greater interest (scores ≥ 3). Interest in the CBT app averaged 2.5 ± 1.9, with 50% expressing a moderate level of interested or higher. Interest in the CBT programme was significantly higher among females and those with greater levels of fatigue (lower FACIT-F scores) or lower levels of emotional well-being. Significant factors associated with higher interest in the CBT app included female sex and greater levels of fatigue. Conclusion Interest in CBT for fatigue management among patients with IBD was moderate, with higher levels of interest observed in patients experiencing greater levels of fatigue, particularly among females. CBT apps offer a promising alternative for addressing fatigue, potentially enhancing accessibility and convenience in clinical settings. Future strategies incorporating CBT apps may help meet the needs of those with limited access to in-person therapies.

Stakeholder perspectives on implementation of internet-delivered cognitive behaviour therapy in physical medicine rehabilitation setting using the Consolidated Framework for Implementation Research.

Despite the growing evidence for the effects of tailored internet-delivered cognitive behaviour therapy (ICBT) programmes for those receiving physical rehabilitation, there is a lack of implementation of these programmes in a clinical or community setting. The aim of the current study was to evaluate barriers and facilitators of implementing an ICBT programme into a physical medicine rehabilitation setting. Stakeholders with expertise in physical medicine rehabilitation were recruited (n = 25) including: 16 clinicians, 4 administrators, 3 persons with lived experience, and 2 care partners. Individual semi-structured interviews were conducted based on the domains of the Consolidated Framework for Implementation Research (CFIR). Transcripts were analysed using a positivist approach, using deductive thematic content analysis. Themes were coded based on the domains of CFIR. Facilitators for implementation primarily fell under intervention characteristics including relative advantage, strong evidence and quality, and design quality. Perceived barriers for implementation were identified in the inner setting including leadership engagement, culture, and available resources. The results from the current study provide insight on the factors that may contribute towards successful implementation of an ICBT programme in a physical medicine setting.

Effectiveness of a Videoconference-Based Cognitive Behavioral Therapy Program for Patients with Schizophrenia: Pilot Randomized Controlled Trial.

Cognitive behavioral therapy for psychosis (CBTp) is not sufficiently widespread in clinical practice, although evidence has been presented. The purpose of this study was to explore whether one-on-one videoconference-based CBTp (vCBTp) is more effective than usual care (UC) alone for improving psychiatric symptoms in patients with schizophrenia attending outpatient clinics. In this exploratory randomized controlled trial, patients with schizophrenia and schizoaffective disorders who were still taking medication in an outpatient clinic were randomly assigned to either the vCBTp plus UC group (n=12) or the UC group (n=12). The vCBTp program was conducted once a week, with each session lasting for 50 minutes, for a total of 7 sessions conducted in real-time and in a one-on-one format remotely using a loaned tablet computer (iPad). The primary outcome was the Positive and Negative Syndrome Scale (PANSS) total score, which measures the difference in the mean change from baseline (week 0) to posttest (week 8). The study included 24 participants. There were no significant differences between the 2 groups at baseline. With regard to significant differences between the 2 groups in terms of the primary outcome, the mean change in the PANSS total score from baseline to week 8 in the vCBTp plus UC group was -9.5 (95% CI -12.09 to -6.91) and the mean change in the UC alone group was 6.9 (95% CI 1.54-12.30). The difference between the 2 groups was significant (P<.001). In addition, significant improvements were observed in the subscales of positive (P<.001) and negative (P=.004) symptoms and general psychopathology (P<.001). Significant differences were also observed in the secondary outcomes of the General Anxiety Disorder-7 (GAD-7; P=.04) and EQ-5D-5L (P=.005). There were no dropouts and no serious adverse events in this study. A total of 7 remote vCBTp sessions conducted in the vCBTp plus UC group could be safely administered to patients with schizophrenia. They were also observed to be effective for psychiatric symptoms, general anxiety, and quality of life. However, because of the observed worsening of scores in the UC group, caution is required in interpreting significant differences between the 2 groups. This approach is expected to improve accessibility to CBTp for outpatients with schizophrenia and social anxiety regarding transportation use and financial and physical burdens related to transportation, and to contribute to promoting CBTp acceptability by compensating for the shortage of implementers. University Hospital Medical Information Network Clinical Trials Registry UMIN000043396; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000049544. RR2-10.1136/bmjopen-2022-069734.

