scholarly journals Understanding eHealth Cognitive-Behavioural Therapy Targeting Sub-stance Use: A Realist Review (Preprint)

2020 ◽  
Author(s):  
Farhud Shams ◽  
James S.H. Wong ◽  
Mohammadali Nikoo ◽  
Ava Outadi ◽  
Ehsan Moazen-Zadeh ◽  
...  
Keyword(s):  
Substance Use ◽  
Cognitive Behavioural Therapy ◽  
Literature Search ◽  
Data Extraction ◽  
Realist Review ◽  
Behavioural Therapy ◽  
Future Research ◽  
Qualitative Evidence ◽  
Cognitive Behavioural ◽  
Growing Body

BACKGROUND There is a growing body of evidence on eHealth interventions that are targeting substance use disorders. Development and decision-making in eHealth has been challenging due to the lack of understanding of how programs work effectively. OBJECTIVE We conducted a realist review on literature of Electronic Health Cognitive-behavioural Therapy (eCBT) programs for substance use with the goal of answering the following realist question: “how do different eCBT interventions for substance use interact with different contexts to pro-duce certain outcomes?” METHODS A literature search of published and gray literature of all eHealth programs targeting substance use was conducted. After data extraction, the scope was refined to only include literature fo-cusing on eCBT programs targeting substance use. We synthesized the available qualitative evidence from the literature into Context-Mechanism-Outcome configurations in order to bet-ter understand when and how programs work. RESULTS A total of 54 papers studying 24 programs were reviewed. Our final results identified 8 Con-text-Mechanism-Outcome configurations from 5 unique programs that met criteria for rele-vance and rigor. CONCLUSIONS 5 strategies that may be applied in future eCBT programs for substance use are discussed and may contribute to a better understanding of mechanisms and ultimately help design more ef-fective solutions in the future. Future research on eHealth CBT programs should try and under-stand mechanisms of program strategies and how they lead to outcomes in different contexts.

scholarly journals Understanding eHealth Cognitive-Behavioural Therapy Targeting Substance Use: A Realist Review (Preprint)

10.2196/20557 ◽  
2020 ◽  
Author(s):  
Farhud Shams ◽  
James S.H. Wong ◽  
Mohammadali Nikoo ◽  
Ava Outadi ◽  
Ehsan Moazen-Zadeh ◽  
...  
Keyword(s):  
Substance Use ◽  
Cognitive Behavioural Therapy ◽  
Realist Review ◽  
Behavioural Therapy ◽  
Cognitive Behavioural

scholarly journals The impact of interventions for youth experiencing homelessness on housing, mental health, substance use, and family cohesion: a systematic review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jean Zhuo Wang ◽  
Sebastian Mott ◽  
Olivia Magwood ◽  
Christine Mathew ◽  
Andrew Mclellan ◽  
...  
Keyword(s):  
Substance Use ◽  
Randomized Controlled Trials ◽  
Cognitive Behavioural Therapy ◽  
Systematic Reviews ◽  
Behavioural Therapy ◽  
Controlled Trials ◽  
Housing Stability ◽  
Randomized Controlled ◽  
Cognitive Behavioural ◽  
Family Based

Abstract Background Youth often experience unique pathways into homelessness, such as family conflict, child abuse and neglect. Most research has focused on adult homeless populations, yet youth have specific needs that require adapted interventions. This review aims to synthesize evidence on interventions for youth and assess their impacts on health, social, and equity outcomes. Methods We systematically searched Medline, Embase, PsycINFO, and other databases from inception until February 9, 2018 for systematic reviews and randomized controlled trials on youth interventions conducted in high income countries. We screened title and abstract and full text for inclusion, and data extraction were completed in duplicate, following the PRISMA-E (equity) review approach. Results Our search identified 11,936 records. Four systematic reviews and 18 articles on randomized controlled trials met the inclusion criteria. Many studies reported on interventions including individual and family therapies, skill-building, case management, and structural interventions. Cognitive behavioural therapy led to improvements in depression and substance use, and studies of three family-based therapies reported decreases in substance use. Housing first, a structural intervention, led to improvements in housing stability. Many interventions showed inconsistent results compared to services as usual or other interventions, but often led to improvements over time in both the intervention and comparison group. The equity analysis showed that equity variables were inconsistently measured, but there was data to suggest differential outcomes based upon gender and ethnicity. Conclusions This review identified a variety of interventions for youth experiencing homelessness. Promising interventions include cognitive behavioural therapy for addressing depression, family-based therapy for substance use outcomes, and housing programs for housing stability. Youth pathways are often unique and thus prevention and treatment may benefit from a tailored and flexible approach.

