Acceptance and Commitment Therapy (ACT) has been demonstrated to be effective in reducing depressive symptoms. However, little is known how and for whom therapeutic change occurs, specifically in web-based interventions. This study focuses on the mediators, moderators and predictors of change during a web-based ACT intervention.
Telehealth interventions include telephone-, internet-, and app-based services and support. The evidence base for the benefits of telehealth interventions so far has been relatively inconsistent and difficult to draw firm conclusions from (Flodgren et al., 2015; Wootton, 2012).
A new paper recently published in Lancet Psychiatry, led by Professor Chris Salisbury (2016), describes a randomised controlled trial (RCT) of a specific telehealth intervention (The Healthlines Service) for depression.
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Panic disorder (PD) is one of the most common psychiatric disorders. Web-based self-help treatments for PD have had promising results. These online treatments seem to have larger effect sizes (ESs) when professional support is added. However, the amount of support or how it should be administered is not yet clear. The aim of this trial was to study two ways of administering psychological support provided by phone as a part of Internet-based self-help treatment for PD based on cognitive behavioral therapy. Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
Cognitive behavioral therapy (CBT) is an effective treatment for anxiety disorders, but many potential candidates have limited access to therapists. Low-quality evidence suggests Internet-based CBT (ICBT), when augmented by remote access to a therapist via telephone or email, may benefit these patients.
Conclusion Help4Mood is acceptable to some patients receiving treatment for depression although none used it as regularly as intended. Changes in depression symptoms in individuals who used the system regularly reached potentially meaningful levels. You can request a copy of this article by replying to this email. Please be clear which article you are requesting.
Journal of Consulting and Clinical Psychology (Sep 5, 2016).
Objective: Evidence of feasibility, safety, and effectiveness of home-based telebehavioral health (HBTBH) needs to be established before adoption of HBTBH in the military health system can occur. The purpose of this randomized controlled noninferiority trial was to compare the safety, feasibility, and effectiveness of HBTBH to care provided in the traditional in-office setting among military personnel and veterans. To read the full article, log in using your NHS OpenAthens details.
We investigated effects of attentional bias modification training on anxiety and depression.
Two types of training were compared to placebo control conditions.
Unselected adolescents received eight sessions of online training.
Visual search, but not dot-probe training reduced negative attentional bias.
Long-term emotional functioning improved irrespective of condition. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Subthreshold depression has a considerable impact on individuals’ subjective well-being and psychosocial functioning and is a predictor of major depressive disorder. Internet-based cognitive behavioural treatments (iCBTs) have been used to reduce the symptoms of subthreshold depression. This meta-analysis aims to systematically review evidence indicating the efficacy of iCBT programs on the improvement of depressive symptoms in this population.
A growing body of evidence suggests that internet-based cognitive behavioural treatments (ICBT) are effective to treat social anxiety disorder (SAD). Whereas the efficacy of clinician-guided ICBT has been established, ICBT in a group format has not yet been systematically investigated. This three-arm RCT compared the efficacy of clinician-guided group ICBT (GT) with clinician guided individual ICBT (IT) and a wait-list (WL). To read the full article, log in using your NHS OpenAthens details.
REGASSA is a randomized controlled study performed in primary care to study the effects of 12 weeks of Internet-based cognitive behaviour therapy (ICBT) and physical exercise (PE) compared with treatment as usual (TAU) in patients with mild-to-moderate mental ill-health. The present study aimed to examine the results of these treatment alternatives on psychological functioning, stress, and sleep disturbances. You can request a copy of this article by replying to this email. Please be clear which article you are requesting.
Depression is known to negatively impact social functioning, with patients commonly reporting difficulties maintaining social relationships. Moreover, a large body of evidence suggests poor social functioning is not only present in depression but that social functioning is an important factor in illness course and outcome. In addition, good social relationships can play a protective role against the onset of depressive symptoms, particularly in late-life depression. However, the majority of research in this area has employed self-report measures of social function. This approach is problematic, as due to their reliance on memory, such measures are prone to error from the neurocognitive impairments of depression, as well as mood-congruent biases. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Conclusions: The systematic review revealed many mixed findings between depression, anxiety, and SNS use. Methodology has predominantly focused on self-report cross-sectional approaches; future research will benefit from leveraging real-time SNS data over time. The evidence suggests that SNS use correlates with mental illness and well-being; however, whether this effect is beneficial or detrimental depends at least partly on the quality of social factors in the SNS environment. Understanding these relationships will lead to better utilization of SNSs in their potential to positively influence mental health.
