Online Psychological Interventions Research Articles

Can guided self-help improve the management of binge eating in adults type 2 diabetes? Results of the POSE-D study

People with type 2 diabetes are more likely to experience binge eating than the general population, which may interfere with their diabetes management. Guided Self-Help (GSH) is the recommended treatment for binge eating disorder (1), but there is currently a lack of evidenced treatment for binge eating in individuals living with type 2 diabetes.The aims of this pilot study were to test the feasibility and acceptability of recruiting and delivering a 12-week, online psychological GSH intervention which has been adapted in an earlier study to the needs of adults with T2 diabetes and binge eating (2).The intervention comprises GSH materials presented online in 7-sections delivered over 12-weeks, supported by a trained Guide. In total 22 participants were recruited in a case series design, through GP practices, NHS specialist weight management and diabetes services and via social media. Outcome measures were collected pre and post-intervention and at 12-week follow-up. The primary outcome was the Gormally Binge Eating Scale and secondary outcomes included eating disorder psychopathology, depression, anxiety, quality of life and HBA1C. Following the intervention, we conducted semi-structured interviews with 6 participants and 4 Guides. Data were analysed using a random intercept multi-level model.Results showed at baseline that 67% of the sample met the criteria for moderate to severe binge eating (cut-off (≤17). At post-intervention there was a statistically significant reduction in self- reported binge eating on the Gormally binge eating scale with a reduction in mean score moving from 26.8 to 14.2, (t= -4.181, p < 0.001) and only 9% meeting criteria for binge eating. There were also notable improvements in anxiety, depression and quality of life scores, but not eating disorder psychopathology.In the interviews both Guides and participants found the adapted online platform easy to use and the sessional support sufficient. They highlighted what a large commitment it was and therefore the importance of the Guide and working in ‘partnership’. The intervention appeared particularly suited to ‘stress eaters’, those experiencing ‘severe binge eating’ episodes and physical symptoms of diabetes. As a result of the intervention, participants reported ‘making broader lifestyle changes’, ‘improvements in their diabetes management’ and ‘confidence’. Guides found the training and supervision helpful but reflected on some ‘challenges with engagement’. On ending the intervention, participants requested ‘ongoing support’, such as an optional follow-up appointment and continued access to the materials.In conclusion, the study shows preliminary evidence for online GSH tailored to the needs of individuals with T2D as a promising approach to improving binge eating, diabetes management, mental wellbeing and quality of life, however effectiveness evidence is needed.

A Self-Applied Psychological Treatment for Gambling-Related Problems via The Internet: A Pilot, Feasibility Study.

The main purpose of this study was to evaluate the feasibility of an online psychological intervention for individuals with gambling-related problems, supported by ecological momentary assessments and interventions (EMAs and EMIs), along with weekly phone-calls, before conducting a randomized controlled trial. Participants were required to complete 3 of the 8 modules of the program based on cognitive-behavioral therapy (CBT) and extensions and innovations of CBT. The study measured the outcomes of feasibility (i.e., reach, appropriateness, technology literacy and technology usability, fidelity, and adherence). In terms of reach, 19.8% (n = 11) of the initial population met the inclusion criteria and completed the three modules (mean age = 41; 90.9% men). The perceived appropriateness and the technology usability after the first use were both excellent, fidelity and adherence to the online treatment (73.3%) were adequate. Adherence to the EMAs and the weekly phone calls were more modest (54.51% and 66.67%, respectively). The results of the present study show that an online treatment for gambling problems enhanced by EMA and EMI might be feasible but challenges were noted in terms of reach and adherence to these assessments and calls. These challenges are important to consider for future trials and the scalability of treatments for individuals with gambling disorders.

Internet-based self-administered intervention to reduce anxiety and depression symptomatology and improve well-being in 7 countries: protocol of a randomized control trial.

