Online Cognitive Behavioral Therapy Research Articles

Effectiveness and mediators of change of an online CBT intervention for students with adjustment disorder—study protocol for a randomized controlled trial

BackgroundAdjustment problems and disorders are highly prevalent among university students worldwide. These problems can cause significant interference in academic and social functioning and increase vulnerability to other mental health disorders. Unfortunately, only half of students in need receive psychological help. Furthermore, few studies have evaluated psychological interventions for adjustment disorders in students. New, more scalable forms of treatment for students with an adjustment disorder need to be developed, evaluated, and implemented. The study aims to determine the effectiveness of an online transdiagnostic cognitive behavioural intervention for students experiencing adjustment disorder and to assess mediators of change.Method/designIn this three-arm randomized controlled trial, we plan to recruit 214 Polish students diagnosed with an adjustment disorder. Participants who meet initial eligibility criteria will be randomly assigned to one of three 6-week conditions: (1) online cognitive behavioural therapy intervention based on an existing, empirically supported transdiagnostic protocol, the unified protocol; (2) online progressive muscle relaxation training as an active control group; or (3) waiting-list control group. Both interventions are asynchronous, interactive, and include minimal amount of therapist support. Assessments will consist of self-report questionnaires, daily diary measures, and neurocognitive tasks for evaluating cognitive functioning. These will be conducted at baseline, post-treatment, and 1-month follow-up. Daily diary measures will be taken during the first and last week of treatment (or waitlist period). Primary outcome measures will include adjustment disorder severity; secondary outcome measures will consist of other negative (psychopathology: depression, anxiety, and stress) and positive (life satisfaction) indexes of mental health as well as process measures (e.g. mindfulness, experiential avoidance, cognitive fusion).DiscussionTo our knowledge, the current study is the first to evaluate the effectiveness of a psychological intervention for students with adjustment disorder. Therefore, it may have important practical implications for students with this disorder. It can potentially guide the development of a scalable, validated treatment option.Trial registrationClinical Trials, NCT05768308, registered 14 March 2023, https://www.clinicaltrials.gov/ct2/show/NCT05768308

EE238 Cost-Effectiveness of Online Cognitive Behavioral Therapy for Children with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) Compared to Online Activity Management: FITNET-NHS Trial Findings

EE238 Cost-Effectiveness of Online Cognitive Behavioral Therapy for Children with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) Compared to Online Activity Management: FITNET-NHS Trial Findings

Time for You: A process evaluation of the rapid implementation of a multi-level mental health support intervention for frontline workers during the COVID-19 pandemic.

The coronavirus (COVID-19) pandemic had wide-ranging negative impacts on mental health. The pandemic also placed extraordinary strain on frontline workers who were required to continue working and putting themselves at risk to provide essential services at a time when their normal support mechanisms may not have been available. This paper presents an evaluation of the Time for You service, a rapidly developed and implemented intervention aimed at providing frontline workers with quick access to flexible online mental health support. Time for You provided service users with three service options: self-guided online cognitive behavioural therapy (CBT) resources; guided engagement with online CBT resources; 1-1 psychological therapy with trainee sport and exercise psychologists and trainee health psychologists. A process evaluation informed by the Consolidated Framework for Implementation Research considered service fidelity, adaptations, perceived impact, reach, barriers, and facilitators. Interviews with project managers (n = 5), delivery staff (n = 10), and service users (n = 14) explored perceptions of the service implementation and outcomes, supported by data regarding engagement with the online CBT platform (n = 217). Findings indicated that service users valued the flexibility of the service and the speed with which they were able to access support. The support offered by Trainee Psychologists was perceived to be of high quality, and the service was perceived by service users to have improved mental health and wellbeing. The rapid implementation contributed to issues regarding appropriate service user screening that led to trainee psychologists being unable to provide the service users with the support they needed as the presenting issues were outside of trainees' competencies. Overall, the findings suggest that interventions offering flexible, online psychological support to frontline workers can be an effective model for future interventions. Trainee psychologists are also able to play an important role in delivering such services when clear screening processes are in place.