This study investigated the long-term outcomes of internet-delivered cognitive behavior therapy (ICBT) for children with anxiety disorders, and potential pre-treatment predictors of treatment outcome. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Conclusions: This study supports the IntelliCare framework of providing a suite of skills-focused apps that can be used frequently and briefly to reduce symptoms of depression and anxiety. The IntelliCare system is elemental, allowing individual apps to be used or not used based on their effectiveness and utility, and it is eclectic, viewing treatment strategies as elements that can be applied as needed rather than adhering to a singular, overarching, theoretical model.
ABSTRACT FROM: Buntrock C, Ebert DD, Lehr D, et al. Effect of a web-based guided self-help intervention for prevention of major depression in adults with subthreshold depression: a randomized clinical trial. JAMA 2016;315:1854–63. To read the full article, log in using your NHS OpenAthens details.
The available treatments can only moderately reduce the enormous burden of disease associated with depression.1 Prevention of the transition from subthreshold depression to a full-blown disorder is therefore highly needed. Offering accessible and affordable preventive interventions at a large scale, such as web-based interventions, could be an indispensable strategy to reduce the global burden of depression. To read the full article, log in using your NHS OpenAthens details.
Computer-administered cognitive–behavioural therapy (CCBT) may be a promising treatment for adolescents with depression, particularly due to its increased availability and accessibility. The feasibility of delivering a randomised controlled trial (RCT) comparing a CCBT program (Stressbusters) with an attention control (self-help websites) for adolescent depression was evaluated. Open Access Article
Background: Computerized cognitive behavioral therapy (cCBT) is an acceptable and promising treatment modality for adolescents with mild-to-moderate depression. Many cCBT programs are standalone packages with no way for clinicians to monitor progress or outcomes. We sought to develop an electronic monitoring (e-monitoring) tool in consultation with clinicians and adolescents to allow clinicians to monitor mood, risk, and treatment adherence of adolescents completing a cCBT program called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts).
Journal of Consulting and Clinical Psychology85.4 (Apr 2017): 367-380.
Objective: To examine the effectiveness of an Internet intervention for depression with a randomized, controlled trial in a large sample of adults recruited from the United States. To read the full article, log in using your NHS OpenAthens details.
Editorial. Virtual reality can be more effective and less burdensome than real-life exposure. Optimal virtual reality delivery should incorporate in situ direct dialogues with a therapist, discourage safety behaviours, allow for a mismatch between virtual and real exposure tasks, and encourage self-directed real-life practice between and beyond virtual reality sessions. You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
People with social anxiety disorder (SAD) fear social interactions and may be reluctant to seek treatments involving exposure to social situations. Social exposure conducted in virtual reality (VR), embedded in individual cognitive–behavioural therapy (CBT), could be an answer. You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
In this meta-analysis of individual participant data from 3876 adults, internet-based cognitive behavioral therapy was more effective compared with controls. Adherence predicted better treatment outcomes within the experimental condition. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Conclusions: We provide new insights into the impact of prolonged participation in an online depression community and highlight the positive emotion change in members.
Conclusions: These results provide evidence that Web- and computer-based stress-management interventions can be effective and have the potential to reduce stress-related mental health problems on a large scale.
Conclusions: This review revealed that therapist-supported iCBT significantly improves stress, anxiety, and depressive symptoms among postpartum women with small to large effects. Future effectiveness studies should establish the essential components, format, and approach of iCBT with optimal levels of human support to maximize a long-term effect.
Computerised cognitive–behavioural therapy (cCBT) for depression has the potential to be efficient therapy but engagement is poor in primary care trials. You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Shape of change, sudden gains and depression spikes were examined in an online 12-session Behavioral Activation (BA) treatment for depression. Client and therapist factors related to sudden gains were examined to investigate processes associated with outcome. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Alcohol use disorders (AUDs) and mood disorders commonly co-occur, and are associated with a range of negative outcomes for patients. Mobile phone technology has the potential to provide personalised support for such patients and potentially improve outcomes in this difficult-to-treat cohort. The aim of this study is to examine whether receiving supporting SMS text messages, following discharge from an inpatient dual diagnosis treatment programme, has a positive impact on mood and alcohol abstinence in patients with an AUD and a comorbid mood disorder.
