Internet-based Treatment Program Research Articles

Internet-based grief therapy program for bereaved individuals at risk: A case series study

Interest in internet-based interventions has increased considerably. The effectiveness of these applications continues to be investigated for the treatment of Prolonged Grief Disorder. This study includes preliminary findings of the internet-based and therapist-supported prolonged grief intervention program developed in Turkish. The internet-based program consists of 10 written sessions, and after each session the participants receive written feedback from the therapist. The program takes approximately 6-8 weeks. The preliminary findings of the program were handled in a proof-of-concept study style based on a case series design. Self-report measures were taken from the first eight participants who completed the program at four different times (pre-test, post-test, 1st and 3rd month follow-ups). In addition, the written contents of the first and last sessions were analyzed by content analysis. As a result of the descriptive findings, remarkable decreases were observed in traumatic grief, global meaning violation, depressive symptoms, and stress levels in a significant part of the participants between pre-post and follow-up measurements. Also, five of the participants had considerable increases in meaning reconstruction scores. In addition, the results of the content analysis indicated that following the intervention, the bereaved individuals expressed less negative and more positive content, as expected. These two data show that the intervention program is promising in reducing the symptoms of Prolonged Grief Disorder in bereaved individuals and may yield good results with controlled designs for a broader range of participants.

Internet-based acceptance and commitment therapy for transdiagnostic treatment of comorbid posttraumatic stress disorder and chronic pain: A development pilot study.

Acceptance and commitment therapy (ACT) is a transdiagnostic, behavioral treatment focusing on common processes behind different diagnoses. Internet-based treatment programs can improve access to treatment and easily be integrated into the individual's life. This single-arm, pre-post-follow-up pilot study examined the acceptability, safety, and effectiveness of internet-based ACT (iACT) for participants with comorbid posttraumatic stress disorder (PTSD) and chronic pain treated at a tertiary pain clinic. All participants (N = 10) received the iACT program over a period of 10 weeks and were assessed pre- and postintervention and at a 3-month follow-up. This study provides preliminary evidence for the acceptability, safety, and effectiveness of iACT for comorbid PTSD and chronic pain. The program showed clinically significant improvement in relation to the primary outcomes PTSD symptom severity and pain interference for this patient group with complex, comorbid symptoms, with sustained effects at the 3-month follow-up. These results add to previous research where face-to-face ACT has been shown to be of benefit to individuals with either chronic pain or PTSD. The findings also suggest that iACT can be delivered to individuals with comorbid PTSD and chronic pain with an effectiveness that is comparable to other cognitive behavioral therapy-based treatments for somatic and psychiatric disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The effect of DNA-V model intervention on learning behaviors and stress in Chinese adolescents: A randomized controlled trial

ObjectiveThe Discoverer Noticer Advisor-Value (DNA-V) model is an adaption of Acceptance and Commitment Therapy, which focuses on adolescent development and value-led behavioral change. However, few studies have validated the effectiveness of this model in adolescents in learning environments. This study thus aimed to examine the effectiveness of a Chinese version of the DNA-V model in a Chinese middle school student population. Additionally, we sought to determine whether online or face-to-face versions of the model were more effective. MethodsOne-hundred and thirty-six middle school students were randomly divided into a face-to-face DNA-V group (n = 40), an Internet DNA-V (iDNA-V) group (n = 50), and a traditional group (control, n = 46). The intervention was administered with a 45-min psychology course once a week for six weeks. The three groups were assessed on three core variables of academic learning motivation, strategies, and confidence, as well as stress at three time points (pre-intervention, post-intervention, and at a two-month follow-up). ResultsRepeated-measures ANOVA showed that the Group × Time Point interaction was significant for learning motivation (F(4,266) = 2.746, p = 0.029, ηp2 = 0.04) and stress (F(4,266) = 3.681, p = 0.006,ηp2 = 0.05). Learning motivation scores showed no between-group differences at any of the three time points, but the iDNA-V group showed significant improvement at the two-month follow-up and the traditional group showed significant gains at post-intervention that were maintained until the follow-up test. The DNA-V group exhibited lower stress scores at follow-up than at the pre-intervention assessment (p = 0.002) and post-intervention assessment (p = 0.005), with significantly lower stress follow-up scores than those of the iDNA-V (p = 0.024) and control (p = 0.023) groups. ConclusionThese results suggest that different intervention formats of DNA-V can be used as an alternative to traditional adolescent school psychology programs. It is important to consider how to emotionally support students when designing and developing internet-based DNA-V intervention programs to increase the effectiveness of this program for stress intervention.