Feasibility and acceptability of an online mental health intervention for pregnant women and their partners: a mixed method study with a pilot randomized control trial

BackgroundUntreated perinatal mood and anxiety disorders (PMAD) have short- and long-term health and social consequences; online cognitive behavioral therapy (CBT) interventions can reduce symptoms. Despite partner support being protective online interventions rarely target couples. This study builds on research on an existing CBT-based intervention, the Mothers and Babies Online Course (eMB), by testing its feasibility with prenatal couples.MethodsWe conducted a pilot, randomized, controlled feasibility trial using a 1:1 parallel design. To be eligible, participant dyads were pregnant people (between 13–30 weeks gestation and with a score of 10 or greater on either the GAD-7 or PHQ-9 scale indicating elevated symptoms of anxiety or depression) and their cohabitating partners, living in Missouri, with access to the internet; both in the dyad consented to participate. Recruitment occurred via Facebook ads, flyers, and a snowball approach. The intervention group received eMB, and the control group received a list of community resources. We examined retention and adherence data extracted from eMB analytics and study databases. All participants were given depression and anxiety scales at baseline, 4 and 8 weeks to test preliminary efficacy; satisfaction and acceptability were measured at trial end (i.e., eight weeks) and via interview.ResultsThere were 441 people who responded to recruitment materials, 74 pregnant people were screened; 19 partners did not complete enrolment, and 25 dyads were ineligible. There were 15 dyads per group (N = 30) who enrolled; all completed the study. The survey response rate was 90% but partners required nearly twice the number of reminders. No participant completed all lessons. Mean depression and anxiety scores dropped over time for dyads in control (M = -1.99, -1.53) and intervention (M = -4.80, -1.99). Intervention pregnant people’s anxiety significantly decreased (M = -4.05; 95% CI [0.82, 7.27]) at time two compared to control. Twelve pregnant people and four partners participated in post-intervention interviews and suggested improvements for eMB.ConclusionOnline dyadic interventions can potentially reduce PMAD symptoms. However, to feasibly study eMB with couples, strategies to increase program adherence are necessary. Tailoring interventions to overtly include partners may be advantageous.Trial registrationClinicalTrials.gov NCT05867680, 19/05/2023.

A randomised controlled trial of clinician supported vs self-help delivery of online cognitive behaviour therapy for Bulimia Nervosa

High dropout rates and poor adherence associated with digital interventions have prompted research into modifications of these treatments to improve engagement and completion rates. This trial aimed to investigate the added benefit of clinician support when paired alongside a ten-session, online cognitive behaviour therapy (CBT) self-help intervention for bulimia nervosa (BN). As part of a three-arm, phase II randomised controlled trial, 114 participants (16 years or over) with full or subthreshold BN were randomly assigned to complete the intervention in a self-help mode (with administrative researcher contact; n = 38), with adjunct clinician support (weekly 30-minute videoconferencing sessions; n = 37), or a no-treatment waitlist control (WLC; n = 39). Baseline to post-treatment (12-weeks) decreases in objective binge episode frequency were significantly greater for clinician-supported participants as compared to WLC, but not for self-help when compared to WLC. However, due to continued improvements for self-help across follow-up (24-weeks), both arms outperformed WLC when analysed as an overall rate of change across three timepoints. Clinician-supported participants outperformed self-help in regards to laxative use and dietary restraint. Our results demonstrate that good clinical outcomes can be achieved with a relatively brief online CBT-based program even in the absence of structured clinical support, indicating a possible overreliance upon clinician support as a primary adherence-facilitating mechanism.

The impact of smartphone use on childhood depression: A pediatric perspective

Introduction: the profound social and family changes experienced in recent decades have also played a decisive role in the rise of depression, especially changes in family models, competition as the axis of life (which is more important than other dimensions of existence) and the availability of mass media, which promote personal distancing. Objectives: to describe the scientific evidence on the impact of smartphone use on childhood depression from a pediatric perspective and what are the underlying factors that influence this relationship. Methods: a search was conducted in Pubmed, Scopus, Web of Science from January 2000 to October 2023. Results: this systematic review included several studies that evaluated different mental health interventions in various populations. Overall, we found that interventions based on smartphones, online cognitive behavioral therapy, and telemedicine had a positive impact on mental health. For example, postnatal mothers who received smartphone interventions experienced a significant reduction in depression. In addition, online therapy was shown to alleviate parental anxiety and depression and improve their quality of life. However, some studies had limitations, such as small samples or lack of effect on certain outcomes. More research would be needed to fully understand the scope and efficacy of these digital interventions. Conclusion: this review highlights the promising efficacy of smartphone-based interventions to improve mental health in different populations. Despite limitations and challenges, the use of mobile technology in mental health care is an evolving area that could offer significant benefits in the future, transforming the way we approach and treat childhood mental health disorders.