Open Access Article
Dave Steele explores a literature review that focuses on how wearable technology can be used to measure and support social functioning in older adults.
Conclusions: These findings suggest that in Web-based interventions outcome and adherence can be predicted by patterns of early change, which can inform treatment decisions and potentially help optimize the allocation of scarce clinical resources.
We’ve just heard that SSOTP will not be renewing their agreement with SSSFT LKS for library services for this financial year. Because of this we will be reviewing our Be Aware bulletins. Sadly we won’t be accepting any new sign-ups from SSOTP staff and will be withdrawing some of the physical healthcare bulletins that we…
The majority of patients with depressive disorders are treated by general practitioners (GPs) and are prescribed antidepressant medication. Patients prefer psychological treatments but they are under-used, mainly due to time constraints and limited accessibility. A promising approach to deliver psychological treatment is blended care, i.e. guided online treatment. However, the cost-effectiveness of blended care formatted as an online psychological treatment supported by the patients’ own GP or general practice mental health worker (MHW) in routine primary care is unknown. We aim to demonstrate non-inferiority of blended care compared with usual care in patients with depressive symptoms or a depressive disorder in general practice. Additionally, we will explore the real-time course over the day of emotions and affect, and events within individuals during treatment.
Conclusions: Adults in the community have a preference for Internet interventions with short modules that are tailored to individual needs. Individuals who are reluctant to seek face-to-face help may also avoid Internet interventions, suggesting that better implementation of existing Internet programs requires increasing acceptance of Internet interventions and identifying specific subgroups who may be resistant to seeking help.
Conclusions: Among those seeking support for their well-being via physical and mental health apps, people are using a variety of health apps. These people use health apps on a daily basis, especially free apps. The most common reason for using a health app is to track some health-related data; for mental health apps specifically, training or habit building was the most popular reason. Understanding the end user perspective is important because it allows us to build on the foundation of previously established mHealth research and may help guide future work in mHealth.
Conclusions: The Web-based intervention was effective in reducing depressive symptoms among adults with sickness absence. As this trial achieved a lower power than calculated, its results should be replicated in a larger sample.
This study aims to examine whether the effects of internet interventions for depression generalise to participants recruited in clinical settings.
Open Access Article
Internet interventions are effective in treating depressive symptoms but few studies conducted a long-term follow-up. The aim of this study was to test the effectiveness of an internet intervention in increasing the remission rate over a twelve months period. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Leicester city patients who experience mild depression, anxiety and stress are set to benefit from an online mental health service which aims to support them at the click of a button, 24 hours a day, 7 days a week and even on the go.
The new online programme called SilverCloud will now be offered as part of the Leicester City Open Mind service, delivered by the Trust and funded by Leicester City Clinical Commissioning Group (CCG). During the pilot in 2016/17 40 patients were referred into and successfully completed courses through the SilverCloud service.
This is a proof of concept study into what is often referred to as "machine learning", where sophisticated algorithms assess massive amounts of data to see if they can begin to spot patterns in the data that humans can't.
The researchers suggest social media could become a useful screening tool. But aside from whether the science stacks up, there are ethical and legal implications that would need to be considered before this could happen.
The aim of this systematic review is twofold: (1) to characterise the purpose and description of available social anxiety apps and (2) to review the evidence on the effectiveness of social anxiety apps. To read the full article, log in using your NHS OpenAthens details.
Objective: Our aim was to examine the technological and program delivery features of Internet-based CBT and IPT for adolescent depression and to document their potential relation to treatment outcomes and program use.
Objective: This study evaluated the applicability of Man Central, a new Web and mobile phone intervention for men with depression. The impact of the use of Man Central on depression, resilience, and work and social functioning was assessed.
Social anxiety disorder (SAD) can be effectively treated with internet-delivered cognitive behavioural therapy (ICBT), but studies on long-term cost minimisation from a healthcare provider perspective in comparison to an evidence-based control treatment of therapeutic equivalence are lacking. The objective of the study was to determine whether ICBT reduces healthcare costs and use of healthcare resources compared with cognitive behavioural group therapy (CBGT).