“I was Treated by the Program, the Therapist, and Myself”: Feasibility of an Internet-Based Treatment Program for Gambling Disorder

The majority of people with problematic gambling behavior never seek or receive professional help. Internet-based treatment approaches have been shown to help patients overcome practical and psychological barriers associated with face-to-face therapy. In this uncontrolled pilot study, we explored the feasibility of the eight-module therapist-guided internet-based treatment program SpilleFri (“Free from Gambling”) for patients with gambling disorder (GD). We included 24 patients seeking treatment at a Danish hospital-based treatment clinic. The focus of the feasibility study was evaluation of recruitment and retention rates, data completion rates, treatment response, satisfaction, and program utility. In addition, a series of semi-structured interviews were conducted to explore patient-perceived acceptability and potential barriers to treatment completion and positive outcome. Treatment acceptability among therapists was examined in a focus group interview. Sixteen of the included patients completed the program, yielding an acceptable treatment dropout rate (29.17%), and 82.35% of treatment completers provided full data at all assessment points. Overall, patients were satisfied with the treatment received, and patient interviews highlighted multiple psychological as well as practical benefits associated with the treatment form and content. Patients with more severe gambling symptoms at baseline might be more likely to drop out before treatment completion than patients with less severe symptoms. The results suggest that SpilleFri may be a feasible alternative to face-to-face treatment for GD. However, the uncontrolled design and small sample size of the study limit the robustness of the findings. In the future, the effect of SpilleFri treatment should be examined in a randomized controlled trial.Clinical trial registrations: The study protocol was prospectively registered at clinicaltrials.gov (TRN: NCT05051085; registration date: September 21, 2021).

I-TREAT: Internet-based Cognitive Behavioral Treatment for Other Specified Feeding or Eating Disorders (OSFED) in Danish Adolescents and Adults – Study Protocol for a Randomized Controlled Trial

IntroductionEating disorders severely impair psychosocial functioning, physical health, and quality of life. In particular, Anorexia Nervosa has the highest mortality rate among all psychiatric diseases. Other Specified Feeding or Eating Disorders have the highest lifetime prevalence with weighted means of 7.64% for women. Eating disorders are considered hard-to-treat, and studies have indicated that people suffering from eating disorders prefer low-threshold interventions compared to traditional mental health care. International studies show promising results of internet-based interventions for Other Specified Feeding or Eating Disorders.ObjectivesTo test the effectiveness of an internet-based psychologist-guided cognitive behavioral treatment program (I-TREAT) to reduce eating disorder symptoms in Danish adolescents and adults with Other Specified Feeding or Eating Disorders.MethodsThis study is a randomized controlled trial with two arms: 1) an intervention group and 2) an active control group. Participants are adolescents from the age of 15 or above, as well as adults, diagnosed with Other Specified Feeding or Eating Disorders. The intervention group receives the I-TREAT program while the control group receives self-guided mindfulness exercises. I-TREAT comprises 12 text-based treatment sessions with psychoeducation and treatment-related tasks, based on cognitive behavioral therapy and elements of compassion-focused therapy. The treatment duration is approximately 12 to 36 weeks. Videos, pictures, and animations support the treatment content and the program is accessible by web-browser and app. A specialist in eating disorders guides the patient through treatment with task-related feedback and asynchronous written communication. Patients will answer questionnaires regarding eating disorder symptoms, quality of life, and motivational states before, during, and after treatment, with follow-up measures at 3, 6, and 12 months. We expect to include 63 patients to each group and commence recruitment in August 2023. Preliminary results from a feasibility study on I-TREAT show good evaluations from clinicians and patients (N=30).ResultsNo results have yet been obtained. The results will be submitted to international scientific journals and presented at conferences.ConclusionsThe internet-based cognitive behavioral treatment program I-TREAT may be a promising tool for effectively treating adolescents and adults with Other Specified Feeding or Eating Disorders in Denmark.Disclosure of InterestNone Declared

