Cognitive behaviour therapy
-
Randomized Controlled Trial
Changes in catastrophizing and depressed mood during and after early cognitive behaviorally oriented interventions for pain.
Catastrophizing and depressed mood are risk factors for poor outcome in treatments for pain and appear to act as mediators for favorable outcome. However, little is known about how catastrophizing and depressed mood co-occur within individuals and how these patterns change during treatment, which is the focus of the current study. The study uses data from a randomized controlled trial about early cognitive behaviorally oriented interventions for patients with nonspecific spinal pain (N = 84). ⋯ There was little individual transition from one scoring pattern to another across time, not at least for those scoring high on both depressed mood and catastrophizing. Moreover, high stability within this cluster was related to low levels of psychological flexibility at baseline. It is concluded that catastrophizing and depressed mood at the start of treatment were likely to remain high despite a cognitive behavioral intervention and that a lack of psychological flexibility may have a role.
-
Randomized Controlled Trial
Comorbidity and internet-delivered transdiagnostic cognitive behavioural therapy for anxiety disorders.
Internet-delivered transdiagnostic anxiety interventions aim to reduce symptoms across several anxiety disorders using one treatment protocol. However, it is unclear whether comorbidity affects outcomes of such treatment. This study re-examined data from a recent randomised controlled trial (N = 129) that evaluated the efficacy of an Internet-delivered transdiagnostic cognitive behavioural therapy (iCBT) intervention for participants with principal diagnoses of generalised anxiety disorder (GAD), social phobia (SP) panic disorder and agoraphobia (PDA), of whom 72% met criteria for a comorbid anxiety disorder or depression. ⋯ Both groups showed significant reductions in symptoms over treatment; however, participants with comorbid disorders showed greater reductions in measures of GAD, PDA, SP, depression, and neuroticism. In addition, treatment significantly reduced the number of comorbid diagnoses at follow-up. These results indicate transdiagnostic iCBT protocols have the potential to reduce comorbidity.
-
Randomized Controlled Trial
Guided internet-delivered cognitive behavior therapy for generalized anxiety disorder: a randomized controlled trial.
Generalized anxiety disorder (GAD) has been effectively treated with cognitive behavioural therapy (CBT) in face-to face settings. Internet-delivered CBT could be a way to increase the accessibility and affordability of CBT for people suffering from GAD. The aim of this study was to evaluate the efficacy of guided Internet-delivered CBT for GAD in a controlled trial with a wait-list control group. ⋯ Large effect sizes (Cohen's d > 0.8) were found both within the treatment group and between the groups in favor of the treatment on all outcome measures except on a measure of quality of life. Results at 1- and 3-year follow-up indicated that treatment results improved or were maintained. The authors conclude that Internet-delivered CBT with therapist support can reduce symptoms and problems related to GAD.
-
Randomized Controlled Trial
Internet-based treatment of depression: a randomized controlled trial comparing guided with unguided self-help.
Internet-delivered self-help for depression with therapist guidance has shown efficacy in several trials. Results from meta-analyses suggest that guidance is important and that self-help programs without support are less effective. However, there are no direct experimental comparisons between guided and unguided internet-based treatments for depression. ⋯ In both groups, treatment gains were maintained at 6-month follow-up. The findings provide evidence that internet-delivered treatments for depression can be effective whether support is added or not. However, all participants were interviewed in a structured diagnostic telephone interview before inclusion, which prohibits conclusions regarding unguided treatments that are without any human contact.
-
Randomized Controlled Trial
Can exposure and acceptance strategies improve functioning and life satisfaction in people with chronic pain and whiplash-associated disorders (WAD)? A randomized controlled trial.
Although 14% to 42% of people with whiplash injuries end up with chronic debilitating pain, there is still a paucity of empirically supported treatments for this group of patients. In chronic pain management, there is increasing consensus regarding the importance of a behavioural medicine approach to symptoms and disability. Cognitive behaviour therapy has proven to be beneficial in the treatment of chronic pain. ⋯ No change for any of the groups was seen in pain intensity. Improvements in the treatment group were maintained at 7-month follow-up. The authors discuss implications of these findings and offer suggestions for further research in this area.