Talking treatment in general.
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801 to 825 of 1,623Can group interventions facilitate forgiveness of an ex-spouse? A randomized clinical trial.
This study evaluated the effectiveness of 2 versions of an 8-session forgiveness group intervention for divorced individuals. Participants (randomized, n=192; analyzed, n=149) were randomly assigned to a secular forgiveness condition, a religious forgiveness condition, or a no-intervention comparison condition. Measures of forgiveness and mental health were obtained at pretest, posttest, and 6-week follow-up. Participants in both intervention conditions increased significantly more than comparison participants on self-reported forgiveness of an ex-spouse and understanding of forgiveness. Participants in the secular condition showed a greater decrease in depressive symptoms than comparison participants. Intrinsic religiousness did not moderate intervention effects.
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Grilo CM, Masheb RM (2005)randomised controlled trialMEDLINE-indexed journal, not yet read by usBehaviour research and therapy124 citations A randomized controlled comparison of guided self-help cognitive behavioral therapy and behavioral weight loss for binge eating disorder.
We performed a randomized controlled study to test the relative efficacy of guided self-help (gsh) cognitive-behavioral therapy (CBTgsh) and behavioral weight loss treatment (BWLgsh) treatments for binge eating disorder (BED). To provide an additional partial control for non-specific influences of attention, a third control (CON) treatment condition was included. We tested the treatments using a guided self-help approach given the promising results from initial studies using minimal therapist guidance. Ninety consecutive overweight patients (19 males, 71 females) with BED were randomly assigned (5:5:2 ratio) to one of three treatments: CBTgsh (N=37), BWLgsh (N=38), or CON (N=15). The three 12-week treatment conditions were administered individually following guided self-help protocols. Overall, 70 (78%) completed treatments; CBTgsh (87%) and CON (87%) had significantly higher completion …
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Hertenstein E, Trinca E, Wunderlin M, Schneider CL, Züst MA, Fehér KD, Su T, Straten AV, Berger T, Baglioni C, Johann A, Spiegelhalder K, Riemann D, Feige B, Nissen C (2022)meta-analysisMEDLINE-indexed journal, not yet read by usSleep medicine reviews263 citations Cognitive behavioral therapy for insomnia in patients with mental disorders and comorbid insomnia: A systematic review and meta-analysis.
Almost 70% of patients with mental disorders report sleep difficulties and 30% fulfill the criteria for insomnia disorder. Cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment for insomnia according to current treatment guidelines. Despite this circumstance, insomnia is frequently treated only pharmacologically especially in patients with mental disorders. The aim of the present meta-analysis was to quantify the effects of CBT-I in patients with mental disorders and comorbid insomnia on two outcome parameters: the severity of insomnia and mental health. The databases PubMed, CINHAL (Ebsco) und PsycINFO (Ovid) were searched for randomized controlled trials on adult patients with comorbid insomnia and any mental disorder comparing CBT-I to placebo, waitlist or treatment as usual using self-rating questionnaires as outcomes for either insomnia or mental health or bo…
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Liu X, Yi P, Ma L, Liu W, Deng W, Yang X, Liang M, Luo J, Li N, Li X (2021)meta-analysisMEDLINE-indexed journal, not yet read by usPsychiatry research42 citations Mindfulness-based interventions for social anxiety disorder: A systematic review and meta-analysis.
Various psychiatric disorders are treated with mindfulness-based interventions (MBIs), although the efficacy of MBIs in patients with social anxiety disorder (SAD) is unclear. In this meta-analysis, we investigated the efficacy of MBIs on SAD symptoms. Systematic searches were performed in various databases, and 11 eligible randomized controlled trials (RCTs) and 5 single-arm trials were identified. The between-groups analysis of the 11 RCTs showed that Hedges' g = 0.00, while the within-group analysis showed a large pre-post effect size (g = 1.20).MBIs were superior to the no-treatment comparator (g = 0.89), equivalent to specific active treatment (g = -0.19), and less effective than evidence-based treatment (i.e., cognitive behavioral therapies) (g = -0.29).MBIs significantly alleviated depressive symptoms and improved mindfulness, quality of life, and self-compassion. Meta-regression …
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Effects of expressive writing intervention for women's PTSD, depression, anxiety and stress related to pregnancy: A meta-analysis of randomized controlled trials.