Early development of treatment motivation predicts adherence and symptom reduction in an internet-based guided self-help program for binge eating disorder.

ObjectiveLack of motivation is widely acknowledged as a significant factor in treatment discontinuity and poor treatment outcomes in eating disorders. Treatment adherence is lower in internet-based treatment. The current study aimed to assess the relationship between treatment motivation and treatment outcomes in an internet-based therapist-guided intervention for Binge Eating Disorder (BED).MethodAdults (N = 153) with mild to moderate symptoms of BED participated in a 10-session internet-based treatment program. Baseline and between-session scores of “Readiness to change” and “Belief in change” were used to predict treatment completion and eating disorder symptom reduction (EDE-Q Global, BED-Q, and weekly number of binge eating episodes) at post-treatment.ResultsBaseline treatment motivation could not predict treatment completion or symptom reduction. Early measures of treatment motivation (regression slope from sessions 1–5) significantly predicted both treatment completion and post-treatment symptom reduction. “Belief in change” was the strongest predictor for completing treatment (OR = 2.18, 95%-CI: 1.06, 4.46) and reducing symptoms (EDE-Q Global: B = −0.53, p = 0.001; number of weekly binge eating episodes: B = 0.81, p < 0.01).DiscussionThe results indicated that patients entering online treatment for BED feel highly motivated. However, baseline treatment motivation could not significantly predict treatment completion, which contradicts previous research. The significant predictive ability of early measures of treatment motivation supports the clinical relevance of monitoring the development of early changes to tailor and optimize individual patient care. Further research is needed to examine treatment motivation in regard to internet-based treatment for BED with more validated measures.

The Effect of Internet-Based Intervention on Lifestyle and Healthy Nutrition Habits of Women in North of Iran: A Field-Based Trial Study

Background: A healthy lifestyle based on healthy eating habits and appropriate physical activity during different periods of life, bring healthy old age to women through preventing overweight or maintaining a healthy weight Objectives: This study was aimed to determine the effect of Internet-based intervention on the lifestyle and healthy eating habits of women in northern Iran. Materials &amp; Methods: The present field-trial study was conducted on 268 women who were members of Population of Mental Health Assistants from November 2014 to May 2015. The educational intervention was carried out through a website containing information on healthy lifestyle, nutrition, and cooking methods of various healthy foods. The participants of the intervention group were also received their special diet. All participants were evaluated after 3 and 6 months in terms of changes in weight, BMI, systolic and diastolic blood pressure, and nutritional habits. Their lifestyle were measured using the standard questionnaire of Health- Promoting Lifestyle Profile-II (HPLP-II). Data was analyzed using repeated measure analysis of variance. Results: The average age (Standard Deviation (SD)) of the intervention and comparison group was 38.7 (10.8) and 36.9 (10.8) years, respectively. After six months, the average BMI of the intervention group decreased from 27.4 (SD=5.3) to 26.3 (SD=5.7) kg/m2 (P&lt;0.001). Systolic and diastolic blood pressure of both groups showed a significant decrease (P&lt;0.001). Nutrition (F1,266=62.09, P=0.001, η2=0.19) followed by health responsibility (F1,255=30.4, P= 0.001, η2= 0.11) were the most important dimensions of HPLP-II affected by intervention. Conclusion: The Internet-based educational intervention program, using a bottom-up approach, has a favorable effect on the improvement of the lifestyle and weight loss of the participants. The findings of the present study showed the possibility of using the new e-health technology in order to promote healthy lifestyle and eating habits in women.