Cognitive Behavioural Therapy to Optimize Post-Operative Recovery (COPE): a randomized controlled feasibility trial in extremity fracture patients

BackgroundOutcomes following surgery to operatively manage extremity fractures are variable, and up to two-thirds of patients report chronic post-surgical pain. Preliminary evidence suggests that psychotherapy directed at improving coping skills and reducing somatic vigilance may improve outcomes among fracture patients. The objective of this pilot study was to test the feasibility and acceptability of a randomized controlled trial comparing an online cognitive behavioural therapy (CBT) program versus usual care in patients with an operatively managed open or closed extremity fracture.MethodsWe conducted a single-centre internal pilot study over a 10-month period in patients with at least one operatively managed open or closed fracture of the appendicular skeleton. Participants were randomized to an online CBT program or usual care and followed for 12 months. The goals of our pilot study were to determine an acceptable rate of recruitment, the degree to which participants randomized to CBT were compliant with treatment, the site investigator’s ability to adhere to study protocol and data collection procedures, and our ability to achieve high follow-up rates. Feasibility criteria were evaluated using a graded “traffic light” approach, in which “green light” indicates moving forward with the definitive trial, “yellow light” indicates proceeding with modifications to the protocol and trial procedures, and “red light” indicates a definitive trial is not feasible without significant protocol and trial procedure modifications.ResultsWe enrolled 94 participants over 10 months, which resulted in a “yellow light” for recruitment. Participant compliance with completion of the online CBT program received a “yellow light”, with 60% of participants who were randomized to CBT completing all seven modules. However, 40% of participants in the CBT-arm withdrew from the program, resulting in a “red light”. Adherence with the study protocol activities at baseline was relatively high (88%) which resulted in a “yellow light”. Follow-up was 85% (80 of 94) at 12 months, resulting in a “yellow light”.ConclusionsThese results suggest feasibility of a definitive, multi-centre trial to compare CBT versus usual care in the management of persistent post-operative pain in fracture patients despite the pilot phase identifying some challenges with enrollment timelines, compliance with the CBT program, and participant follow-up. For the definitive trial, we will expand participant recruitment to additional centres and implement strategies to optimize participant engagement and compliance with the CBT program and follow-up.Trial registrationClincialTrials.gov (NCT04274530). Registered February 18, 2020, https://classic.clinicaltrials.gov/ct2/show/NCT04274530.

Acceptability and Feasibility of a Blended School-Based Intervention to Prevent Suicidal Ideation Among Adolescents in Chile: Results from a Randomized Control Pilot Study.

Suicide prevention programs delivered in school settings have been shown to reduce suicide attempts and ideation among adolescents. School-based digital interventions targeting at-risk youth are a promising avenue for suicide prevention, and some evidence has shown that blending digital and face-to-face components may improve the effectiveness. However, further evidence on its acceptability, feasibility, and effectiveness is needed, especially in Latin America, where mental health support is limited. Reframe-IT is an internet-based Cognitive Behavioral Therapy (CBT) program to reduce youth suicidal ideation in school settings. We created four complementary face-to-face CBT sessions and, through a pilot study, tested the acceptability, feasibility, and effectiveness of a blended intervention (Reframe-IT +) in adolescents (N = 52) from 6 public schools in Chile, randomized into two groups: Reframe-IT + (N = 33) and Control (N = 19). We found that the intervention was acceptable and feasible, with high degrees of satisfaction and adherence. We also observed a significant reduction in suicidal ideation and depressive symptoms in the intervention group compared to the control group at post-intervention. Our results suggest that the Reframe-IT + could be delivered as a suitable, acceptable, and effective intervention to reduce suicide ideation in adolescents in school settings. Further research is needed to confirm these preliminary results.