Expressive writing (EW) is a common psychological intervention that aims to improve the mental health of traumatized individuals. Pregnancy is considered an anxious or traumatic experience for some women, and any crisis in relation to pregnancy is closely associated with their psychological well-being. Post-traumatic stress disorder (PTSD), depression, anxiety and stress are the most prominent emotional and psychological responses that may occur during the process. However, the effects of EW in mediating women's PTSD, depression, anxiety and stress related to pregnancy remain uncertain, and no qualified meta-analysis has assessed such effects. The aim of this study was to assess the effectiveness of EW as a psychological intervention for women. Five databases, including PubMed, EMBASE, Cochrane, Web of Science and PsycINFO, were searched from inception to September 2019 for eligible stud…
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Harrer M, Adam SH, Baumeister H, Cuijpers P, Karyotaki E, Auerbach RP, Kessler RC, Bruffaerts R, Berking M, Ebert DD (2019)meta-analysisMEDLINE-indexed journal, not yet read by usInternational journal of methods in psychiatric research254 citations Internet interventions for mental health in university students: A systematic review and meta-analysis.
Objectives: Mental health disorders are highly prevalent among university students. Universities could be an optimal setting to provide evidence-based care through the Internet. As part of the World Mental Health International College Student initiative, this systematic review and meta-analysis synthesizes data on the efficacy of Internet-based interventions for university students' mental health.
Method: A systematic literature search of bibliographical databases (CENTRAL, MEDLINE, and PsycINFO) for randomized trials examining psychological interventions for the mental health (depression, anxiety, stress, sleep problems, and eating disorder symptoms), well-being, and functioning of university students was performed through April 30, 2018.
Results: Forty-eight studies were included. Twenty-three studies (48%) were rated to have low risk of bias. Small intervention effects were found on d…
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Motivational interviewing in medical care settings: a systematic review and meta-analysis of randomized controlled trials.
Objective: Motivational Interviewing (MI) is a method for encouraging people to make behavioral changes to improve health outcomes. We used systematic review and meta-analysis to investigate MI's efficacy in medical care settings.
Methods: Database searches located randomized clinical trials that compared MI to comparison conditions and isolated the unique effect of MI within medical care settings.
Results: Forty-eight studies (9618 participants) were included. The overall effect showed a statistically significant, modest advantage for MI: Odd ratio=1.55 (CI: 1.40-1.71), z=8.67, p<.001. MI showed particular promise in areas such as HIV viral load, dental outcomes, death rate, body weight, alcohol and tobacco use, sedentary behavior, self-monitoring, confidence in change, and approach to treatment. MI was not particularly effective with eating disorder or self-care behaviors or some medic…
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Otte C (2011)meta-analysisMEDLINE-indexed journal, not yet read by usDialogues in clinical neuroscience113 citations Cognitive behavioral therapy in anxiety disorders: current state of the evidence.
A plethora of studies have examined the efficacy and effectiveness of cognitive-behavioral therapy (CBT) for adult anxiety disorders. In recent years, several meta-analyses have been conducted to quantitatively review the evidence of CBT for anxiety disorders, each using different inclusion criteria for studies, such as use of control conditions or type of study environment. This review aims to summarize and to discuss the current state of the evidence regarding CBT treatment for panic disorder, generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Overall, CBT demonstrates both efficacy in randomized controlled trials and effectiveness in naturalistic settings in the treatment of adult anxiety disorders. However, due to methodological issues, the magnitude of effect is currently difficult to estimate. In conclusion, CBT…
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The integration of the heart-centered paradigm of Sufi psychology in contemporary psychotherapy practice.