Meta-Analysis of Psychological Interventions for Reducing Stress, Anxiety, and Depression among University Students during the COVID-19 Pandemic.

(1) Background: The aim of this study is to investigate the effects of internet-based intervention programs for reducing stress, anxiety, and depression among university students during the COVID-19 pandemic by conducting a meta-analysis. (2) Methods: Searches were conducted in the following databases: MEDLINE, EbscoHost Academic Search Ultimate, and PsycArticles, using a combination of “Covid-19 AND ‘Randomized Controlled Trial’ AND students”, as well as a combination of the following search terms: “internet”, “online”, “treat_”, “psycholog_”, “intervention”, “program_”, “stress_”, “depress_”, “anxiety”, “university”, “college”, ”freshm_”, “sophomore_”, and “undergraduat_”. The population, intervention, control, outcomes, and study design (PICOS) framework was used (P (population): university students during the COVID-19 pandemic; I (intervention): internet-based intervention programs for reducing stress, anxiety, and depression; C (control): no intervention, usual care, or on a waiting list; O (outcomes): stress, anxiety, and depression indicators; S (study design): meta-analysis including only randomized controlled trials (RCTs)). A meta-analysis was performed on the 10 retrieved studies published between 2021 and 2022. Only RCTs were analyzed. (3) Results: All 10 analyzed papers revealed a trend in the effectiveness of internet-based intervention for reducing stress, anxiety, and depression in university students during COVID-19. Significant effects from the included RCTs with interventions for reducing stress and depression were established. (4) Conclusions: Psychological internet-based interventions may help to reduce depression and stress among university students; however, more research is needed to determine their effectiveness in reducing anxiety.

Experiences of internet-based treatment for vulvodynia: A qualitative study

ObjectiveThe aim of this study was to describe women's experiences before, under, and after a guided internet-based intervention for vulvodynia. MethodsThe design was qualitative, based on content analysis. Participants were women who had undergone guided internet-based treatment for vulvodynia based on acceptance and commitment therapy principles (n = 13). Data were collected through in-depth interviews approximately-one month after participants completed treatment. ResultsThe analysis revealed the women’s experiences of internet-based treatment for vulvodynia. Three themes emerged: “dealing with pain alone,” which was related to experiences of living with vulvodynia before internet-based treatment; “finding new ways,” which described the experiences of undergoing an internet-based treatment for vulvodynia and “feeling empowered to take control,” referring to the experiences of living with vulvodynia after the internet-based treatment. The women described a long search for a diagnosis, revealing a negative experience of healthcare. The internet-based treatment helped them find new ways to manage vulvodynia, but difficulties with the treatment were also experienced. After the intervention, the women reported improvements in wellbeing and having better strategies to manage pain, but also stated that the treatment was insufficient to perceive changes in vulvar pain. ConclusionsThe guided internet-based treatment program for vulvodynia based on acceptance and commitment therapy principles was perceived as credible, helpful to manage vulvodynia, and could serve as a complement to regular care. Questions regarding the need for more support and optimal length of treatment need to be further evaluated.