scholarly journals A Pragmatic Pilot Study Of Cognitive Behavioural Therapy For Insomnia Among People Living With HIV

2021 ◽  
Author(s):  
Tyler Gordon Tulloch
Keyword(s):  
Pilot Study ◽  
Sleep Disturbance ◽  
Cognitive Behavioural Therapy ◽  
Thematic Analysis ◽  
Behavioural Therapy ◽  
Future Research ◽  
People Living With Hiv ◽  
Cognitive Behavioural ◽  
Living With Hiv ◽  
Insomnia Severity

The prevalence of insomnia among people living with HIV (PWH) is considerably higher than in the general population. Cognitive, behavioural, and biopsychosocial explanations for this elevated prevalence have been proposed, but there is a lack of consensus in the literature. Sleep disturbance is associated with disrupted immune functioning at the cellular level and increased risk of contracting infectious diseases; therefore, insomnia may be particularly problematic for PWH. Cognitive behavioural therapy for insomnia (CBT-I) is the first-line treatment for insomnia, and is effective at treating insomnia among individuals with comorbid medical disorders. Surprisingly, no study has examined its efficacy among PWH. This pragmatic pilot study examined features of insomnia among 48 PWH and was the first study to examine sleep disturbance among PWH using American Academy of Sleep Medicine guidelines for evaluating chronic insomnia. On average, insomnia chronicity was 8.2 years and was of moderate severity. Psychiatric comorbidity was common, as were comorbid sleep disorders. Insomnia severity was associated with psychosocial variables including sleep effort, self-efficacy for sleep, depression, anxiety, stress, and social functioning-related quality of life. This study was also the first to examine safety, feasibility, acceptability, and intervention effects of CBT-I. These were examined among a subsample of 10 PWH using single-case interrupted time-series design. Thematic analysis was used to explore participant perceptions of CBT-I. Large effect sizes were observed for improvement in insomnia severity, sleep efficiency, and total wake time. Reliable and clinically significant reduction in insomnia severity was observed for all but one participant, and half met criteria for insomnia remission. Overall, CBT-I was an efficacious treatment for insomnia, and participant feedback was consistent with quantitative results. Participants viewed CBT-I as a safe and acceptable treatment for insomnia. Participant feedback identified preexisting needs, positive impacts and challenges of CBT-I, perceived mechanisms of change, and suggested modifications to tailor CBT-I for PWH. Given this preliminary support for the efficacy of CBT-I among PWH, future research should seek to demonstrate generalizability of these effects. Partnering with HIV community organizations may be important next step in conducting future research and increasing accessibility of CBT-I to PWH. Keywords: HIV, insomnia, cognitive behavioural therapy, pilot study, pragmatic trial, thematic analysis

scholarly journals O005 Cognitive behavioural therapy and light dark therapy for postpartum insomnia symptoms: a randomised controlled trial

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A2-A3
Author(s):  
S Verma ◽  
N Quin ◽  
L Astbury ◽  
C Wellecke ◽  
J Wiley ◽  
...  
Keyword(s):  
Sleep Disturbance ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Future Research ◽  
Depression And Anxiety ◽  
Post Intervention ◽  
Cognitive Behavioural ◽  
Randomised Controlled ◽  
Insomnia Symptoms