Eating behavior changes with an online cognitive behavioral therapy program for weight loss in individuals with overweight or obesity: A pilot study

Eating behavior changes with an online cognitive behavioral therapy program for weight loss in individuals with overweight or obesity: A pilot study

At What Cost? Interrogating Cognitive-Behavioral Programs in Prison

This article describes the issues inherent in prison cognitive-behavioral therapy (CBT) programs using a case study from the author’s previous research as an example, assesses the state of the literature on these programs today, and offers practical suggestions for researchers and practitioners to counteract the troubling content these programs produce. These programs represent a new form of discipline impacting on the stories prisoners are supposed to tell about themselves and their offences – about their narrative identity (discursive discipline). The article concludes with the recommendation that researchers qualify their studies investigating whether or not CBT programs in prison reduce recidivism by also investigating the non-material costs of these programs to their incarcerated participants.

EVALUATING THE EFFICACY OF COGNITIVE BEHAVIORAL THERAPY FOR AMPHETAMINE USE DISORDER: IMPACT OF SOCIO-DEMOGRAPHIC AND BEHAVIORAL FACTORS IN PAKISTAN

Background: Amphetamine use disorder (AUD) is a significant public health concern globally, with rising incidence in Pakistan. Cognitive Behavioral Therapy (CBT) is a well-established intervention for substance use disorders, yet its effectiveness may vary based on socio-demographic and behavioral factors. This study aims to assess the efficacy of CBT for AUD in Pakistan and explore how factors such as education, profession, duration of addiction, residence, age, family support, smoking, and alcohol intake impact treatment outcomes. Methods: A quasi-experimental design was utilized with 100 participants recruited from outpatient treatment facilities and rehabilitation centers across Pakistan. Fifty participants received a culturally adapted CBT program, while 50 participants in the control group received standard treatment as usual (TAU). Pre-test and post-test assessments measured changes in AUD symptoms, psychological well-being, quality of life, and relapse rates. Data were analyzed using descriptive statistics, paired t-tests, ANOVA, multiple regression, and survival analysis. Results: Participants in the CBT group showed a significant reduction in the frequency of amphetamine use from 5.8 to 2.3 days per week (p &lt; 0.001), and a substantial decrease in Addiction Severity Index (ASI) scores from 30.2 to 18.7 (p &lt; 0.001). Improvements were also observed in psychological measures, with Beck Depression Inventory (BDI) scores decreasing from 22.4 to 14.1 (p &lt; 0.001) and General Anxiety Disorder-7 (GAD-7) scores decreasing from 18.5 to 11.3 (p &lt; 0.001). Quality of Life (WHOQOL-BREF) scores improved significantly from 45.3 to 62.0 (p &lt; 0.001). The TAU group showed improvements, but these were less pronounced compared to the CBT group. Socio-demographic factors such as higher education, stable employment, and strong family support were positively associated with better outcomes, while unemployment, longer duration of addiction, and regular alcohol intake were negatively associated. Conclusions: CBT is effective in reducing amphetamine use, improving psychological well-being, and enhancing quality of life among individuals with AUD in Pakistan. The study highlights the importance of tailoring CBT interventions to consider socio-demographic and behavioral factors to optimize treatment outcomes.

Non-pharmacological interventions for ICU nurses’ burnout syndrome: A meta-analysis