Dissociative experiences reduce online problem gambling treatment effectiveness

AimsTo determine whether dissociative experiences moderate online problem gambling treatment effectiveness, and to characterize the temporal persistence of the relationship between dissociation and problem gambling. DesignRepeatedly measured self-report data on a guided online cognitive behavioral therapy for problem gambling collected on four occasions: before treatment, after treatment, and at 6- and 12-month follow-ups. Setting and participantsThe data (N = 1243, 59.2% males) were collected in Finland between 2019 and 2021. MeasurementsThe primary outcome variable was the self-reported level of problem gambling. The predictors were the treatment phase and dissociative experiences, their interaction, and the demographic covariates of age, education, income, and gender. FindingsProblem gambling scores and dissociative experiences declined significantly following treatment and remained low through the follow-ups (retention rates: 52.6% [post-treatment], 26.3% [at the 6-month follow-up], and 16.1% [at the 12-month follow-up]). However, the treatment was significantly less effective in reducing problem gambling for individuals who kept experiencing dissociation after the treatment. ConclusionsDissociation is an integral sign of problem gambling severity and sustained dissociative experiences may significantly reduce the long-term effectiveness of online problem gambling treatments. Treatment efforts should be customized to account for individual differences in dissociative tendencies, and future research should broaden the study of dissociative experiences to other behavioral addictions.

A randomized controlled trial on using predictive algorithm to adapt level of psychological care for community college students: STAND triaging and adapting to level of care study protocol

BackgroundThere is growing interest in using personalized mental health care to treat disorders like depression and anxiety to improve treatment engagement and efficacy. This randomized controlled trial will compare a traditional symptom severity decision-making algorithm to a novel multivariate decision-making algorithm for triage to and adaptation of mental health care. The stratified levels of care include a self-guided online wellness program, coach-guided online cognitive behavioral therapy, and clinician-delivered psychotherapy with or without pharmacotherapy. The novel multivariate algorithm will be comprised of baseline (for triage and adaptation) and time-varying variables (for adaptation) in four areas: social determinants of mental health, early adversity and life stressors, predisposing, enabling, and need influences on health service use, and comprehensive mental health status. The overarching goal is to evaluate whether the multivariate algorithm improves adherence to treatment, symptoms, and functioning above and beyond the symptom-based algorithm.Methods/designThis trial will recruit a total of 1000 participants over the course of 5 years in the greater Los Angeles Metropolitan Area. Participants will be recruited from a highly diverse sample of community college students. For the symptom severity approach, initial triaging to level of care will be based on symptom severity, whereas for the multivariate approach, the triaging will be based on a comprehensive set of baseline measures. After the initial triaging, level of care will be adapted throughout the duration of the treatment, utilizing either symptom severity or multivariate statistical approaches. Participants will complete computerized assessments and self-report questionnaires at baseline and up to 40 weeks. The multivariate decision-making algorithm will be updated annually to improve predictive outcomes.DiscussionResults will provide a comparison on the traditional symptom severity decision-making and the novel multivariate decision-making with respect to treatment adherence, symptom improvement, and functional recovery. Moreover, the developed multivariate decision-making algorithms may be used as a template in other community college settings. Ultimately, findings will inform the practice of level of care triage and adaptation in psychological treatments, as well as the use of personalized mental health care broadly.Trial registrationClinicalTrials.gov NCT05591937, submitted August 2022, published October 2022.

Cognitive Behavioral Therapy Improves Quality of Life in Patients With Symptomatic Paroxysmal Atrial Fibrillation