Maktab Tarighat Oveyssi (M.T.O) Sufi Psychology provides a psychological method based on the teachings of the M.T.O Shahmaghsoudi School of Islamic Sufism. Sufi Psychology aims to address physical and spiritual aspects of patients in order to foster a sense of identity that is not limited to a diagnostic status or an emotional state. The present work provides an overview of what Sufi Psychology is and how it builds on current gold-standard psychotherapeutic practices. We also present data from a bottom-up, practice-based observational study in which male and female patients from various cultural and religious backgrounds received Sufi Psychotherapy and provided self-report measures of distress, perceived stress, hope, and resilience. Results from multilevel models fit to examine within- and between-person variance and change over time indicated significant reductions in therapeutic, rela…
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Dynamic prediction of psychological treatment outcomes: development and validation of a prediction model using routinely collected symptom data.
Background: Common mental disorders can be effectively treated with psychotherapy, but some patients do not respond well and require timely identification to prevent treatment failure. We aimed to develop and validate a dynamic model to predict psychological treatment outcomes, and to compare the model with currently used methods, including expected treatment response models and machine learning models.
Methods: In this prediction model development and validation study, we obtained data from two UK studies including patients who had accessed therapy via Improving Access to Psychological Therapies (IAPT) services managed by ten UK National Health Service (NHS) Trusts between March, 2012, and June, 2018, to predict treatment outcomes. In study 1, we used data on patient-reported depression (Patient Health Questionnaire 9 [PHQ-9]) and anxiety (Generalised Anxiety Disorder 7 [GAD-7]) symptom…
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Impact of a progressive stepped care approach in an improving access to psychological therapies service: An observational study.
England's national Improving Access to Psychological Therapies (IAPT) programme advocates stepped care as its organizational delivery of psychological therapies to common mental health problems. There is limited evidence regarding the efficacy of stepped care as a service delivery model, heterogeneity of definition and differences in model implementation in both research and routine practice, hence outcome comparison in terms of effectiveness of model is difficult. Despite sound evidence of the efficacy of low intensity interventions there appears to be a perpetuation of the notion that severity and complexity should only be treated by a high intensity intervention through the continuation of a stratified care model. Yet no psychotherapy treatment is found to be more superior to another, and not enough is known about what works for whom to aid the matching of treatment decision. In the a…
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Love Yourself as a Person, Doubt Yourself as a Therapist?
Objective: There are reasons to suggest that the therapist effect lies at the intersection between psychotherapists' professional and personal functioning. The current study investigated if and how the interplay between therapists' (n = 70) professional self-reports (e.g., of their difficulties in practice in the form of 'professional self-doubt' and coping strategies when faced with difficulties) and presumably more global, personal self-concepts, not restricted to the professional treatment setting (i.e., the level of self-affiliation measured by the Structural Analysis of Social Behaviour (SASB) Intrex, Benjamin, ), relate to patient (n = 255) outcome in public outpatient care.
Method: Multilevel growth curve analyses were performed on patient interpersonal and symptomatic distress rated at pre-, post- and three times during follow-up to examine whether change in patient outcome was i…
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The therapeutic alliance as a predictor of outcome in dialectical behavior therapy versus nonbehavioral psychotherapy by experts for borderline personality disorder.
The purpose of the present study was to explore facets of the client- and therapist-rated therapeutic alliance as predictors of suicide attempts, nonsuicidal self-injury, depression, and introject during the course of 2 psychosocial treatments for borderline personality disorder. A total of 101 women meeting Diagnostic and Statistical Manual of Mental Disorders-IV DSM-IV criteria for borderline personality disorder participated in a randomized controlled trial of dialectical behavior therapy (DBT) versus community treatment by experts. Clients and therapists rated the therapeutic alliance at 4 time points during 1 year of treatment. Multilevel models showed no significant differences in client ratings of the alliance by treatment condition. DBT therapists reported greater working strategy consensus early in treatment and an overall greater alliance during treatment. Client ratings of com…
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Psychotherapy dropouts: differences by modality, license, and DSM-IV diagnosis.