Burnout syndrome is a critical issue among Intensive Care Unit (ICU) nurses due to high workloads, emotional distress, and constant exposure to life-threatening situations. Characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, burnout negatively impacts both the well-being of nurses and the quality of patient care. While pharmacological interventions may offer some relief, non-pharmacological strategies are increasingly recognized as essential for preventing and managing burnout without the risk of medication-related side effects. This meta-analysis aims to evaluate the effectiveness of various non-pharmacological interventions, such as art therapy, guided meditation, mindfulness-based stress reduction, cognitive-behavioral therapy (CBT), and peer support programs, in reducing the symptoms of burnout syndrome among ICU nurses.A systematic literature search was conducted across multiple databases (PubMed, CINAHL, PsycINFO, and Cochrane Library) for randomized controlled trials (RCTs) and quasi-experimental studies evaluating non-pharmacological interventions for burnout in ICU nurses. Studies published between 2010 and 2024 were included. The primary outcome measure was the reduction in burnout symptoms as assessed by validated scales such as the Maslach Burnout Inventory (MBI). Data extraction and quality assessment were performed independently by two reviewers, and statistical analyses were conducted using a random-effects model to calculate pooled effect sizes. A total of 18 studies involving 2,346 ICU nurses were included in the meta-analysis. The pooled effect size indicated that non-pharmacological interventions significantly reduced emotional exhaustion (Hedges’ g = 0.67, 95% CI [0.45, 0.89], p &amp;#60; 0.01) and depersonalization (Hedges’ g = 0.59, 95% CI [0.38, 0.81], p &amp;#60; 0.01) while improving personal accomplishment (Hedges’ g = 0.53, 95% CI [0.30, 0.76], p &amp;#60; 0.01). Among the interventions, mindfulness-based stress reduction and CBT showed the highest efficacy, followed by art therapy and guided meditation. Peer support programs also demonstrated moderate effectiveness but were less studied.The findings suggest that non-pharmacological interventions, particularly mindfulness and cognitive-behavioral therapies, are effective in reducing burnout symptoms among ICU nurses. These interventions offer a sustainable, low-risk alternative to pharmacological approaches, contributing to better mental health outcomes and improved nurse retention in high-stress environments. Future research should focus on larger, multi-center trials and explore the long-term impacts of these interventions.

Promoting Mental Health as an HIV Prevention Strategy in Low-Income Settings

The intersection of mental health and HIV prevention is a critical issue, particularly in low-income settings where both challenges are prevalent. Individuals living with mental health conditions are at an increased risk of engaging in HIV-related risk behaviors, such as unprotected sex, substance abuse, and neglecting HIV care. This review explores the role of mental health promotion as an essential strategy in HIV prevention, emphasizing the need for integrated approaches that address both mental health and HIV risk. By fostering mental well-being through psychological support, psychoeducation, and community-based interventions, mental health promotion can play a significant role in reducing HIV transmission in these vulnerable populations. In many low-resource settings, the lack of access to mental health services is compounded by cultural stigma, limited healthcare infrastructure, and financial constraints. Despite these challenges, effective mental health interventions, such as counseling, cognitive-behavioral therapy (CBT), and community-based programs, have shown promise in improving mental health outcomes and reducing HIV risk behaviors. Integrating mental health support into HIV care settings and ensuring that healthcare providers are trained to address mental health needs can substantially improve both mental and physical health outcomes, leading to a reduction in HIV transmission. Keywords: mental health, HIV prevention, low-income settings, psychological support, health outcomes

A novel smartphone application to prevent postpartum depression adapted from an evidence-based cognitive behavioral therapy program: Individual end-user interviews to optimize the intervention.

Postpartum depression (PPD) is more common among pregnant patients who have unmet social needs, such as financial stress or food insecurity, compared to those who do not. Mothers and Babies (MB) is a cognitive behavioral therapy (CBT)-based program that prevents up to 50% of de novo PPD when provided in-person to low-income Spanish- and English-speaking pregnant people without depression. MB's reach has been limited by the need for trained personnel to support the program. Transforming MB into a smartphone application (app) may mitigate this key barrier to scaling MB. To utilize qualitative data from target end-users to create and optimize MBapp, a novel app centered on the MB program. Draft wireframes of MBapp were created in English and Spanish with CBT-based modules adapted from MB. These wireframes included several features shown previously to sustain app engagement: 1) push notifications delivered at participant-preferred times; 2) text-, graphic-, and video-based content; and 3) gamification with digital rewards for app engagement. English- or Spanish-speaking individuals with public health insurance who were between 32 weeks' gestation and six months postpartum and owned smartphones were eligible to consent for individual in-depth interviews. Individuals with prior or current depression were excluded. Interviews were recorded, transcribed, and analyzed using deductive and inductive codes to characterize opinions about MBapp and perceptions of challenges and facilitators of use of MBapp or other perinatal or mental health apps. End-user feedback led to major modifications to the wireframes. Each of these changes was categorized according to the Framework for Modification and Adaptation (FRAME), an established method of systematically reporting adaptations and modifications to evidence-based interventions via end-user feedback. Recruitment ceased with content saturation, defined as three successive participants providing only positive feedback on MBapp's wireframe, without further suggestions for improvement. 25 interviews were completed. Participants were racially and ethnically diverse, generally representing our target end-user population, and 48% of interviews were conducted in Spanish. Participants' suggestions to improve MBapp were categorized within the FRAME as adaptations that improved either content or context to optimize reach, retention, engagement, and fit for end users. Specifically, the following features were added to MBapp secondary to end-user feedback: 1) audio narration; 2) "ask a clinician" non-urgent questions; 3) on-demand module summaries accessible upon module completion; and 4) choice to defer assessments and start the next module. Participants also provided insights into features of perinatal or mental health apps they found appealing or unappealing to understand preferences, challenges, and (non)negotiables for MBapp. Adapting MBapp to incorporate end users' perspectives optimized our digital PPD prevention intervention, ideally increasing its appeal to future users. Our team's next steps will confirm that MBapp is a feasible, acceptable intervention among English- and Spanish-speaking perinatal people at risk of PPD.

