Waitlist Control Participants Research Articles

Tailored Activities to Manage Neuropsychiatric Behaviors in Persons With Dementia and Reduce Caregiver Burden: A Randomized Pilot Study

To test whether the Tailored Activity Program (TAP) reduces dementia-related neuropsychiatric behaviors, promotes activity engagement, and enhances caregiver well-being. Prospective, two-group (treatment, wait-list control), randomized, controlled pilot study with 4 months as main trial endpoint. At 4 months, controls received the TAP intervention and were reassessed 4 months later. Patients' homes. Sixty dementia patients and family caregivers. The eight-session occupational therapy intervention involved neuropsychological and functional testing, selection, and customization of activities to match capabilities identified in testing, and instruction to caregivers in use of activities. Behavioral occurrences, activity engagement, and quality of life in dementia patients; objective and subjective burden and skill enhancement in caregivers. At 4 months, compared with controls, intervention caregivers reported reduced frequency of problem behaviors, and specifically for shadowing and repetitive questioning, and greater activity engagement including the ability to keep busy. Fewer intervention caregivers reported agitation or argumentation. Caregiver benefits included fewer hours doing things and being on duty, greater mastery, self-efficacy, and skill enhancement. Wait-list control participants following intervention showed similar benefits for reductions in behavioral frequency and caregiver hours doing things for the patient and mastery. Caregivers with depressed symptoms derived treatment benefits similar to nondepressed caregivers. Tailoring activities to the capabilities of dementia patients and training families in activity use resulted in clinically relevant benefits for patients and caregivers. Treatment minimized trigger behaviors for nursing home placement and reduced objective caregiver burden. Noteworthy is that depressed caregivers effectively engaged in and benefited from the intervention.

Tailored Activities to Manage Neuropsychiatric Behaviors in Persons With Dementia and Reduce Caregiver Burden: A Randomized Pilot Study

To test whether the Tailored Activity Program (TAP) reduces dementia-related neuropsychiatric behaviors, promotes activity engagement, and enhances caregiver well-being.Prospective, two-group (treatment, wait-list control), randomized, controlled pilot study with 4 months as main trial endpoint. At 4 months, controls received the TAP intervention and were reassessed 4 months later.Patients' homes.Sixty dementia patients and family caregivers.The eight-session occupational therapy intervention involved neuropsychological and functional testing, selection, and customization of activities to match capabilities identified in testing, and instruction to caregivers in use of activities.Behavioral occurrences, activity engagement, and quality of life in dementia patients; objective and subjective burden and skill enhancement in caregivers.At 4 months, compared with controls, intervention caregivers reported reduced frequency of problem behaviors, and specifically for shadowing and repetitive questioning, and greater activity engagement including the ability to keep busy. Fewer intervention caregivers reported agitation or argumentation. Caregiver benefits included fewer hours doing things and being on duty, greater mastery, self-efficacy, and skill enhancement. Wait-list control participants following intervention showed similar benefits for reductions in behavioral frequency and caregiver hours doing things for the patient and mastery. Caregivers with depressed symptoms derived treatment benefits similar to nondepressed caregivers.Tailoring activities to the capabilities of dementia patients and training families in activity use resulted in clinically relevant benefits for patients and caregivers. Treatment minimized trigger behaviors for nursing home placement and reduced objective caregiver burden. Noteworthy is that depressed caregivers effectively engaged in and benefited from the intervention.

Can the effects of a 1-day CBT psychoeducational workshop on self-confidence be maintained after 2 years? A naturalistic study

The continued high prevalence of depression in the general population has been in part attributed to a reluctance to consult and also to the limited capacity of psychological therapy services. In a previous randomized controlled trial, self-referral day-long workshops, each for 25 people, offering a cognitive-behavioral therapy approach, seemed to be effective at 3-month follow-up [Brown et al., 2004]. In this study, both experimental group participants and waiting list control participants who went on to attend the workshops (n=102) were followed up and 54.9% provided data after 2 years. The dropout mechanism was investigated and random effects models were used for all analyses. This is a naturalistic study that lacked a control group and had a relatively high attrition rate. The results nevertheless suggest that positive changes in depression, anxiety, distress, and self-esteem achieved at 3 months follow-up were largely maintained at 2 years for those who were "depressed" (Beck Depression Inventory [BDI] scores of 14 and above). However, nondepressed (BDI scores below 14) did not show any significant change. The overall results of this naturalistic study indicate that a very brief, intensive, and large-scale intervention can largely maintain its effects for participants with depression over a 2-year period.