Efektifitas Intervensi Multidomain terhadap Resiko Penyakit Kardiovaskular pada Pra-Lansia di Jawa Barat

Cardiovascular disease is the highest cause of death in Indonesia, which is also known as the “silent killer. However, research focused on preventing cardiovascular disease in the elderly is still very limited. In Indonesia, there is no multi-domain intervention using the internet that is intended to improve pre-elderly health.The aim of this study was to design an internet-based multidomain intervention program to prevent cardiovascular disease in the pre-elderly. This study used a quasi-experimental pre-post-test design with two groups (intervention group and control group). The inclusion criteria in this study were: elderly aged 55-65 years, had at least two risk factors for cardiovascular disease (such as hypertension, hypercholesterolemia, obesity, smoking, inactivity, DM, history of cardiovascular disease) previously to participate in the study. The sampling technique that will be used is the convivence sample with a total sample to be recruited is 100.The results of this study will be very useful as a guide for pre-elderly and health workers in the prevention of cardiovascular disease. It is hoped that the results of this study can be used as material for health policy makers in Indonesia to make guidelines and recommendations for disease prevention management in the pre-elderly.

A Mobile App-Based Intervention Program for Nonprofessional Caregivers to Promote Positive Mental Health: Randomized Controlled Trial.

BackgroundWhile nonprofessional caregivers often experience a sense of fulfillment when they provide care, there is also a significant risk of emotional and physical burnout. Consequently, this can negatively affect both the caregiver and the person being cared for. Intervention programs can help empower nonprofessional caregivers of people with chronic diseases and develop solutions to decrease the physical and psychological consequences resulting from caregiving. However, most clinically tested intervention programs for nonprofessional caregivers require face-to-face training, and many caregivers encounter obstacles that hinder their participation in such programs. Consequently, it is necessary to design internet-based intervention programs for nonprofessional caregivers that address their needs and test the efficacy of the programs.ObjectiveThe aim of this study was to evaluate the effectiveness of a smartphone app–based intervention program to increase positive mental health for nonprofessional caregivers.MethodsThis study was a randomized controlled trial of 3 months’ duration. A total of 152 caregivers over 18 years of age with a minimum of 4 months’ experience as nonprofessional caregivers were recruited from primary health care institutions. Nonprofessional caregivers were randomized into two groups. In the intervention group, each caregiver installed a smartphone app and used it for 28 days. This app offered them daily activities that were based on 10 recommendations to promote positive mental health. The level of positive mental health, measured using the Positive Mental Health Questionnaire (PMHQ), and caregiver burden, measured using the 7-item short-form version of the Zarit Caregiver Burden Interview (ZBI-7), were the primary outcomes. Users’ satisfaction was also measured.ResultsIn all, 113 caregivers completed the study. After the first month of the intervention, only one factor of the PMHQ, F1–Personal satisfaction, showed a significant difference between the groups, but it was not clinically relevant (0.96; P=.03). However, the intervention group obtained a higher mean change for the overall PMHQ score (mean change between groups: 1.40; P=.24). The results after the third month of the intervention showed an increment of PMHQ scores. The mean difference of change in the PMHQ score showed a significant difference between the groups (11.43; P<.001; d=0.82). Significant changes were reported in 5 of the 6 factors, especially F5–Problem solving and self-actualization (5.69; P<.001; d=0.71), F2–Prosocial attitude (2.47; P<.001; d=1.18), and F3–Self-control (0.76; P=.03; d=0.50). The results of the ZBI-7 showed a decrease in caregiver burden in the intervention group, although the results were inconclusive. Approximately 93.9% (46/49) of the app users indicated that they would recommend the app to other caregivers and 56.3% (27/49) agreed that an extension of the program’s duration would be beneficial.ConclusionsThe app-based intervention program analyzed in this study was effective in promoting positive mental health and decreasing the burden of caregivers and achieved a high range of user satisfaction. This study provides evidence that mobile phone app–based intervention programs may be useful tools for increasing nonprofessional caregivers’ well-being. The assessment of the effectiveness of intervention programs through clinical trials should be a focus to promote internet-based programs in health policies.Trial RegistrationISRCTN Registry ISRCTN14818443; http://www.isrctn.com/ISRCTN14818443International Registered Report Identifier (IRRID)RR2-10.1186/s12889-019-7264-5

Effectiveness of guided internet-based interventions in the indicated prevention of depression in green professions (PROD-A): Results of a pragmatic randomized controlled trial