A multicenter, single-group, open feasibility study of a new individual cognitive behavioral therapy program for adult Japanese patients with attention-deficit/hyperactivity disorder: Study protocol.

Attention-deficit/hyperactivity disorder (ADHD) symptoms, including executive function, emotional regulation, and motivation, can persist into adulthood and are often associated with mental illnesses. Cognitive behavioral therapy (CBT) may help ADHD adults in Japan, but the lack of studies and the variability in group CBT approaches make its effects unclear. Japan lacks unified CBT programs and adult ADHD guidelines, making it difficult to implement international individual CBT recommendations due to cultural differences. This study will assess the feasibility of a novel CBT program for Japanese adult ADHD patients. This feasibility study will be open, nonrandomized, single-arm, multicenter study. Twelve ADHD patients aged 20-65 years who are currently receiving treatment will be included based on Conners' Adult ADHD Rating Scale (CAARS) clinical severity threshold. An intervention phase of 12-16 weeks and a 12-week follow-up will total 24-28 weeks for all participants. The intervention will use a new CBT program tailored to individual assessments. The primary objective is to determine feasibility using dropout rates, adverse events, and CAARS score changes between Weeks 1 and 16. The secondary outcomes will assess long-term effects of treatment beyond the intervention period and provide descriptive statistics on sex, depression, quality of life, and autistic scores in relation to the intervention outcomes. The full analysis set and per protocol set will be used for statistical analysis. This study is essential for the development of CBT interventions in accordance with Japan's healthcare system that are tailored to the unique needs of its population.

Intervention programme to improve emotional regulation among adolescent with mental disorders: a systematic review

Adolescence is an important period for developing social and emotional habits that are important for mental well-being. This research aimed to know the effectiveness of intervention programs to improve emotional regulation in adolescents with mental disorders. Preparation using the PICO approach, determination of inclusion and exclusion criteria, and a literature review of scientific English articles published between 2016 and 2023 were conducted. Data were obtained from the SCOPUS, Science Direct, SpringerLink, ProQuest, and SAGE databases. Assessment of the title, abstract, and full text of the article with the keywords "Adolescent," "Child," "Teenager," "Emotion regulation," "Emotion exposure," "Intervention," "Mental Disorders," "Randomised Control Trial." The systematic review report was reviewed critically to ensure that all PRISMA steps and items were included. Nine articles met the inclusion criteria. The choice of programs and methods of intervention may vary depending on the specific mental disorders and individual needs of adolescents. Nursing interventions, including cognitive behavioral therapy, mindfulness-based interventions, group therapy, support groups, and school-based programs, are widely used to manage and treat mental health disorders with the aim of improving well-being and recovery. The effectiveness of intervention programs varies, and selection should consider adolescent needs, resources, and cultural contexts. Consulting mental health professionals or organizations is recommended.

Improving Oral Nutrition Intake Through One-on-One Meal Support for Patients With Eating Disorders.