Online psychological interventions have emerged as a treatment alternative because they are accessible, flexible, personalized, and available to large populations. The number of Internet interventions in Latin America is limited, as are Randomized Controlled Trials (RCTs) of their effectiveness and a few studies comparing their effectiveness in multiple countries at the same time. We have developed an online intervention, Well-being Online, which will be available to the public free of charge in 7 countries: Mexico, Ecuador, Peru, Chile, Brazil, Spain, and the Netherlands. We expect a reduction in depression and anxiety symptoms and an increase in well-being of the participants. A multi-country, randomized controlled trial will be conducted. The intervention is multicomponent (Cognitive Behavioral Therapy, Behavioral Activation Therapy, Mindfulness, Acceptance and Commitment Therapy, and Positive Psychology), with 10 sessions. In each country, eligible participants will be randomized to one of three groups: Enriched Intervention (interactive web design with videos, infographics, text, audio, and forum), Text Intervention (text on the website), and Wait List (control group). Repeated measures will be obtained at 5-time points. Our primary outcomes will be anxiety symptomatology, depressive symptomatology, and mental well-being. MANOVA analysis will be used for our main analysis. This protocol describes the design of a randomized trial to evaluate the efficacy of a web-based intervention to reduce anxiety and depression symptomatology and increase subjective well-being. The intervention will be made available in four languages (Spanish, Portuguese, Dutch, and English). Its results will contribute to the evidence of effectiveness in terms of randomized trials and Internet interventions, mainly in Latin America and Europe.

Caring the caregivers. An online psychological intervention for family caregivers of oncological palliative patients

Aim: analyze the effectiveness of an online delivered psychological intervention program for oncological palliative caregivers in order to reduce the distress and caregiver burden. Methods: The program was developed for primary caregivers of advanced cancer patients, with a life expectancy of less than 6 months. The intervention consisted of 4 weekly sessions. The assessment instruments were the Caregiver Emotional Distress Detection Scale and the Zarit’s Reduced Scale and were applied at the beginning and end of the program. In addition, the main worries of the caregivers were categorized by the Caregiver Emotional Distress Detection Scale. Descriptive statistics and Student’s t were used. Results: 38 caregivers enrolled in intervention, 81.6% of whom were women. Regarding the degree of kinship, 44.7% were descendants of the patient. The distress was significantly reduced after the intervention. Uncertainty remained the main worry at both moments of measurement. Before the program, the second most frequent worry was the suffering of the patient, while after the intervention it was worries about the suffering of other family members. Conclusions: Carrying out this online group psychological intervention program proved to be effective in reducing emotional distress in the main caregivers of cancer patients at the end of life. Uncertainty was a constant concern throughout the program in the relatives.

Breaking the maternity mold: navigating the return to work and challenging rigid maternal beliefs through an online psychological intervention.

Working mothers must often balance work and family responsibilities which can be affected by rigid and irrational beliefs about motherhood. The present study had two aims: (a) to provide psychometric evidence for a shortened Italian version of the Rigid Maternal Beliefs Scale (RMBS) and (b) to facilitate mothers' return to work after maternity leave by reducing perceptions of anxiety and stress related to rigid maternal beliefs (i.e., perceptions and societal expectations of mothers, maternal confidence, maternal dichotomy) and by teaching specific recovery strategies (e.g., relaxation, mastery experiences) to manage anxiety and stress through an online psychological intervention. Results replicated the three-factor structure of the original RMBS and showed good psychometric properties. The online psychological intervention resulted in decrease in the rigidity of maternal beliefs, perceived anxiety and stress, and increase in recovery strategies. These initial results are promising and encourage further investigation into online psychological interventions for improving the well-being of working mothers.