BackgroundMajor Depressive Disorder (MDD) has a major impact on public health. Reduction of depression burden in general population is of greatest importance and might be achieved by implementation of depression prevention measures into routine care. We evaluate an online prevention measure as part of a national project aiming to reduce depression in the occupational group of green professions. MethodsThis two-armed pragmatic RCT (n = 360) evaluates the effectiveness of a tailored internet-based intervention (IMI) program compared to enhanced treatment as usual. The IMI program entailed access to one of six guided IMIs each focusing on different symptom areas (depressive mood with optional comorbid diabetes, perceived stress, insomnia, panic and agoraphobia and harmful alcohol consumption). Eligible were entrepreneurs, spouses, family members and pensioners in green professions with adequate insurance status and at least subthreshold depression (PHQ≥5). Primary outcome was depressive symptom severity (QIDS-SR16) at 9-weeks post-treatment (T1). Various secondary outcomes were assessed at T1. ResultsA small effect of depression reduction (d=-0.28, 95%-CI: -0.50 to -0.07) was found at T1 favouring the IMI program (β=-0.22, 95%-CI: -0.41 to -0.02, p=.033). Categorical analysis indicated a reduced risk of potential MDD with NNTB=28.11. Adherence to the IMI program at T1 was exceptionally low. LimitationsResults are limited to green professions and representativeness might be restricted by self-selection of participants. ConclusionDepression burden in green professions can be reduced by this online prevention measure. Yet, short-term effectiveness is restricted by low adherence rates. Trial RegistrationGerman Clinical Trial Registration: DRKS00014000. Registered: 09 April 2018.

Effectiveness of internet-based guided self-help for binge-eating disorder and characteristics of completers versus noncompleters.

Binge-eating disorder (BED) is characterized by recurrent episodes of binge eating, accompanied by a lack of control and feelings of shame. Online intervention is a promising, accessible treatment approach for BED. In the current study, we compared completers with noncompleters in a 10-session guided internet-based treatment program (iBED) based on cognitive behavioral therapy. Adults (N = 75) with mild to moderate BED participated in iBED with weekly written support from psychologists. Participants were compared on the Eating Disorder Examination Questionnaire (EDE-Q), diagnostic criteria for BED (BED-Q), major depression inventory (MDI), quality of life (EQ-5D-5L), body mass index (BMI) and sociodemographic variables. Minor differences were observed between completers and noncompleters on depression. No differences were found in BED-symptoms, BMI, and sociodemographic variables. Participants who completed treatment showed large reductions in eating disorder pathology. More research is needed to determine risk factors for attrition or treatment outcome in internet-based interventions for BED. It is suggested that iBED is an efficient intervention for BED. However, more studies of internet-interventions are needed.

Implementing Web-Based Therapy in Routine Mental Health Care: Systematic Review of Health Professionals’ Perspectives

BackgroundWeb-based therapies hold great promise to increase accessibility and reduce costs of delivering mental health care; however, uptake in routine settings has been low.ObjectiveOur objective in this review was to summarize what is known about health care professionals’ perceptions of the barriers to and facilitators of the implementation of web-based psychological treatments in routine care of adults in health care settings.MethodsWe searched 5 major databases (MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Library) for qualitative, quantitative, or mixed-methods studies exploring health professionals’ views on computer- or internet-based psychological treatment programs. We coded included articles for risk of bias and extracted data using a prepiloted extraction sheet.ResultsWe identified 29 eligible articles: 14 qualitative, 11 quantitative, and 4 mixed methods. We identified the following themes: patient factors, health professional factors, the therapeutic relationship, therapy factors, organizational and system factors, and models of care. Health professionals supported web-based therapies only for patients with relatively straightforward, low-risk diagnoses, strong motivation and engagement, high computer literacy and access, and low need for tailored content. They perceived flexibility with timing and location as advantages of web-based therapy, but preferred blended therapy to facilitate rapport and allow active monitoring and follow-up of patients. They emphasized the need for targeted training and organizational support to manage changed workflows. Health professionals were concerned about the confidentiality and security of client data for web-based programs, suggesting that clear and transparent protocols need to be in place to reassure health professionals before they will be willing to refer.ConclusionsWithout health professionals’ support, many people will not access web-based therapies. To increase uptake, it is important to ensure that health professionals receive education, familiarization, and training to support them in incorporating web-based therapies into their practice, and to design systems that support health professionals in this new way of working with patients and addressing their concerns.Trial RegistrationPROSPERO CRD42018100869; https://tinyurl.com/y5vaoqsk