INTRODUCTION: Treatment for eating disorders (EDs) after hospitalization requires structured environments such as residential care programs where treatment options such as meal support therapy can help manage the physical and psychological effects of their illness. The residential center for this project follows a multidisciplinary approach that uses cognitive behavior therapy (CBT) as a treatment modality for ED. Structured meal support is an essential part of implementing the center's CBT program. AIM(S): The project aimed to determine if one-on-one mealtime support training for staff can help increase oral nutrition intake in adolescents with ED. METHODS: Meal consumption data for five residents of the ED center was used for this project. First, 2 weeks of meal consumption data were collected (210 meals). Then residential center staff were trained on using meal support strategies adapted from the Auckland Eating Disorder Manual. After training the staff and having them implement the strategies with ED clients for a week, another 2 weeks of meal consumption data were collected (210 meals). The preimplementation and postimplementation data were compared to determine if the intervention had an impact on the overall meal intake by residents of the ED center. RESULTS: Before implementing the project, patients completed 122 meals in 2 weeks, representing 58.1% of their meals and after the intervention, patients completed 141 meals representing 67.14% of their meals. CONCLUSION: Project findings show that the use of mealtime support strategies while providing one-on-one support for patients with EDs led to an increase in the overall oral intake.

Investigating the Effectiveness of Technology-Based Distal Interventions for Postpartum Depression and Anxiety: Systematic Review and Meta-Analysis.

Postpartum anxiety and depression are common in new parents. While effective interventions exist, they are often delivered in person, which can be a barrier for some parents seeking help. One approach to overcoming these barriers is the delivery of evidence-based self-help interventions via websites, smartphone apps, and other digital media. This study aims to evaluate the effectiveness of technology-based distal interventions in reducing or preventing symptoms of postpartum depression or anxiety in male and female birth and adoptive parents, explore the effectiveness of technology-based distal interventions in increasing social ties, and determine the level of adherence to and satisfaction with technology-based distal interventions. A systematic review and series of meta-analyses were conducted. Three electronic bibliographic databases (PsycINFO, PubMed, and Cochrane Library) were searched for randomized controlled trials evaluating technology-based distal interventions for postpartum depression or anxiety in birth and adoptive parents. Searches were updated on August 1, 2023, before conducting the final meta-analyses. Data on trial characteristics, effectiveness, adherence, satisfaction, and quality were extracted. Screening and data extraction were conducted by 2 reviewers. Risk of bias was assessed using the Joanna Briggs Institute quality rating scale for randomized controlled trials. Studies were initially synthesized qualitatively. Where possible, studies were also quantitatively synthesized through 5 meta-analyses. Overall, 18 articles met the inclusion criteria for the systematic review, with 14 (78%) providing sufficient data for a meta-analysis. A small significant between-group effect on depression favored the intervention conditions at the postintervention (Cohen d=-0.28, 95% CI -0.41 to -0.15; P<.001) and follow-up (Cohen d=-0.27, 95% CI -0.52 to -0.02; P=.03) time points. A small significant effect on anxiety also favored the intervention conditions at the postintervention time point (Cohen d=-0.29, 95% CI -0.48 to -0.10; P=.002), with a medium effect at follow-up (Cohen d=-0.47, 95% CI -0.88 to -0.05; P=.03). The effect on social ties was not significant at the postintervention time point (Cohen d=0.04, 95% CI -0.12 to 0.21; P=.61). Effective interventions tended to be web-based cognitive behavioral therapy programs with reminders. Adherence varied considerably between studies, whereas satisfaction tended to be high for most studies. Technology-based distal interventions are effective in reducing symptoms of postpartum depression and anxiety in birth mothers. Key limitations of the reviewed evidence include heterogeneity in outcome measures, studies being underpowered to detect modest effects, and the exclusion of key populations from the evidence base. More research needs to be conducted with birth fathers and adoptive parents to better ascertain the effectiveness of interventions in these populations, as well as to further assess the effect of technology-based distal interventions on social ties. PROSPERO CRD42021290525; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=290525.