BackgroundAtrial fibrillation (AF) is often associated with troubling symptoms leading to impaired quality of life (QoL) and high health care use. Symptom preoccupation, that is, fear of cardiac-related symptoms and avoidance behavior, potentially contributes to disability in AF but is not targeted by current interventions. ObjectivesWe sought to evaluate the effect of online cognitive behavior therapy (AF-CBT) on QoL in patients with symptomatic paroxysmal AF. MethodsPatients with symptomatic paroxysmal AF (n = 127) were randomly assigned to receive AF-CBT (n = 65) or standardized AF education (n = 62). Online AF-CBT lasted 10 weeks and was therapist guided. The main components were exposure to cardiac-related symptoms and reduction of AF-related avoidance behavior. Patients were evaluated at baseline, posttreatment, and at the 3-month follow-up. Primary outcome was AF-specific QoL as assessed by the Atrial Fibrillation Effect on Quality of Life summary score (range: 0-100) at the 3-month follow-up. Secondary outcomes included AF-specific health care consumption and AF burden assessed by 5-day continuous electrocardiogram recording. The AF-CBT group was followed for 12 months. ResultsAF-CBT led to large improvements in AF-specific QoL (Atrial Fibrillation Effect on Quality of Life summary score) by 15.0 points (95% CI: 10.1-19.8; P < 0.001). Furthermore, AF-CBT reduced health care consumption by 56% (95% CI: 22-90; P = 0.025). The AF burden remained unchanged. Results on self-assessed outcomes were sustained 12 months after treatment. ConclusionsIn patients with symptomatic paroxysmal AF, online CBT led to large improvements in AF-specific QoL and reduced health care use. If these results are replicated, online CBT may constitute an important addition to AF management. (Internet-Delivered Cognitive Behavior Therapy for Atrial Fibrillation; NCT03378349)

A Comparative Study of Readability, Acceptability, and the Adaptation of an Internet-based Cognitive Behavioral Therapy for Tinnitus.

Internet-based cognitive behavioral therapy has shown effectiveness in managing chronic tinnitus. Internet-based cognitive behavioral therapy is currently available in only a few languages (English, Swedish, Spanish, and German). The current study aimed to adapt, evaluate, and compare the readability and acceptability of the Turkish internet-based cognitive behavioral therapy materials compared to previous versions. Internet-based cognitive behavioral therapy materials were adapted from the preexisting American English to the Turkish population in a 4-step process: (1) cultural adaptations, (2) acceptability adaptation of materials to the Turkish-speaking population, and (3) literacy-level adjustments. Experts (n=11) and patients (n=11) rated the intervention materials and the ePlatform for acceptability, including usability, content, presentation, and suitability (4). Literacy-level adjustments generated acceptable and readability levels of the Turkish version of the internet-based cognitive behavioral therapy program. The average readability score was 76.15 ± 0.35. The Turkish internet-based cognitive behavioral therapy (Mdn: 7.00) was statistically lower compared to the Swedish (Mdn: 9.00) but higher when compared to the American English and Spanish (Mdn: 5.00) versions. There were no statistical differences between the British English and Turkish versions in readability scores. Acceptability in the internet-based cognitive behavioral therapy platform was rated favorably. The Turkish internet-based cognitive behavioral therapy was found to be user-friendly and easy to understand, with navigations that are straightforward, have clear information, and are supported by audiologists. The readability score of the Turkish internet-based cognitive behavioral therapy is within recommended limits to ensure comprehensibility. We suggest that an online cognitive behavioral therapy program is adaptable for other languages for countries with a limited number of clinicians focused on cognitive behavioral therapy and tinnitus.

User profile of an online cognitive behavioral therapy self-help platform in Turkey.

Online mental health self-help services are of societal importance and increasingly popular. Therefore, we have developed an online platform offering free self-help to the Turkish public with modules based on Cognitive Behavioral Therapy (CBT) targeting depression, anxiety, and stress respectively. The main purpose of this study is to describe the user profile of this platform. A pre-intervention self-report assessment including general demographic information and the Brief Symptom Inventory questionnaire during October 2020 until September 2022. 8331 participants completed the assessment and created an account out of the 11.228 users who registered during a two-year period, of which 8.331 (74%) completed the assessment and created an account. The majority of these users were female (76.17%), highly educated (82%), single (68%) and actively studying or working (84%). Slightly more than half (57%) of the platform user had not received psychological assistance before, while those who did receive previous assistance indicate to have benefitted from that (74%). The psychological symptoms of users are widely distributed, encompassing a broad range of user profiles. Approximately half of all users actively used the platform, while the other half did not complete any module. Among active users, the course "coping with depressive mood" was the most popular (41.45%), followed by "coping with anxiety" (37.25%) and "coping with stress" (21.30%). Offering a free online CBT self-help platform to the Turkish public seems feasible, with strong uptake among both man and woman struggling with a variety of psychological symptoms. Further research is needed to assess user satisfaction and change in symptoms over time during platform use by means of a feasibility trial.

Predicting online problem gambling treatment discontinuation: New evidence from cross-validated models.