Dropouts are frequent in mental health care. Several client factors have been identified as dropout predictors, including ethnic minority status, race, low SES, and more severe symptoms. Research on therapist and process variables is less common, and findings are inconsistent. This study used administrative data for 434,317 patients from CIGNA Behavioral Health (CIGNA) to examine dropout rates by profession of provider, therapy modality, and DSM-IV diagnosis. Results indicate that among the providers, MFTs have the lowest dropout rates in the CIGNA network. Of the therapy modalities, individual therapy is associated with lower dropout rates than family therapy. Mood and anxiety disorders have lower dropout rates than other diagnosis categories, while schizophrenia, psychotic, and substance use disorders have the highest dropout rates.
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Davidson JR (2010)cohort or longitudinalMEDLINE-indexed journal, not yet read by usThe Journal of clinical psychiatry212 citations Major depressive disorder treatment guidelines in America and Europe.
The various major American and European guidelines for the treatment of depression provide similar basic principles of treatment, which include individualizing the treatment plan, preparing the patient for potential long-term treatment, providing measurement-based care, and treating to remission. While the guidelines are all evidence-based, certain factors can influence differences in specific recommendations, such as the consensus group's composition, underlying mandates, and cultural attitudes. The similarities and differences among 6 sets of guidelines from Europe and the Americas published in the past decade are reviewed here (American Psychiatric Association, British Association for Psychopharmacology, Canadian Network for Mood and Anxiety Treatments, National Institute for Health and Clinical Excellence, Texas Medication Algorithm Project, and World Federation of Societies of Biolo…
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Common and specific elements of psychosocial treatments for bipolar disorder: a survey of clinicians participating in randomized trials.
Background: There are 14 randomized trials that indicate the benefits of various adjunctive psychosocial interventions for bipolar disorder. Efficient planning of future interventions requires identification of the common, putatively active components of these treatments. We investigated whether different forms of psychotherapy consisted of overlapping versus modality-specific ingredients.
Methods: We identified five categories of active psychosocial treatment in 14 trials: cognitive-behavioral therapy (CBT; 4 studies), family psychoeducation (5 studies), interpersonal and social rhythm therapy (IPSRT; 2 studies), individual psychoeducation (3 studies), and group psychoeducation (5 studies). In this study, 31 investigators and therapists who participated in these trials completed a questionnaire in which they rated the frequency of 17 treatment strategies in their active and treatment-as…
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Physiologic correlates of perceived therapist empathy and social-emotional process during psychotherapy.
The present study was designed to investigate the relationship among physiologic concordance, patient-perceived therapist empathy, and social-emotional process during psychotherapy. Simultaneous measures of skin conductance (SC) were obtained from 20 unique and established patient-therapist dyads during a live therapy session followed by patient ratings of therapist empathy. Paired SC data of hypothetical dyads were used to test the reliability of the proposed measure of SC concordance. Observer microanalyses of social-emotional process were used to compare short segments of high versus low physiologic concordance. Results show a significant positive correlation (r=0.47, p=0.03) between SC concordance and patient ratings of perceived therapist empathy. Microanalyses suggest that during moments of high versus low SC concordance, there were significantly more positive social-emotional inte…
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Self-injury: a research review for the practitioner.