CarersCanADAPT: Study protocol of a stepped care pathway and hybrid type 1 effectiveness-implementation trial of an online cognitive behavioural therapy (iCBT) program for cancer carers with anxiety and depression

BackgroundFamily or friend carers of people with cancer report high levels of depression, anxiety, caregiving strain, and unmet needs. Limited strategies for identification and management of distress have been established among cancer carers. This paper describes the protocol of two linked studies: Study 1a, a distress screening and stepped care pathway feasibility study and Study 1b, a hybrid implementation-effectiveness Randomised Controlled Trial (RCT) to assess the benefit of a comprehensive, carer-centred online Cognitive Behavioural Therapy (iCBT) program for carers with anxiety and depression. MethodsFor Study 1a, 300 cancer carers will be screened for distress. Carers with low distress will be referred to publicly available carer resources. Carers scoring 4 and higher on the distress thermometer will complete depression and anxiety measures. Carers with high anxiety/depression will be recommended psychological therapy. Carers with mild/moderate anxiety and/or depression will be allocated to the Carers iCBT Program, evaluated via a RCT with waitlist control group (Study 1b). For Study 1b, intervention group carers will receive access to a 6-lesson self-directed online iCBT program. Waitlist-controls will access the intervention at 14 weeks. Intervention and control groups will complete baseline, 6 week, and 14 week self-report measures; controls will complete additional measures at 20 and 28 weeks. A sample size of n = 166 carers in the iCBT RCT is needed. ConclusionsIf acceptable, feasible and effective, this pathway and iCBT intervention could offer a sustainable, scalable and low-cost approach to identifying and managing distress in carers, and potentially improving patient and carer outcomes.Trial Registration: Australian and New Zealand Clinical Trial Registry number: ACTRN12623001341617p.

Feasibility study of the e-learning version of the “Journey of the Brave:” a universal anxiety-prevention program based on cognitive behavioral therapy

BackgroundSchool-based cognitive behavioral therapy (CBT) programs could contribute toward preventing anxiety disorders in children. However, setting aside class time for such programs is difficult. Internet-based CBT (I-CBT) is an efficient way to provide CBT. However, studies on I-CBT for anxiety prevention remain scarce, including I-CBT for school-based universal prevention programs. Therefore, we developed an e-learning version of a school-based anxiety-prevention CBT program, “Journey of the Brave,” which was effective in Japan, to make it more flexible and accessible. This study evaluated its feasibility.MethodsWe conducted a single-arm study based on 44 parents and children. Children aged 10–12 years took the e-learning program at home. Parents and children responded to a questionnaire three times: before the learning (Pre), after the learning (Post), and three months later (FU: Follow-up). Feasibility was comprehensively evaluated through dropout rates, satisfaction and learning records, and changes in scores on psychological scales assessing anxiety symptoms, emotion-regulation skills, and children’s emotional and behavioral problems.ResultsOf the 44 children, 42 started the e-learning, and 32 continued it (dropout rate of 23.8%). Furthermore, 83.9% of the children and 96.8% of the parents responded “agree” or “somewhat agree” regarding overall satisfaction. The parent-rated Spence Children’s Anxiety Scale(SCAS) (SCAS-P) showed a significant decrease between Pre and FU (p = 0.014, 95% CI = (-9.22, -0.84)); however, the child-rated SCAS (SCAS-C) reduction was not significant (p = 0.08). The Emotion‑Regulation Skills Questionnaire (ERSQ) also increased significantly between Pre and FU (p = 0.045, 95% CI = (0.18, 18.31)). The Total Difficulties Score of the Strengths and Difficulties Questionnaire(SDQ) decreased significantly from Pre to Post (p = 0.025, 95% CI = (-3.62, -0.19)); however, it was not significantly different between Pre and FU (p = 0.67).ConclusionThe e-learning version showed low dropout rates and high satisfaction ratings from parents and children. Moreover, this study did not rule out the possibility that the program reduced children’s anxiety and improved their emotional-regulation skills. Therefore, its potential and feasibility were indicated.Trial registrationUMIN, UMIN000049182, Registered 11 October 2022.