Internet-based Intervention Program for Treatment of Depression in the Ecuadorian Population: a Pilot Study

Internet-based Intervention Program for Treatment of Depression in the Ecuadorian Population: a Pilot Study

The Use of Digital Health Technologies to Manage Insomnia in Military Populations

Up to one-third of US Active Duty Service Members endorse insomnia symptoms. To support the overall readiness of service members at home and abroad, this rapid review analyzes findings from clinical trials and the results of an innovative market research protocol investigating digital health technologies to support treatment for insomnia. The authors searched the PubMed database for clinical trials incorporating internet and mobile technologies for treatment of insomnia. Market research used internet search engines to identify insomnia interventions available on the internet, and mobile app distribution platforms to identify insomnia-related mobile apps. A rapid review of the literature found that internet-based cognitive behavioral programs showed similar effectiveness when compared with in-person-delivered cognitive treatments. Similarly, mobile apps developed for smartphones were found to be an effective technology for treating insomnia and sleep disorders. Based on market research findings, this report identified four internet-based treatment programs and five mobile apps for the treatment of insomnia. While there is limited research on this topic, results show a potential for successfully delivering CBT-I treatments for insomnia using the internet and mobile apps. Future evidence-based studies are needed to determine the efficacy of technology-based treatments, and for determining best practices for the military population.

Talk to Your Doctors Online: An Internet-based Intervention in China

ABSTRACT China has long faced the problem of having health care that is difficult to access. Online patient-provider communication (OPPC) may offer a new option for the delivery of affordable health services in a timely manner. However, OPPC is still novel in China, particularly among middle-aged and older adults. Thus, to promote effective use of OPPC for these population groups, the current study implemented a four-week Internet-based intervention program, with a general basis of Social Cognitive Theory. With analyses of three-wave panel data, the results offer the promise of this intervention program in increasing usage frequency, quality of users’ experience, self-efficacy, behavioral capability, and awareness of OPPC. This Internet-based intervention program also provides important implications for future research, practice, and policy in promoting e-Health in China.

Supplementing stuttering treatment with online cognitive behavior therapy: An experimental trial

PurposeIt is now well established that adults who present to speech clinics for help with stuttering will have an increased risk of having an anxiety disorder, particularly social anxiety disorder. Concomitant psychological problems are known to interfere with the maintenance of the benefits of behavioral speech treatments for stuttering. The current team has developed and trialed a cognitive behavior therapy (CBT) program designed specifically to reduce anxiety in adults who stutter, and trials have shown promise for both an in-clinic version and a standalone internet-based version. The aim of the present study is to determine whether iGlebe, the internet-based version of the team’s internet CBT treatment (previously known as CBTPsych), enhances the benefits of behavioral stuttering treatment. MethodParticipants were 32 adults seeking treatment for stuttering. The design was a two-arm randomized experimental trial with blinded outcome assessments at 6 and 12 months post-randomization. Both arms received basic speech-restructuring training to reduce stuttering, without any anxiolytic (anxiety reducing) components. The experimental arm also received 5 months access to iGlebe. ResultsThere was evidence that, at 12 months post-randomization, iGlebe added clinically significant improvements to self-reported stuttering severity and quality of life. The present experimental trial provides the first evidence that the addition of CBT to speech restructuring improves speech outcomes. ConclusionsThe present results will be the basis for the development of a comprehensive, internet-based treatment program for anxiety associated with stuttering. Ultimately, it may be possible for such an economical, scalable, and translatable comprehensive treatment model to supplement standard speech-language pathology treatment practices for those who stutter.