Abstract Introduction Symptoms of postpartum insomnia are common however interventions remain scarce. Cognitive Behavioural Therapy (CBT) and Light Dark Therapy (LDT) target distinct mechanisms to improve sleep. This randomised controlled superiority trial compared CBT and LDT against treatment-as-usual (TAU) in reducing maternal postpartum insomnia symptoms. Methods Nulliparous females 4–12 months postpartum with self-reported symptoms of insomnia (Insomnia Severity Index scores >7) were included; excluded were those at risk or with high medical/psychiatric needs. Eligible participants were randomised 1:1:1 to 6 weeks of CBT, LDT (gaining light upon awakening, night-time light avoidance) or TAU. Interventions were therapist-assisted through two telephone calls and included automated self-help emails over six weeks. Symptoms of insomnia (ISI; primary outcome), sleep disturbance, fatigue, sleepiness, depression, and anxiety were assessed at baseline, mid-intervention, post-intervention, and 1-month post-intervention. Latent growth models were used. Results 114 participants (mean age=32.2±4.6 years) were randomised. There were significantly greater reductions in insomnia and sleep disturbance in both intervention groups with very large effect sizes (d>1·4, p<0·0001) from baseline to post-intervention compared to TAU; improvements were maintained at one-month follow-up. There were greater reductions in fatigue symptoms in the CBT group (d=0.85, p<.0001) but not LDT (p=0.11) compared to TAU; gains were maintained for CBT at follow-up. Changes in sleepiness, depression and anxiety over time were non-significant compared to TAU (p-values>0.08). Conclusion Therapist-assisted CBT and LDT are both efficacious for reducing postpartum insomnia symptoms. Findings were mixed for fatigue, sleepiness and mood. Future research is needed on predictors of treatment response.

scholarly journals Evaluating the Outcomes of Transactional Analysis and Integrative Counselling Psychology within UK Primary Care Settings

2011 ◽  
Vol 2 (2) ◽  
Author(s):  
Biljana Van Rijn ◽  
Ciara Wild ◽  
Patricia Moran
Keyword(s):  
Primary Care ◽  
Working Alliance ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Future Research ◽  
Transactional Analysis ◽  
Psychological Therapies ◽  
Cognitive Behavioural ◽  
Uk National Health Service ◽  
Counselling Psychology

The paper reports on a naturalistic study that replicated the evaluative design associated with the UK National Health Service initiative IAPT − Improving Access to Psychological Therapies (CSIP 2008, NHS 2011), as previously used to assess Cognitive Behavioural Therapy (CBT), with the aim of evaluating 12-session treatments for anxiety and depression, applying Transactional Analysis and Integrative Counselling Psychology approaches within real clinical settings in primary care. Standard outcome measures were used in line with the IAPT model (CORE 10 and 34, GAD-7, PHQ-9), supplemented with measurement of the working alliance (WAI Horvath 1986) and an additional depression inventory BDI-II (Beck, 1996), and ad-herence to the therapeutic model using newly designed questionnaires. Results indicated that severity of problems was reduced using either approach, comparative to Cognitive Behavioural Therapy; that initial severity was predictive of outcome; and that working alliance increased as therapy progressed but was not directly related to outcomes. Adherence was high for both approaches. Several areas for enhance-ments to future research are suggested.

scholarly journals A Pragmatic Pilot Study Of Cognitive Behavioural Therapy For Insomnia Among People Living With HIV

2021 ◽  
Author(s):  
Tyler Gordon Tulloch
Keyword(s):  
Pilot Study ◽  
Sleep Disturbance ◽  
Cognitive Behavioural Therapy ◽  
Thematic Analysis ◽  
Behavioural Therapy ◽  
Future Research ◽  
People Living With Hiv ◽  
Cognitive Behavioural ◽  
Living With Hiv ◽  
Insomnia Severity

