scholarly journals CBT-I Coach: A Description and Clinician Perceptions of a Mobile App for Cognitive Behavioral Therapy for Insomnia

2016 ◽  
Vol 12 (04) ◽  
pp. 597-606 ◽  
Author(s):  
Eric Kuhn ◽  
Brandon J. Weiss ◽  
Katherine L. Taylor ◽  
Julia E. Hoffman ◽  
Kelly M. Ramsey ◽  
...  
2021 ◽  
Author(s):  
Erin Dawna Reilly ◽  
Stephanie A Robinson ◽  
Beth Ann Petrakis ◽  
Melissa M Gardner ◽  
Renda Soylemez Wiener ◽  
...  

BACKGROUND Insomnia is a prevalent and debilitating disorder among veterans. Cognitive behavioral therapy for insomnia (CBTI) can be effective for treating insomnia, although many cannot access this care. Technology-based solutions and lifestyle changes, such as physical activity (PA), offer affordable and accessible self-management alternatives to in-person CBTI. OBJECTIVE This study aims to extend and replicate prior pilot work to examine whether the use of a mobile app for CBTI (cognitive behavioral therapy for insomnia coach app [CBT-i Coach]) improves subjective and objective sleep outcomes. This study also aims to investigate whether the use of the CBT-i Coach app with adjunctive PA improves sleep outcomes more than CBT-i Coach alone. METHODS A total of 33 veterans (mean age 37.61 years, SD 9.35 years) reporting chronic insomnia were randomized to use either the CBT-i Coach app alone or the CBT-i Coach app with a PA intervention over 6 weeks, with outcome measures of objective and subjective sleep at pre- and posttreatment. RESULTS Although the PA manipulation was unsuccessful, both groups of veterans using the CBT-i Coach app showed significant improvement from baseline to postintervention on insomnia (<i>P</i>&lt;.001), sleep quality (<i>P</i>&lt;.001), and functional sleep outcomes (<i>P</i>=.002). Improvements in subjective sleep outcomes were similar in those with and without posttraumatic stress disorder and mild-to-moderate sleep apnea. We also observed a significant but modest increase in objective sleep efficiency (<i>P</i>=.02). CONCLUSIONS These findings suggest that the use of a mobile app–delivered CBTI is feasible and beneficial for improving sleep outcomes in veterans with insomnia, including those with comorbid conditions such as posttraumatic stress disorder or mild-to-moderate sleep apnea. CLINICALTRIAL ClinicalTrials.gov NCT03305354; https://clinicaltrials.gov/ct2/show/NCT03305354


2021 ◽  
Author(s):  
Bokyoung Shin ◽  
Jooyoung Oh ◽  
Byung-Hoon Kim ◽  
Hesun Erin Kim ◽  
Hyunji Kim ◽  
...  

BACKGROUND Virtual reality (VR) is an effective technique as a traditional cognitive behavioral therapy (CBT) and a promising tool for treating panic disorder (PD) symptoms because VR exposure can be safer, with higher acceptability, than in vivo exposure; it is more immersive than exposure through imagination. CBT techniques can be delivered more effectively using VR. Thus far, VR has required high quality devices; however, the development of mobile VR technology has improved users' availability. Meanwhile, a well-structured form of VR can be reproduced and used anywhere, which means that VR is appropriate for self–guided treatment to address the high-treatment costs of evidence–based therapy and the lack of professional therapists. This study investigates the potential of self-guided VR as an alternative to high-cost treatment. OBJECTIVE The study’s main goal is to offer data about the efficacy of the mobile app–based self-led VR CBT in the treatment of PD. METHODS 54 subjects with PD were enrolled and randomly assigned to either the VR treatment group or waitlist group. The VR treatment was designed for a total of 12 sessions in 4 weeks. The VR comprises 4 steps in which patients are gradually exposed to phobic stimuli while learning to cope with panic symptoms. The effectiveness of the treatment was assessed through the PD Severity Scale (PDSS), the Hamilton Rating Scale for Depression (HRSD), the body sensation questionnaire (BSQ), the Albany Panic and Phobia Questionnaire (APPQ), the Anxiety Sensitivity Index (ASI), the state-trait anxiety inventory (STAI), the hospital anxiety and depression scale (HADS), the social avoidance and distress scale (K-SAD), the inventory for depressive symptomatology self-report (KIDS-SR), and the perceived stress scale, (PSS). Additionally, physiological changes using heart rate variability (HRV) were evaluated. RESULTS In total, 40 subjects (20 VR treatment and 20 waitlist patients) were included in the final analysis. For the PDSS scores, the main time (F_1,39 = 20.76, P < 0.01, η_p^2 = 0.09) and group-by-time interaction (F_1,39 = 10.59, P < 0.01, η_p^2 = 0.04) effects were significant. The post-hoc tests showed that the PDSS scores decreased significantly in the VR group (t_37 = 2.68; P = 0.01), but not in the waitlist group. The group-by-time interaction effect on the HADS total scores (F_1,39 = 5.51, P = 0.02, η_p^2 = 0.01) was significant, as was the main time effect on the STAI_total (F_1,39 = 4.32; P = 0.04) and STAI_S (F_1,39 = 6.00; P = 0.01) scores; however, there were no statistically significant between-group differences on the other scales. CONCLUSIONS The self-guided, mobile app–based VR was effective in treating panic symptoms and helped restore the autonomic nervous system, demonstrating the validity of VR for self-guided treatment and its cost-effective therapeutic approach.