There are tens of millions of problem gamblers in the world, many of whom either do not seek treatment or fail to commit to it. Dropout rates are high, and not enough is known about factors predicting treatment adherence. We focus on an online cognitive behavioral therapy program for severe problem gambling to determine the likelihood of treatment discontinuation at three different treatment phases: pretreatment, before halfway, and before the end of the program. Participants were Finnish adults (N = 1,139, 670 males, Mage = 34.5) registered in the program between 2019 and 2021. Using logistic regression and five-fold cross-validated naïve Bayes classification, we predicted discontinuation with demographic-, psychometric-, and other gambling-related variables, including the quality of one's social relations, time spent on the waiting list, and experienced readiness to behavioral change. The models had acceptable predictive ability (area under the curve [AUC] values from .69 to .745; cross-validated balanced classification accuracy = 63.2%). In logistic regressions, treatment discontinuation was prominently associated with younger age (p = .008), lower education (p < .001), not being ready to change gambling behavior (p < .001), problem gambling severity (p < .0001), longer time spent on the treatment waiting list (p < .0001), and fewer close social relationships (p < .001). We found significant new real-world evidence on factors statistically predicting treatment discontinuation, which is crucial when existing programs are modified to better serve those in need. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Comparison of online and in-person cognitive behavioral therapy in individuals diagnosed with major depressive disorder: a non-randomized controlled trial.

The increased prevalence of major depressive disorder (MDD) amid the COVID-19 pandemic has resulted in substantial growth in online mental health care delivery. Compared to its in-person counterpart, online cognitive behavioral therapy (e-CBT) is a time-flexible and cost-effective method of improving MDD symptoms. However, how its efficacy compares to in-person CBT is yet to be explored. Therefore, the current study compared the efficacy of a therapist-supported, electronically delivered e-CBT program to in-person therapy in individuals diagnosed with MDD. Participants (n = 108) diagnosed with MDD selected either a 12 week in-person CBT or an asynchronous therapist-supported e-CBT program. E-CBT participants (n = 55) completed weekly interactive online modules delivered through a secure cloud-based online platform (Online Psychotherapy Tool; OPTT). These modules were followed by homework in which participants received personalized feedback from a trained therapist. Participants in the in-person CBT group (n = 53) discussed sessions and homework with their therapists during one-hour weekly meetings. Program efficacy was evaluated using clinically validated symptomatology and quality of life questionnaires. Both treatments yielded significant improvements in depressive symptoms and quality of life from baseline to post-treatment. Participants who opted for in-person therapy presented significantly higher baseline symptomatology scores than the e-CBT group. However, both treatments demonstrated comparable significant improvements in depressive symptoms and quality of life from baseline to post-treatment. e-CBT seems to afford higher participant compliance as dropouts in the e-CBT group completed more sessions on average than those in the in-person CBT group. The findings support e-CBT with therapist guidance as a suitable option to treat MDD. Future studies should investigate how treatment accessibility is related to program completion rates in the e-CBT vs. in-person group. ClinicalTrials.Gov Protocol Registration and Results System (NCT04478058); clinicaltrials.gov/ct2/show/NCT04478058.

Cognitive behavioural therapy to treat stress and insomnia: A randomized wait list-controlled trial of two online courses.

This randomized, wait list-controlled trial aimed to evaluate the efficacy of the cognitive behavioural therapy-based online e-learning course stressfit for better stress management and the cognitive behavioural therapy for insomnia-based online course SweetDreams for coping with insomniac problems. The course modules offer state of the art psychoeducation and cognitive behavioural strategies concerning different aspects of stress, sleep and insomnia. They provide practice-oriented exercises for self-reflection, as well as a variety of evidence-based methods and measures to increase self-efficacy when dealing with stress or insomnia. Study participants were randomly assigned to the three test conditions stressfit, SweetDreams or a wait list. Participants filled in questionnaires on a wide range of scales relevant to stress and insomnia at three points in time (before, 4 weeks after, and 3 months after the treatment). Of the 588 participants in total, data from 347 participants (59%) were finally included in the data analyses. Data analyses showed that both courses yielded significant positive effects compared with the wait list condition 4 weeks and to some degree 3 months after completion in relation to insomnia symptoms, physical and psychological wellbeing, life satisfaction and general health (General Health Questionnaire), as well as on satisfaction with and effectiveness of coping with stress and sleep disorders. In conclusion, SweetDreams and stressfit proved to be feasible and effective online cognitive behavioural therapy (for insomnia) tools to reduce insomnia and stress symptoms on a broad variety of scales at the 4-weeks measurement point as well as at the 3-months follow-up.