The effectiveness of psychological interventions delivered online on the mental health of university students: New challenges for psychological sciences

The purpose of this study was to provide an overview of studies on the effectiveness of online psychological and psychotherapeutic interventions aimed at college students. Studies were identified through a search of PubMed and Scopus. Empirical studies included were in English language with peer review and focused on online psychological or psychotherapeutic interventions. 18 studies were selected. The predominant online intervention was cognitive-behavioral therapy. Online psychological interventions were found to be effective in reducing symptoms of anxiety and depression and treating other conditions. In addition, they have been shown to be at least as effective and acceptable as classical interventions. Interventions delivered online have been found to be effective in improving the mental health of college students. They represent a useful tool to be implemented in health services provided by universities.

Efficacy of online psychoeducation and relaxation training program (OnPR) on mental health problems in COVID-19 patients: A randomized controlled trial

PurposePrior studies found that the prevalence of anxiety, depression, stress and insomnia were relatively high in COVID-19 patients. This study aimed to explore the efficacy of OnPR on mental health outcomes in patients with asymptomatic or mildly symptomatic COVID-19. Patients and methodsWe employed a randomized controlled trial following the CONSORT guidelines. The Thai Clinical Trials Registry identification number of this study is TCTR20220729003. We used a block of 4 randomizations generated by a computer program. The intervention group (n = 38) received the OnPR program, and the control group (n = 36) received care as usual. OnPR was an online psychological intervention comprising psychoeducation, sleep hygiene education and relaxation techniques. OnPR was provided by qualified therapists trained with a standard protocol. The primary outcomes were depression, anxiety, and stress, which were determined by the Depression Anxiety and Stress Scale-21 (DASS-21). Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI). Outcomes were compared between groups at pre-intervention and post-intervention at 1, 4, and 12 weeks using paired t-test or Wilcoxon signed-rank test. In addition, a linear mixed model was employed to demonstrate the effect changes of OnPR over time. All analyses were two-tailed, with a significance level of 0.05. ResultsOf 74 Thai participants, 89.2 % were female, and 11.8 % were male. The average age was 31 years. Participants' baseline characteristics were not statistically significant between the intervention and control groups except for depression and stress scores from DASS-21. OnPR resulted in significantly better improvement in depression, anxiety, stress, and sleep quality. The mean differences between groups of DASS-21 scores in depression, anxiety and stress at 7-day follow-up were −4.69, −3.29, and −5.50 respectively. The differences continue to be significant at 4-week and 12-week follow-ups. The mean difference between groups of PSQI at 7-day follow-up is −0.91. ConclusionOnPR improved mental health outcomes, and the effect on depression, anxiety and stress lasted for at least a 12-week follow-up period. In addition, it could enhance sleep quality after the intervention.

Online Interventions for Mental Health in Times of COVID: A Systematic Review and Quality Assessment of Scientific Production

The impact of the COVID-19 pandemic on psychological well-being led to a proliferation of online psychological interventions, along with the publications of studies assessing their efficacy. The aim of the present work was to assess the scientific quality of studies addressing online psychological interventions for common mental health problems, comparing studies published during the COVID-19 pandemic to equivalent control articles published four years before the pandemic. To this end, we developed and applied a quality checklist to both samples of articles (N=108). Overall, we found that the methodological quality of many studies on psychological interventions was poor both before and during the pandemic. For instance, 33% of the studies lacked a control group of any kind in both samples of articles, and less than 5% of studies used blinding of any sort. Within this context, we found that studies conducted during the pandemic were published faster, but showed a decrease in key indicators such as the randomized allocation of participants of the experimental groups, pre-registration or data sharing. We conclude that the low overall quality of the available research on online psychological interventions deserves further scrutiny and should be taken into consideration to make informed decisions on therapy choice, policy making, and public health –particularly in times of increased demand and public interest such as the COVID-19 pandemic.