10.2196/29573 ◽  
2021 ◽  
Vol 5 (12) ◽  
pp. e29573
Author(s):  
Erin Dawna Reilly ◽  
Stephanie A Robinson ◽  
Beth Ann Petrakis ◽  
Melissa M Gardner ◽  
Renda Soylemez Wiener ◽  
...  

Background Insomnia is a prevalent and debilitating disorder among veterans. Cognitive behavioral therapy for insomnia (CBTI) can be effective for treating insomnia, although many cannot access this care. Technology-based solutions and lifestyle changes, such as physical activity (PA), offer affordable and accessible self-management alternatives to in-person CBTI. Objective This study aims to extend and replicate prior pilot work to examine whether the use of a mobile app for CBTI (cognitive behavioral therapy for insomnia coach app [CBT-i Coach]) improves subjective and objective sleep outcomes. This study also aims to investigate whether the use of the CBT-i Coach app with adjunctive PA improves sleep outcomes more than CBT-i Coach alone. Methods A total of 33 veterans (mean age 37.61 years, SD 9.35 years) reporting chronic insomnia were randomized to use either the CBT-i Coach app alone or the CBT-i Coach app with a PA intervention over 6 weeks, with outcome measures of objective and subjective sleep at pre- and posttreatment. Results Although the PA manipulation was unsuccessful, both groups of veterans using the CBT-i Coach app showed significant improvement from baseline to postintervention on insomnia (P<.001), sleep quality (P<.001), and functional sleep outcomes (P=.002). Improvements in subjective sleep outcomes were similar in those with and without posttraumatic stress disorder and mild-to-moderate sleep apnea. We also observed a significant but modest increase in objective sleep efficiency (P=.02). Conclusions These findings suggest that the use of a mobile app–delivered CBTI is feasible and beneficial for improving sleep outcomes in veterans with insomnia, including those with comorbid conditions such as posttraumatic stress disorder or mild-to-moderate sleep apnea. Trial Registration ClinicalTrials.gov NCT03305354; https://clinicaltrials.gov/ct2/show/NCT03305354


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Mutsuhiro Nakao ◽  
Kentaro Shirotsuki ◽  
Nagisa Sugaya

AbstractCognitive–behavioral therapy (CBT) helps individuals to eliminate avoidant and safety-seeking behaviors that prevent self-correction of faulty beliefs, thereby facilitating stress management to reduce stress-related disorders and enhance mental health. The present review evaluated the effectiveness of CBT in stressful conditions among clinical and general populations, and identified recent advances in CBT-related techniques. A search of the literature for studies conducted during 1987–2021 identified 345 articles relating to biopsychosocial medicine; 154 (45%) were review articles, including 14 systemic reviews, and 53 (15%) were clinical trials including 45 randomized controlled trials. The results of several randomized controlled trials indicated that CBT was effective for a variety of mental problems (e.g., anxiety disorder, attention deficit hypersensitivity disorder, bulimia nervosa, depression, hypochondriasis), physical conditions (e.g., chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, breast cancer), and behavioral problems (e.g., antisocial behaviors, drug abuse, gambling, overweight, smoking), at least in the short term; more follow-up observations are needed to assess the long-term effects of CBT. Mental and physical problems can likely be managed effectively with online CBT or self-help CBT using a mobile app, but these should be applied with care, considering their cost-effectiveness and applicability to a given population.


2019 ◽  
Author(s):  
Saptarshi Purkayastha ◽  
Siva Abhishek Addepally ◽  
Sherri Bucher

BACKGROUND Recent evidence in mobile health has demonstrated that, in some cases, apps are an effective way to improve health care delivery. Health care interventions delivered via mobile technology have demonstrated both practicality and affordability. Lately, cognitive behavioral therapy (CBT) interventions delivered over the internet have also shown a meaningful impact on patients with anxiety and depression. OBJECTIVE Given the growing proliferation of smartphones and the trust in apps to support improved health behaviors and outcomes, we were interested in comparing a mobile app with Web-based methods for the delivery of CBT. This study aimed to compare the usability of a CBT mobile app called MoodTrainer with an evidence-based website called MoodGYM. METHODS We used convenience sampling to recruit 30 students from a large Midwestern university and randomly assigned them to either the MoodGYM or MoodTrainer user group. The trial period ran for 2 weeks, after which the students completed a self-assessment survey based on Nielsen heuristics. Statistical analysis was performed to compare the survey results from the 2 groups. We also compared the number of modules attempted or completed and the time spent on CBT strategies. RESULTS The results indicate that the MoodTrainer app received a higher usability score when compared with MoodGYM. Overall, 87% (13/15) of the participants felt that it was easy to navigate through the MoodTrainer app compared with 80% (12/15) of the MoodGYM participants. All MoodTrainer participants agreed that the app was easy to use and did not require any external assistance, whereas only 67% (10/15) had the same opinion for MoodGYM. Furthermore, 67% (10/15) of the MoodTrainer participants found that the navigation controls were easy to locate compared with 80% (12/15) of the MoodGYM participants. MoodTrainer users, on average, completed 2.5 modules compared with 1 module completed by MoodGYM users. CONCLUSIONS As among the first studies to directly compare the usability of a mobile app–based CBT with smartphone-specific features against a Web-based CBT, there is an opportunity for app-based CBT as, at least in our limited trial, it was more usable and engaging. The study was limited to evaluate usability only and not the clinical effectiveness of the app.


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