Feasibility and acceptability of CD‐ROM‐based cognitive‐behavioural treatment for binge‐eating disorder

We compared preliminary feasibility and acceptability of CD-ROM-delivered CBT for overweight individuals with binge-eating disorder (BED) to 10 weekly group CBT sessions (Group) and to a waiting list control (WL). Attrition was numerically greater in the Group than the CD-ROM condition; although only Group differed significantly from WL in dropout rates. Those in the CD-ROM condition reported continued use of their CD-ROM after treatment. Also, the majority of WL participants elected to receive CD-ROM over Group treatment at the end of the waiting period. Preliminarily, no significant differences emerged across the active treatment groups on most outcome measures. However, there was a significantly greater decline in binge days in the two active groups relative to WL. CD-ROM appears to be an acceptable and at least initially preferred method of CBT delivery for overweight individuals with BED.

A brief mindfulness-based stress reduction intervention for nurses and nurse aides

Whereas the causes and negative consequences of stress among nurses are well known, less is known about effective ways to reduce or prevent this growing problem. Mindfulness-based stress reduction programs are proving to be effective in reducing stress and improving health in a variety of clinical populations. A smaller body of evidence suggests that these programs are also effective for nonclinical populations at risk for stress-related health problems. This study involved the development and evaluation of a brief 4-week mindfulness intervention for one such group—nurses and nurse aides. In comparison with 14 wait-list control participants, 16 participants in the mindfulness intervention experienced significant improvements in burnout symptoms, relaxation, and life satisfaction. The results of this pilot study, together with a natural fit between mindfulness philosophy and nursing practice theory, suggest that mindfulness training is a promising method for helping those in the nursing profession manage stress, even when provided in a brief format.

Preliminary evaluation of a broad-spectrum cognitive-behavioral group therapy for anxiety

This study involved the development and outcome evaluation of a cognitive-behavioral group treatment program for anxiety disorder using a randomized controlled design. This treatment program deviated from traditional anxiety disorder treatment protocols in that anxiety diagnosis was de-emphasized and treatment focused on shared common features across the anxiety disorders. Twenty-three participants were recruited and randomly assigned to either immediate treatment or waitlist control conditions. Nine randomly assigned participants representing a range of anxiety diagnoses completed the 12-week group treatment, and were compared with 10 waitlist control participants who stayed in the study during the waitlist period. Participants in the two conditions were compared on change in diagnosis, diagnostic severity, self-report fear on ideographic measures, and self-report questionnaires of anxiety and state negative affect. Results were generally supportive of the efficacy of the treatment program. Compared to controls participants, those receiving treatment showed significantly greater improvement on diagnostic measures and ideographic fear-avoidance hierarchies. Data from self-report measures of anxiety and state negative affect were less supportive of the treatment efficacy. Implications for emerging conceptualizations of anxiety disorders, as well as implications for treatment and treatment dissemination, are discussed.

Effects of a transdiagnostic group treatment for anxiety on secondary depression

Researchers have recently explored transdiagnostic anxiety treatments based on models of anxiety emphasizing a single common pathway across diagnostic categories. Results from a previous study [Norton and Hope, in press] indicated that a transdiagnostic approach was effective for both targeted and untargeted anxiety disorders. Consistent with the tripartite model, the transdiagnostic treatment should also influence symptoms of a broader pathology such as negative affectivity. This follow-up to Norton and Hope found significant decreases in depressed mood for clients undergoing transdiagnostic treatment for anxiety when compared to wait-list control participants. Although not statistically established, severity of depressive diagnoses seemed to generally decrease across treatment, whereas no change in severity occurred for those not receiving treatment.

Mechanism of change in cognitive-behavioral treatment of panic disorder: evidence for the fear of fear mediational hypothesis.

Numerous clinical trials have demonstrated the efficacy of cognitive-behavioral treatment (CBT) for panic disorder. However, studies investigating the mechanisms responsible for improvement with CBT are lacking. The authors used regression analyses outlined by R. M. Baron and D. A. Kenny (1986) to test whether a reduction in fear of fear (FOF) underlies improvement resulting from CBT. Pre- and posttreatment measures were collected from 90 CBT-treated patients and 40 wait-list control participants. Overall, treatment accounted for 31% of the variance in symptom reduction. The potency of FOF as a mediator varied as a function of symptom facet, as full mediation was observed for the change in global disability, whereas the effects of CBT on agoraphobia, anxiety, and panic frequency were partially accounted for by reductions in FOF. Clinical implications and future research directions are discussed.