Long-term psychological intervention for parents of children with prolonged disorders of consciousness: a pilot study

BackgroundChildren with prolonged disorders of consciousness experience severe intellectual and behavioral disabilities that will last for decades or even a lifetime. Parents generally experience severe anxiety, stress, sadness, or family conflicts, which can lead to abnormal parenting behavior and can, in turn, adversely affect the cognitive, emotional, and behavioral well-being of the children. This causes a serious burden on children, families, and society. Psychological interventions targeting parents using online conversations provide an opportunity to improve the overall well-being of the parents, their children, and the family as a whole.MethodsA total of 13 patients completed the protocol. Six were girls (46.2%), the mean age was 4.5 ± 3.0 years, and the length of time before emergent from minimally consciousness state was 244 ± 235 days. A staff member with psychological counseling qualifications implemented all psychological interventions. Regular online psychological interventions were performed annually before and after discharge. Evaluation data were collected before discharge and at 1 and 3–5 years post-discharge.ResultsWith the extension of intervention time, the Strengths and Difficulties Questionnaire, the Depression Anxiety and Stress Scale-21, and the Parenting Sense of Competence Scale scores showed significant improvement (p < 0.05), while the Revised Scale for Caregiving Self-Efficacy scores did not. With the extension of intervention time, the Strengths and Difficulties Questionnaire (Total Difficulties scores, TD) scores showed significant improvement (p < 0.05), while the scores did not after 1 year compared with before intervention. The Index of Child Care Environment evaluation scores declined significantly (p < 0.05).ConclusionPsychological interventions aimed at the parents of children with prolonged disorders of consciousness performed at least once per year resulted in significant improvements in negative parental emotions, parental self-efficacy, and emotional and behavioral problems in their children. However, the childcare environment continued to decline.

Parents' acceptability of blended psychological interventions for children with emotional disorders

ObjectivesThis study aims to (1) describe parents' knowledge and use of online resources to address children's mental health issues and the family's general internet and technology usage patterns; (2) examine parents' acceptance of blended interventions for children with emotional disorders (ED); and (3) analyse the predictors of parents' intention to use a blended intervention if their children experienced an ED. MethodThe sample included 164 Portuguese parents (95.7 % mothers) of children between the ages of 6 and 13 years who completed an online survey. The study was disseminated through social networks, personal contacts of the researchers, and among parents participating in a randomized controlled trial investigating the efficacy of a psychological intervention for children with ED. ResultsOnly 4.3 % of parents knew about online psychological interventions for children, and only 1.2 % had used them before. Most parents (73.2 %) reported that they would choose face-to-face individual therapy as their first option if their child had any ED, followed by blended therapy (14.8 %). Regression analyses showed that higher levels of parents' intention to use a blended intervention were predicted by their perceptions of the utility or efficacy of this type of delivery format. Discussion/conclusionThese results suggest that although most parents show unfamiliarity with blended psychological interventions for children, they consider it a treatment modality to which they would resort if their children had emotional difficulties. Their intention to use such an intervention seems to be more likely if they perceive it as useful and effective.

Unified Protocol for the transdiagnostic treatment of emotional disorders in people with post COVID-19 condition: study protocol for a multiple baseline n-of-1 trial.

Post COVID-19 syndrome, defined as the persistence of COVID-19 symptoms beyond 3 months, is associated with a high emotional burden. Post COVID-19 patients frequently present comorbid anxiety, depressive and related disorders (emotional disorders, EDs) which have an important impact on their quality of life. Unfortunately, psychological interventions to manage these EDs are rarely provided to post COVID-19 patients. Also importantly, most psychological interventions do not address comorbidity, namely simultaneous EDs present in COVID-19 patients. This study will explore the clinical utility and acceptability of a protocol-based cognitive-behavioral therapy called the Unified Protocol for the transdiagnostic treatment of EDs in patients suffering post COVID-19 condition. A multiple baseline n-of-1 trial will be used, as it allows participants to be their own comparison control. Sample will be composed of 60 patients diagnosed with post COVID-19 conditions and comorbid EDs from three Spanish hospitals. After meeting the eligibility criteria, participants will answer the pre-assessment protocol and then they will be randomly assigned to three different baseline conditions (6, 8, or 10 days of assessments before the intervention). Participants and professionals will be unblinded to participants' allocation. Once the baseline assessment has been completed, participants will receive the online psychological individual intervention through video-calls. The Unified Protocol intervention will comprise 8 sessions of a 1 h duration each. After the intervention, participants will answer the post-assessment protocol. Additional follow-up assessments will be conducted at one, three, six, and twelve months after the intervention. Primary outcomes will be anxiety and depressive symptoms. Secondary outcomes include quality of life, emotion dysregulation, distress tolerance, and satisfaction with the programme. Data analyses will include between-group and within-group differences and visual analysis of patients' progress. Results from this study will be disseminated in scientific journals. These findings may help to provide valuable information in the implementation of psychological interventions for patients suffering post COVID-19 conditions. https://clinicaltrials.gov, identifier (NCT05581277).