Non-suicidal self-injury is the intentional destruction of body tissue without suicidal intent and for purposes not socially sanctioned. In this practice-friendly review, the authors summarize the empirical research on who self-injures, why people self-injure, and what treatments have demonstrated effectiveness. Self-injury is more common in adolescents and young adults as compared to adults. Common forms include cutting, severe scratching, burning, and banging or hitting; most individuals who self-injure have used more than one method. Although diagnostically heterogeneous, self-injurers typically exhibit two prominent characteristics: negative emotionality and self-derogation. Self-injury is most often performed to temporarily alleviate intense negative emotions, but may also serve to express self-directed anger or disgust, influence or seek help from others, end periods of dissociatio…
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Facilitators of peer leader retention within a Type 2 diabetes intervention trial for US Latinos/Hispanics of Mexican origin.
Peer support is effective in improving self-management behaviors and health outcomes among individuals with Type 2 diabetes. Volunteer peer support programs offer a cost-effective resource for diabetes self-management support; however, factors affecting the retention of volunteer peer leaders remain understudied. Herein, we examined factors associated with volunteer retention and satisfaction among 34 predominantly Mexican-origin peer leaders who assisted patients from a Federally Qualified Health Center located on the US/Mexico border with their diabetes management. Peer leaders completed surveys with open- and close-ended questions at baseline, 6 months and 12 months. Quantitative and qualitative data analyses were guided by the Volunteer Process Model. Using nonparametric Mann-Whitney U tests, self-efficacy as a peer leader at 6 months was most associated with interest to continue vol…
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Price AMH, Zhu A, Nguyen HNJ, Contreras-Suárez D, Schreurs N, Burley J, Lawson KD, Kelaher M, Lingam R, Grace R, Raman S, Kemp L, Woolfenden S, Goldfeld S (2021)clinical trialMEDLINE-indexed journal, not yet read by usBMJ open3 citations Study protocol for the Healthier Wealthier Families (HWF) pilot randomised controlled trial: testing the feasibility of delivering financial counselling to families with young children who are identified as experiencing financial hardship by community-based nurses.
Introduction: Poverty and deprivation can harm children's future health, learning, economic productivity and societal participation. The Australian Healthier Wealthier Families project seeks to reduce the childhood inequities caused by poverty and deprivation by creating a systematic referral pathway between two free, community-based services: universal, well-child nursing services, which provide health and development support to families with children from birth to school entry, and financial counselling. By adapting the successful Scottish 'Healthier Wealthier Children' model, the objectives of this Australian pilot are to test the (1) feasibility of systematising the referral pathway, and (2) short-term impacts on household finances, caregiver health, parenting efficacy and financial service use.
Methods and analysis: This pilot randomised controlled trial will run in three sites acro…
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Kwena Z, Kimbo L, Darbes LA, Hatcher AM, Helova A, Owino G, Thirumurthy H, Bukusi EA, Braun T, Kilgore M, Pisu M, Tamhane A, Nghiem VT, Agot K, Neilands TB, Turan JM (2021)clinical trialMEDLINE-indexed journal, not yet read by usTrials14 citations Testing strategies for couple engagement in prevention of mother-to-child transmission of HIV and family health in Kenya: study protocol for a randomized controlled trial.
Background: HIV-related maternal deaths and HIV infection among infants remain unacceptably high across sub-Saharan Africa despite increased antenatal care attendance and provision of antiretroviral therapy to pregnant women. In the Jamii Bora ("Better Family" in Swahili) Study, we seek to test the efficacy of an interdependence theory-based couple intervention. The intervention reaches pregnant women and male partners through home visits by male-female pairs of lay health workers. The aim is to increase access to home-based couples' HIV testing and counseling services to improve family health.
Methods: This is a three-arm randomized control trial among 1080 pregnant women 15 years of age or older, living with their male partners, and who have not undergone couples' HIV testing and counseling in Kisumu and Migori Counties in Kenya. Couples will be randomized into three groups: home-based…
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Böge K, Karnouk C, Hahn E, Schneider F, Habel U, Banaschewski T, Meyer-Lindenberg A, Salize HJ, Kamp-Becker I, Padberg F, Hasan A, Falkai P, Rapp MA, Plener PL, Stamm T, Elnahrawy N, Lieb K, Heinz A, Bajbouj M (2020)clinical trialMEDLINE-indexed journal, not yet read by usEuropean archives of psychiatry and clinical neuroscience32 citations Mental health in refugees and asylum seekers (MEHIRA): study design and methodology of a prospective multicentre randomized controlled trail investigating the effects of a stepped and collaborative care model.