Remote treatment from a psychotherapeutic point of view

There is a broad variety of digital applications available that may enhance psychotherapeutic treatment and potentially lead to enhanced care of mentally ill patients, yet these applications cannot replace psychotherapeutic treatment. Among them are videoconferencing technologies, which allow psychotherapists and their patients to communicate over long distances. Beside this, internet-based treatment programs and health-apps are available for prevention and treatment of mental disorders. The following article describes chances and risks related to the use of digital applications in the care of mentally ill patients.For digital applications to enhance psychotherapeutic care, they need to be applied as thoroughly as psychotherapeutic interventions delivered in direct contact. This means, that diagnostics and education about treatment and setting need to be delivered in direct contact between psychotherapist and patient. The article further describes current regulatory frameworks relevant to the use of digital applications in psychotherapeutic care.

Impact of Internet-Based Interventions on Caregiver Mental Health: Systematic Review and Meta-Analysis

BackgroundThe health of informal caregivers of adults with chronic conditions is increasingly vital since caregivers comprise a large proportion of supportive care to family members living in the community. Due to efficiency and reach, internet-based interventions for informal caregivers have the potential to mitigate the negative mental health outcomes associated with caregiving.ObjectiveThe objective of this systematic review and meta-analysis was to examine the impact of internet-based interventions on caregiver mental health outcomes and the impact of different types of internet-based intervention programs.MethodsMEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane, and AgeLine databases were searched for randomized controlled trials or controlled clinical trials published from January 1995 to April 2017 that compared internet-based intervention programs with no or minimal internet-based interventions for caregivers of adults with at least 1 chronic condition. The inclusion criteria were studies that included (1) adult informal caregivers (aged 18 years or older) of adults living in the community with a chronic condition; (2) an internet-based intervention program to deliver education, support, or monitoring to informal caregivers; and (3) outcomes of mental health. Title and abstract and full-text screening were completed in duplicate. Data were extracted by a single reviewer and verified by a second reviewer, and risk of bias assessments were completed accordingly. Where possible, data for mental health outcomes were meta-analyzed.ResultsThe search yielded 7923 unique citations of which 290 studies were screened at full-text. Of those, 13 studies met the inclusion criteria; 11 were randomized controlled trials, 1 study was a controlled clinical trial, and 1 study comprised both study designs. Beneficial effects of any internet-based intervention program resulted in a mean decrease of 0.48 points (95% CI –0.75 to –0.22) for stress and distress and a mean decrease of 0.40 points (95% CI –0.58 to –0.22) for anxiety among caregivers. For studies that examined internet-based information and education plus professional psychosocial support, the meta-analysis results showed small to medium beneficial effect sizes of the intervention for the mental health outcomes of depression (–0.34; 95% CI –0.63 to –0.05) and anxiety (–0.36; 95% CI –0.66 to –0.07). Some suggestion of a beneficial effect on overall health for the use of information and education plus combined peer and professional support was also shown (1.25; 95% CI 0.24 to 2.25). Overall, many studies were of poor quality and were rated at high risk of bias.ConclusionsThe review found evidence for the benefit of internet-based intervention programs on mental health for caregivers of adults living with a chronic condition, particularly for the outcomes of caregiver depression, stress and distress, and anxiety. The types of interventions that predominated as efficacious included information and education with or without professional psychological support, and, to a lesser extent, with combined peer and psychological support. Further high-quality research is needed to inform the effectiveness of interactive, dynamic, and multicomponent internet-based interventions.Trial RegistrationPROSPERO CRD42017075436; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=75436 (Archived by WebCite at http://www.webcitation.org/709M3tDvn)