The impact of reduced worry on general functioning: Amediation analysis from a randomized trial.

Previous lab findings have indicated that excessive worry may impair cognitive performance and problem solving capabilities but it is unclear if excessive worry also leads to broader impairments in general functioning. We report a secondary process data analysis of a large randomized waitlist-controlled trial (N=670) of a self-guided online psychological intervention for dysfunctional worry related to the Covid-19 pandemic. Specific aims were to investigate (1) if improvements in general functioning were mediated by reductions in worry related to Covid-19 during the acute intervention phase, and (2) if reduced worry related to Covid-19 during acute intervention phase had a positive long-term impact on general functioning up to 1year after the end of the intervention. To address aim 1, we used a mediation analysis framework where outcome (general functioning measured with an adapted version of the Work and Social Adjustment Scale) and the hypothesized mediator (worry measured with an adapted version of the Generalised Anxiety Disorder 7-Item Scale) were administered weekly during the controlled phase of the trial of 3weeks. To address aim 2, we investigated if reductions in worry during the 3-week treatment period predicted improved general functioning at 1- and 12months after treatment completion. Results showed that improvements in general functioning at week 3 were mediated by reductions in worry during the first 2weeks of treatment (indirect effect estimate -0.08; 95% CI -0.15, -0.02). A sensitivity analysis indicated that the mediation effects dropped significantly when the residual correlation values between the mediator and the outcome exceeded r=0. A reversed causation model was not significant. Additionally, reductions in worry during treatment predicted subsequent improvements in general functioning at both 1- and 12-month follow-ups (p<.05, -.001). Altogether, these results provide further support of the importance of targeting worry as a way to improve functioning among the large population of individuals with high levels of worry.

Reply to Aldè et al. Comment on "Manchaiah et al. Social Representations of "Tinnitus" and "Health" among Individuals with Tinnitus Seeking Online Psychological Interventions. Audiol. Res. 2023, 13, 207-220".

We would like to thank Dr. Aldè and his colleuage's for their thoughtful comments [...].

Comment on Manchaiah et al. Social Representations of "Tinnitus" and "Health" among Individuals with Tinnitus Seeking Online Psychological Interventions. Audiol. Res. 2023, 13, 207-220.

We read with pleasure the interesting paper titled "Social Representations of "Tinnitus" and "Health" among Individuals with Tinnitus Seeking Online Psychological Interventions" by Vinaya Manchaiah et al. [...].

Effectiveness of online psychological intervention for caregivers on the quality of life of people with Alzheimer disease: a randomized clinical trial protocol

Background: Alzheimer's disease (AD) has a significant impact on the quality of life (QOL) and interventions aimed at their improvement show inconclusive results. Objectives were study protocol to evaluate the effectiveness of a multicomponent caregiver intervention on the QOL of persons with AD. Methods: The design is a randomized clinical trial with blinded assessment of response variables. Ninety-four dyads of informal caregivers and their relatives with AD will be recruited in the Osona and Ripollès territorial service of geriatrics and palliative care of the Consorci Hospitalari de Vic (Osona, Spain) and randomized into experimental (EG) and control group (CG). An 8-week online multicomponent psychological intervention including psychoeducation and mindfulness will be provided to the EG caregivers. The CG will perform the usual care. Outcome will be the QOL of persons with AD assessed with the QOL-AD. Conclusions: The multicomponent online caregiver research detailed in this protocol could be incorporated into health and care facilities for persons with AD and their families to improve caregiving and QOL.