Self-guided online treatment of disturbed grief, posttraumatic stress, and depression in adults bereaved during the COVID-19 pandemic: A randomized controlled trial

ObjectiveThis randomized-waitlist controlled trial is the first study examining short-term effects of a self-guided online grief-specific cognitive behavioral therapy (CBT) in reducing early persistent complex bereavement disorder (PCBD), posttraumatic stress disorder (PTSD), and depression symptoms in adults bereaved during the COVID-19 pandemic. MethodSixty-five Dutch adults, bereaved at least three months earlier during the pandemic, with clinically-relevant PCBD, PTSD, and/or depression symptoms, were allocated to a treatment (n = 32) or waitlist condition (n = 33). Telephone interviews were conducted to assess PCBD, PTSD, and depression symptoms (using validated instruments) at baseline, post-treatment, and post-waiting period. Participants received an eight-week self-guided online grief-specific CBT including exposure, cognitive restructuring, and behavioral activation assignments. Analyses of covariance were performed. ResultsIntention-to-treat analyses indicated that people in the intervention condition showed significantly lower PCBD (d = 0.90), PTSD (d = 0.71), and depression (d = 0.57) symptom-levels post-treatment relative to waitlist controls post-waiting, while taking baseline symptom-levels and use of professional psychological co-intervention into account. ConclusionsThe online CBT proved to be an effective intervention, reducing PCBD, PTSD, and depression symptoms. Pending replication of these findings, early online interventions may be widely implemented in practice to improve treatments for distressed bereaved people.

Efficacious Web-Based Psychotherapy to Address Depression and Anxiety Among Patients Receiving Oncological and Palliative Care: an Open-Label Randomised Controlled Trial

IntroductionOncological and palliative care patients face unique stressors which increase their risk of developing depression and anxiety. Cognitive behavioural therapy (CBT) and mindfulness has established success in improving this population’s mental health. Traditional face-to-face psychotherapy is costly, has long wait lists, often lacks accessibility, and has strict scheduling, each of which can make attending psychotherapy physically, mentally, and financially out of reach for oncological and palliative patients. Web-based CBT (e-CBT) is a promising alternative that has shown efficacy in this and other patient populations.ObjectivesTo quantify the efficacy of online CBT and mindfulness therapy in oncological and palliative patients experiencing depression and anxiety symptoms.MethodsParticipants with depression or anxiety related to their diagnosis were recruited from care settings in Kingston, Ontario, and randomly assigned to 8 weekly e-CBT/mindfulness modules (N= 25) or treatment as usual (TAU; N=24). Modules consisted of CBT concepts, problem-solving, mindfulness, homework, and personalised feedback from their therapist through a secure platform (Online Psychotherapy Tool- OPTT) Participants completed PHQ-9 and GAD-7 in weeks 1, 4, and 8. (NCT04664270: REB# 6031471).ResultsSignificant decreases in PHQ-9 and GAD-7 scores within individuals support the hypothesis of efficacy. At this time, 10 e-CBT/mindfulness and 12 TAU have completed the study. Decreases in PHQ-9 and GAD-7 scores within e-CBT group support the hypothesis of efficacy. Specifically, PHQ-9 scores decreased over the 3 repeated measures (ANOVA, 2 groups, 3 repeated measures and the decrease in GAD-7 scores was similarly large)ConclusionsAs hypothesized, the results suggest that e-CBT/mindfulness therapy is an affordable, accessible, and efficacious mental health treatment for this population. The virtual, asynchronous delivery format is particularly appropriate given the unique barriers.Disclosure of InterestN. Alavi Shareolder of: OPTT inc, Grant / Research support from: department psychiatry Queen’s University, M. Omrani Shareolder of: OPTT inc, A. Shirazi: None Declared, G. Layzell: None Declared, J. Eadie: None Declared, J. Jagayat: None Declared, C. Stephenson: None Declared, D. Kain: None Declared, C. Soares: None Declared, M. Yang: None Declared

The evaluation of a brief ICBT program with therapist support for individuals with gambling problems in the context of a gambling helpline: a randomized pilot trial