The prevalence of insomnia among people living with HIV (PWH) is considerably higher than in the general population. Cognitive, behavioural, and biopsychosocial explanations for this elevated prevalence have been proposed, but there is a lack of consensus in the literature. Sleep disturbance is associated with disrupted immune functioning at the cellular level and increased risk of contracting infectious diseases; therefore, insomnia may be particularly problematic for PWH. Cognitive behavioural therapy for insomnia (CBT-I) is the first-line treatment for insomnia, and is effective at treating insomnia among individuals with comorbid medical disorders. Surprisingly, no study has examined its efficacy among PWH. This pragmatic pilot study examined features of insomnia among 48 PWH and was the first study to examine sleep disturbance among PWH using American Academy of Sleep Medicine guidelines for evaluating chronic insomnia. On average, insomnia chronicity was 8.2 years and was of moderate severity. Psychiatric comorbidity was common, as were comorbid sleep disorders. Insomnia severity was associated with psychosocial variables including sleep effort, self-efficacy for sleep, depression, anxiety, stress, and social functioning-related quality of life. This study was also the first to examine safety, feasibility, acceptability, and intervention effects of CBT-I. These were examined among a subsample of 10 PWH using single-case interrupted time-series design. Thematic analysis was used to explore participant perceptions of CBT-I. Large effect sizes were observed for improvement in insomnia severity, sleep efficiency, and total wake time. Reliable and clinically significant reduction in insomnia severity was observed for all but one participant, and half met criteria for insomnia remission. Overall, CBT-I was an efficacious treatment for insomnia, and participant feedback was consistent with quantitative results. Participants viewed CBT-I as a safe and acceptable treatment for insomnia. Participant feedback identified preexisting needs, positive impacts and challenges of CBT-I, perceived mechanisms of change, and suggested modifications to tailor CBT-I for PWH. Given this preliminary support for the efficacy of CBT-I among PWH, future research should seek to demonstrate generalizability of these effects. Partnering with HIV community organizations may be important next step in conducting future research and increasing accessibility of CBT-I to PWH. Keywords: HIV, insomnia, cognitive behavioural therapy, pilot study, pragmatic trial, thematic analysis

scholarly journals Socialization to the model in adolescent cognitive behavioural therapy: measurement and insights

2017 ◽  
Vol 10 ◽  
Author(s):  
Gerwyn Mahoney-Davies ◽  
Cara Roberts-Collins ◽  
Ailsa Russell ◽  
Maria Loades
Keyword(s):  
Young People ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Future Research ◽  
The Novel ◽  
Subjective Ratings ◽  
Limited Evidence ◽  
Behavioural Model ◽  
Cognitive Behavioural ◽  
Clinician Rating

AbstractSocializing a client to the cognitive behavioural model is advised in almost every cognitive behavioural therapy (CBT) textbook, but there is limited evidence for whether socialization is measurable or important. The aim of the study was to pilot a written and interview-based measure of socialization to investigate whether socialization to the model can be measured in a sample of young people who have completed CBT. Sixteen participants (mean age 14.9 years, 75% female) completed a semi-structured socialization interview and a novel written measure of socialization. Treating clinicians were asked to provide subjective ratings of participant socialization. The structure and content of these measures was examined. A moderate but non-significant correlation was found between the novel written measure of socialization and clinician rating of socialization (r = .37). The concept of ‘socialization’ is not well understood and the socialization interview presented mixed, unclear results. This may be due to issues with the design, but may also be that socialization, as currently understood, is more complex than can be captured in this way. The important aspect of this study is introducing the concept of measuring socialization and factors that may be important in future research. Socialization to the model is an important construct within CBT but at present is a challenging concept to measure. Future research will need to focus on operationalizing the concept further and refining measures so that it can be accurately captured. Understanding which therapist and client behaviours contribute to the process of socialization could conceivably improve outcomes, but this cannot be done until this area is understood more fully.

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