The sudden arrival of culturally diverse asylum seekers and refugees into Germany has created a strong demand for recognizing and appropriately treating those suffering from mental health issues. Due to many systemic, organizational, cultural and socio-linguistic barriers, psychiatric treatment of refugees is posing a major challenge to Germany's mental health care system. Thus, there is a need for alternative models that allow for increased access to adequate, effective and efficient culturally sensitive mental health care services. Here, we describe the Mental Health in Refugees and Asylum Seekers (MEHIRA) project, a multicentre randomized controlled trial investigating a stepped collaborative care model (SCCM) for providing mental health treatment in this vulnerable population. The proposed SCCM aims to decrease the aforementioned barriers. Adult and adolescent participants will be sc…
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Clinical Utility of an Internet-Delivered Version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (iUP-A): A Pilot Open Trial.
The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A; Ehrenreich-May et al., 2018) has been shown to be effective for reducing symptoms of anxiety and depression in adolescents with emotional disorders. Internet-delivered psychological treatments have great potential to improve access to evidence-based psychological therapy since they are associated with reduced human and economic costs and less social stigma. Recently, our group developed an online version of the UP-A (the iUP-A) for the treatment of emotional disorders in adolescents. The aim of this pilot trial was to test the clinical utility of the iUP-A in a small sample (n = 12) of adolescents with elevated anxiety and/or depressive symptoms. Intention-to-treat and completer analyses revealed pre- to post-intervention self-reported decreases of anxiety and depressive symptoms, anxiety sens…
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Dorsey S, Gray CL, Wasonga AI, Amanya C, Weiner BJ, Belden CM, Martin P, Meza RD, Weinhold AK, Soi C, Murray LK, Lucid L, Turner EL, Mildon R, Whetten K (2020)clinical trialMEDLINE-indexed journal, not yet read by usBMC psychiatry42 citations Advancing successful implementation of task-shifted mental health care in low-resource settings (BASIC): protocol for a stepped wedge cluster randomized trial.
Background: The mental health treatment gap-the difference between those with mental health need and those who receive treatment-is high in low- and middle-income countries. Task-shifting has been used to address the shortage of mental health professionals, with a growing body of research demonstrating the effectiveness of mental health interventions delivered through task-shifting. However, very little research has focused on how to embed, support, and sustain task-shifting in government-funded systems with potential for scale up. The goal of the Building and Sustaining Interventions for Children (BASIC) study is to examine implementation policies and practices that predict adoption, fidelity, and sustainment of a mental health intervention in the education sector via teacher delivery and the health sector via community health volunteer delivery.
Methods: BASIC is a Hybrid Type II Imple…
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Hands-off: Study protocol of a two-armed randomized controlled trial of a web-based self-help tool to reduce problematic pornography use.
Background and aims: The past-year prevalence of problematic pornography use (PPU) was 1-6% in adult populations. As a result of treatment obstacles and barriers, such as unaffordable treatments, only a minority of problematic pornography users may seek treatment. Having a free, online, self-help program may overcome treatment barriers and may help those individuals who cannot receive traditional or offline treatment for PPU. Although the effectiveness of such online programs reducing substance use and problematic gambling have been reported, no prior study has examined the efficacy of an online self-help intervention aiming to reduce PPU.
Methods: This two-armed randomized controlled trial (RCT) will examine the effectiveness of an online self-help program (Hands-off) to reduce PPU, while also considering psychopathological comorbidities. The six-week intervention condition includes six…
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