Open Access Article
Depression and anxiety are prevalent and under treated conditions that create enormous burden for the patient and the health system. Internet-delivered cognitive behavior therapy (ICBT) improves patient access to treatment by providing therapeutic information via the Internet, presented in sequential lessons, accompanied by brief weekly therapist support. While there is growing research supporting ICBT, use of ICBT within community mental health clinics is limited. In a recent trial, an external unit specializing in ICBT facilitated use of ICBT in community mental health clinics in one Canadian province (ISRCTN42729166; registered November 5, 2013). Patient outcomes were very promising and uptake was encouraging. This paper reports on a parallel process evaluation designed to understand facilitators and barriers impacting the uptake and implementation of ICBT.
Head to Head. It could raise awareness to improve identification and treatment of depression, says Ken Duckworth, but Simon Gilbody worries that screening for depression is not recommended because it could cause harm.
To read the full article, log in using your NHS OpenAthens details.
Psychiatric Rehabilitation Journal40.3(Sep 2017): 320-324.
Objective: This article evaluates the potential of smartphone audio data to monitor individuals recovering from mood disorders. To read the full article, log in using your NHS OpenAthens details.
The authors evaluated the efficacy and durability of a therapist-supported method for computer-assisted cognitive-behavioral therapy (CCBT) in comparison to standard cognitive-behavioral therapy (CBT). Login at top right hand side of page using your SSSFT NHS OpenAthens for full text.
Open access. Major depressive disorder is characterised by low mood and poor motivation. Literature suggests that increased physical activity has positive effects on alleviating depression. Fitness-tracking devices may complement behavioural activation (BA) therapy to improve physical activity and mental health in patients with depression.
Commentary on: Rollman BL, Belnap BH, Mazumdar S, et al. Telephone-delivered stepped collaborative care for treating anxiety in primary care: a randomized controlled trial. J Gen Intern Med 2017;32:245–55.
Implications for practice and research
Telephone-based stepped collaborative care yields lasting improvements in anxiety and mood for primary care patients with generalised anxiety disorder and/or panic disorder.
Research is needed to determine which collaborative care intervention components are most beneficial to which subgroups of patients.
To read the full article, log in using your NHS OpenAthens details.
Letters. Duckworth and Gilbody debate whether Google should offer an online screening test for depression—namely, the patient health questionnaire 9 (PHQ-9).
As the website Patient points out, PHQ-9 “is not a screening tool for depression, but it is used to monitor the severity of depression and response to treatment. However, it can be used to make a tentative diagnosis of depression in at risk populations, such as those with coronary heart disease or after stroke.” Using PHQ-9 as an online screening tool is highly inappropriate.
To read the full article, log in using your NHS OpenAthens details.
There are many effective psychological therapies to help teenagers with depression, anxiety or other mental health problems. Unfortunately, for various reasons, most teenagers never get access to a professional therapist. To overcome this problem, some researchers are exploring the potential of brief, “single-session” interventions that can be delivered cheaply and easily to many at-risk teenagers outside of a clinical context. In The Journal of Child Psychology and Psychiatry, Jessica Schleider and John Weisz at Harvard University present extremely promising results from their trial of a 30-minute computer session teaching depressed and anxious teenagers that personality is malleable.
Depression is a complex and burdensome condition; it often leads to personal, societal and economic costs. Despite advances in treatments, its management over time remains a challenge; many treated for depression do not achieve full recovery or remain well for long. Novel ways to monitor patients are warranted, as well as better understanding of contributors to relapse or sustained wellness. Mobile health technologies (m-Health) are emerging as useful tools for real-time assessments of moods, behaviours and activities in a more convenient and less burdensome manner. Yet, there are numerous questions around privacy, reliability and accuracy of data collected via mobile apps. This review provides a critical overview of advances in m-Health and evaluate the future potential of smartphone technology in the assessment and treatment of depression. . SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Lisa Burscheidt on a school-based RCT of an online CBT intervention (SPARX-R) for preventing depression in final year secondary school students in Australia
Journal of Consulting and Clinical Psychology Vol. 86, Iss. 6, (Jun 2018): 493-504.