PS04 Assessment and management of patients with vitiligo and psychological distress: clinician survey

Abstract Vitiligo is a common, pigmentary skin disorder, affecting 1% of people worldwide. People with vitiligo have a significantly higher prevalence of psychosocial comorbidities, including anxiety, depression and suicidal ideations, than nonaffected individuals (Ezzedine K, Eleftheriadou V, Jones H et al. Psychosocial effects of vitiligo: a systematic literature review. Am J Clin Dermatol 2021; 22:757–74). The British Association of Dermatologists’ (BAD) 2022 vitiligo guidelines recommend the assessment of psychosocial impact in all patients with vitiligo, with management tailored to severity (Eleftheriadou V, Atkar R, Batchelor J et al. BAD guidelines for the management of people with vitiligo 2021. Br J Dermatol 2022; 186:18–29). We conducted a UK-wide consultation exercise aimed at establishing the current assessment and management practices of patients with vitiligo who experience psychological distress due to their skin. This project was supported by the UK Dermatology Clinical Trials Network and was also distributed to BAD members. Seventy-eight responders completed the online questionnaire (83% doctors, 14% nurses and 3% psychologists). On average, responders reviewed eight patients with vitiligo in the clinic during the preceding 6 months; 37% of these patients were estimated to have moderate/severe psychological distress. Sixty-seven per cent reported routine screening for psychological impact using mainly the Dermatology Life Quality Index (56%) and Patient Health Questionnaire-9 (16%). Forty-eight per cent used no formal screening tool but asked general questions. Thirty-three per cent do not routinely screen for psychological impact. For the management of mild psychological distress, 83% of responders signpost to online resources or advise self-referral to local services; 16% wrote to the general practitioner only. For the management of moderate-to-severe psychological distress, 28% referred patients to psychiatric services, 29% to psychological services and 37% to community services. Four per cent stated they would not take any action. Interestingly, 18% were not aware of any available local, regional or national psychological services. Waiting times for urgent psychological input ranged from 2 months to 2 years. Eighty-seven per cent of responders felt that their patients with vitiligo would benefit from a tailor-made online psychological intervention targeting specific aspects of the condition and that patients with vitiligo would engage with it (80%). Digital accessibility was highlighted as the main concern by remaining responders. Sixty per cent of responders expressed interest in participating in a trial examining the effectiveness of an online-delivered psychological intervention for patients with vitiligo and moderate/severe psychological distress. In summary, significant variation exists in the assessment and management of patients with vitiligo and psychological distress. Our survey suggests an unmet need for such an online intervention and a need for educational resources to give to clinicians regarding pathways to mental health services.

Determinants of psychotherapists' attitudes to online psychotherapy.