Background and aimsGambling helplines are a natural way of first contact for individuals with gambling problems. However, few studies have evaluated the feasibility and effectiveness of brief interventions in a gambling helpline. To reduce this knowledge gap, this study evaluated the feasibility of an online cognitive behavioral therapy (ICBT) program in the context of a gambling helpline as a first step towards a full-scale RCT.DesignThis is a two-group parallel randomized controlled pilot trial where the participants were randomized to either a brief four-module ICBT program (n = 22) or a control group (n = 21). Participants were followed up weekly during the intervention, post intervention, and 6 weeks upon completion of intervention.ParticipantsA total of 43 self-identified individuals with gambling problems (scoring 3 or more on the Problem Gambling Severity Index) were recruited via the Swedish national gambling helpline, 59% females, mean age 43.7 years.MeasurementsFeasibility of the procedure and intervention (i.e., recruitment pace, attrition, program engagement, and satisfaction) were the primary outcomes; treatment effect (net gambling losses) was the secondary outcome.ResultsApproximately 2 participants per week were randomized, and retention was low, with 47% lost to follow-up at the 6-week follow-up time-point. Most participants engaged in the online modules (86%) and rated their overall satisfaction with the program as high (7.5 out of 10). Both groups decreased their weekly gambling losses at both follow-up time-points, but the between-group comparisons were inconclusive.ConclusionIt is not advisable to conduct a full-scale RCT based on the results from this pilot study. Future studies in a gambling helpline should consider interventions that are more suited to be incorporated in a gambling helpline and identify ways to increase participant engagement.Trial registrationThe study was retrospectively registered on ClinicalTrials.gov (ID: NCT04609007, 29/10/2020).

Brief self-guided digital intervention versus a comprehensive therapist-guided online cognitive behavioural therapy for atopic dermatitis: a trial protocol for a randomised non-inferiority trial

IntroductionOur aim is to investigate whether a shortened digital self-care intervention is non-inferior to, and cost-effective compared with, a comprehensive and therapist-guided cognitive behavioural therapy treatment for atopic dermatitis (AD).Methods...

Enhancing an online cognitive behavioural therapy intervention for depression: Harnessing the feedback of sexual and gender minority youth to help improve SPARX.

SPARX is an online cognitive behavioural therapy self-help intervention for adolescent depression provided in serious game format. Since 2014, it has been freely available in Aotearoa New Zealand (NZ) due to funding from the NZ government. In 2020/21, feedback from sexual and gender minority youth (SGMY) was used to refine and update SPARX. Three online focus groups and follow-up email consultations involved 12 SGMY (16 to 25 years old) in NZ. A general inductive approach was used to analyse data. SGMY had specific needs as well as preferences and four themes were identified: attend to our contextual realities; portrayals of sexual and gender minority people in games; envisaged ideals for serious gaming and appraisals of SPARX. SGMY feedback was used to improve SPARX for this unique population, with the updates launched in October 2021. SGMY are underserved in terms of their mental health needs. Refining or tailoring existing interventions proffers a potential way forward in terms of addressing these needs.

Comparison of the Effectiveness of Online Narrative Therapy and Cognitive Behavioral Therapy on Mental Health and Adherence to Treatment in Cancer Patients with Low Psychological Hardiness

Objective: Cancer is among the diseases that can cause various psychological issues for its sufferers, necessitating the discovery of effective methods to assist these individuals. This research aimed to compare the effectiveness of online narrative therapy and cognitive-behavioral therapy on mental health and adherence to treatment in cancer patients with low psychological hardiness. Methods and Materials: This was a quasi-experimental study conducted using a pre-test-post-test design with two experimental groups and one control group. The study population comprised all cancer patients attending hospitals in Tehran in 2022. The sample consisted of 45 patients selected through purposive sampling and randomly assigned to three groups: online narrative therapy, cognitive-behavioral therapy, and a control group. Data were collected using the General Health Questionnaire by Goldberg and Hiller (1972) and the Treatment Adherence Scale by Madanloo (2018). Data were analyzed using MANCOVA and Bonferroni post-hoc tests with SPSS software version 22. Findings: Results indicated significant differences between the online narrative therapy and cognitive-behavioral therapy groups in terms of general health dimensions (physical health, anxiety, and social functioning disturbance) (P&lt;0.01), with online narrative therapy showing greater effectiveness in these dimensions. However, no significant difference was found in treatment adherence between the online narrative therapy and cognitive-behavioral therapy groups. Conclusion: According to the findings of this study, both narrative and cognitive-behavioral therapies can be effective methods for improving mental health and treatment adherence in cancer patients. In this context, online narrative therapy may be more efficient.