Objective: Internet-based cognitive–behavioral treatments (ICBT) have shown promise for various mental disorders, including social anxiety disorder (SAD). Most of these treatments have been delivered on desktop computers. However, the use of smartphones is becoming ubiquitous and could extend the reach of ICBT into users’ everyday life. Only a few studies have empirically examined the efficacy of ICBT delivered through a smartphone app and there is no published study on mobile app delivered ICBT for SAD. This three-arm randomized-controlled trial (RCT) is the first to compare the efficacy of guided ICBT for smartphones (app) and conventional computers (PC) with a wait list control group (WL).. To read the full article, log in using your NHS OpenAthens details.
A new web-based “feedback” technology which allows therapists to accurately monitor how patients with depression are coping has been found to reduce the probability of deterioration during psychological treatment by 74%, a new study has found.
Sarah Knowles on a next-generation social media-based relapse prevention intervention for youth depression, explored in an Australian qualitative study.
Conclusions: Acceptability of eMental healthcare technology is high among users and is the most commonly investigated implementation outcome. Perceptions of the appropriateness and adoption of eMental healthcare technology were varied
Big increase in demand for mental health apps and new web-based 'feedback technology' makes it easier for healthcare professionals to spot deterioration in depression more quickly
Depression is the leading cause of life years lost due to disability. Appropriate prevention has the potential to reduce the incidence of new cases of depression, however, traditional prevention approaches face significant scalability issues. Prevention programmes delivered by via smartphone applications provide a potential solution.
Open Access Article
In order to realise the potential of internet interventions, we need to develop an evidence base supporting the efficacy of internet interventions for co-occurring depression and hazardous alcohol use without any therapist involvement. This study aims to evaluate the effects on drinking, and on depressive symptoms, of combining an internet intervention targeting hazardous alcohol consumption with one for depression. Open Access Article
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Despite the growing number of mental health apps available for smartphones, the perceived usability of these apps from the perspectives of end users or health care experts has rarely been reported. This information is vital, particularly for self-guided mHealth interventions, as perceptions of navigability and quality of content are likely to impact participant engagement and treatment compliance.
Anxiety levels among all monitoring users were markedly reduced in the first few days of usage with some bounce back effect thereafter. A small group of users demonstrated long-term anxiety reduction (using a robust measure), typically monitored for 12-110 days, with 10-30 discrete updates and showed low levels of social participation
Psychological Services (Nov 8, 2018). DOI:10.1037/ser0000261
Depression is common in primary care settings, but barriers prevent many primary care patients from initiating treatment. Smartphone apps stand as a possible means to overcome such barriers. However, there is limited evidence to understand the use and efficacy of these apps. The purpose of the current study was to pilot an evaluation of the usage and efficacy of apps for depression based upon behavioral or cognitive intervention skills, compared to a wait-list control.. To read the full article, log in using your MPFT NHS OpenAthens details.
Psychotherapy is a complex intervention, consisting of various components and being implemented flexibly in consideration of individual patient’s characteristics. It is then of utmost importance to know which of the various components or combinations thereof are more efficacious, what their specific effect sizes are and which types of patients may benefit more from different components or their combinations. Open Access Article
Although evidence exists for the efficacy of psychosocial interventions in preventing depression, little is known about its prevention through online interventions. The objective of this study is to conduct a systematic review and meta-analysis of randomised controlled trials assessing the effectiveness of online interventions in preventing depression in heterogeneous populations. Open Access Article
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Conclusions: This study offers evidence that AI can serve as a cost-effective and accessible therapeutic agent. Although not designed to appropriate the role of a trained therapist, integrative psychological AI emerges as a feasible option for delivering support.
Conclusions: The results suggest that adding M-CT to TAU is not effective and cost effective compared to TAU alone. Adherence rates were similar to other studies and therefore do not explain this finding. The participants scarcely booked additional therapist support, resulting in 17.3 minutes of mean total therapist support. More studies are needed to examine the cost effectiveness of internet-based interventions with respect to long-term outcomes and the role and optimal dosage of therapist support. Overall, more research is needed on scalable and cost-effective interventions that can reduce the burden of recurrent MDD.
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