Online psychotherapy is a form of work that is becoming more and more popular. Public health problems, such as COVID-19, forced mental health professionals and patients to incorporate new methodologies such as the use of electronic media and internet to provide follow-up, treatment and also supervision. The aim of this study was to investigate which factors shape the therapists' attitudes toward online psychotherapy during a pandemic taking into account: (1) attitudes toward the COVID-19 pandemic (fear of contagion, pandemic fatigue, etc.), (2) personal characteristics of the psychotherapists (age, gender, feeling of efficacy, anxiety, depression, etc.), and (3) characteristics of the psychotherapeutic practice (guideline procedure, client age group, professional experience, etc). Study participants were 177 psychotherapists from four European countries: Poland (n = 48), Germany (n = 44), Sweden (n = 49), and Portugal (n = 36). Data were collected by means of an individual online survey through the original questionnaire and the standardized scales: a modified version of the Attitudes toward Psychological Online Interventions Scale (APOI), Fear of Contagion by COVID-19 Scale (FCS COVID-19), Pandemic Fatigue Scale (PFS), Hospital Anxiety and Depression Scale (HADS), Social Support Questionnaire (F-SozU K-14), and the Sense of Efficiency Test (SET). Determinants that impacted psychotherapists' attitudes toward online therapy were: COVID-19 belief in prevention-keeping distance and hand disinfection, pandemic behavioral fatigue, previous online therapy experience (including voice call), working with youth and adults. Our study showed that belief in the sense of prevention in the form of taking care of hand disinfection before the session, pandemic behavioral fatigue and experience in working with adults were significant predictors of negative attitudes of therapists toward online psychological interventions. On the other hand, belief in the sense of prevention in the form of keeping distance during the session had a positive effect on general attitudes toward therapy conducted via the internet. The online therapy boom during the COVID-19 pandemic has spawned a powerful tool for psychotherapists. More research in this area and training of psychotherapists are needed for online psychological interventions to become an effective therapy format that is accepted by patients and therapists alike.

An analysis of attendance and future need for therapy from an online psychoeducation course for Non-epileptic Attack Disorder (NEAD)

124 participants started an online Non-Epileptic Attack Disorder (NEAD) psychoeducation intervention between July 2020 and August 2022. Drop-out and completion rates were then examined, as well as outcomes following course-completion (discharge or further psychological support). Results found that 31 per cent of participants dropped-out, 20 per cent of participants required further 1:1 therapy, 22 per cent opted for infrequent reviews and 27 per cent were discharged with no further support required. The study therefore showed positive outcomes for an online psychological intervention, in terms of engagement, low attrition rates and reducing further requirements on specialised clinician support. Clinical service implications, study limitations and future avenues for research are discussed.

Evaluating preferences for online psychological interventions to decrease cannabis use in young adults with psychosis: An observational study

Innovative technology-based solutions have the potential to improve access to clinically proven interventions for cannabis use disorder (CUD) in individuals with first episode psychosis (FEP). High patient engagement with app-based interventions is critical for achieving optimal outcomes. 104 individuals 18 to 35 years old with FEP and CUD from three Canadian provinces completed an electronic survey to evaluate preferences for online psychological intervention intensity, participation autonomy, feedback related to cannabis use, and technology platforms and app functionalities. The development of the questionnaire was informed by a qualitative study that included patients and clinicians. We used Best-Worst Scaling (BWS) and item ranking methodologies to measure preferences. Conditional logistic regression models for BWS data revealed high preferences for moderate intervention intensity (e.g., modules with a length of 15 min) and treatment autonomy that included preferences for using technology-based interventions and receiving feedback related to cannabis use once a week. Luce regression models for rank items revealed high preferences for smartphone-based apps, video intervention components, and having access to synchronous communications with clinicians and gamification elements. Results informed the development of iCanChange (iCC), a smartphone-based intervention for the treatment of CUD in individuals with FEP that is undergoing clinical testing.

Attitudes of Mental Health Professionals towards Telepsychology during the Pandemic: A Pilot Study.

This pilot study investigated mental health professionals' attitudes towards remote psychological consultations and internet-based interventions. An online survey in Italian and English was administered to a sample of 191 psychologists and psychotherapists to collect detailed information about their professional experience providing online psychological interventions a year and a half after the beginning of the SARS-CoV-2 pandemic. The results did not reveal a statistically significant association between the participants' theoretical approaches and the number of patients treated via the online modality. Overall, most of the participants found advantages to the online setting but also noted critical issues regarding privacy and the ease of integrating new technology into their clinical practice. According to the participants, despite the challenges that must be addressed, telehealth is a viable psychological therapeutic option that is destined to grow in importance in the near future.