Cognitive Behavioral Therapy delivered online can be a cost-effective solution that allows previously ignored communities access therapy. Hence, it should be considered a viable and default alternative to current forms of talk-therapy.
Cognitive behavioural therapy (CBT) is a widely used treatment for depression. However, limited resource availability poses several barriers to patients seeking access to care, including lengthy wait times and geographical limitations. This has prompted health care services to introduce electronically delivered CBT (eCBT) to facilitate access.
Upon analysing 17 studies in this paper, the authors found eCBT to be slightly more effective in reducing depressive symptom severity than face-to-face CBT, with no noticeable difference in the satisfaction of participants.
Although the authors found eCBT to have moderate evidence of effectiveness in reducing symptoms of depression, high heterogeneity among studies precludes definitive conclusions for all outcomes. With the current reliance and accessibility of technology to increasing number of people worldwide, serious consideration in utilizing technology should be given to maximize accessibility for depression treatments. Results found eCBT is at least as effective as face to face CBT, thus eCBT should be offered if preferred by patients and therapists.
The purpose of this study was to assess differences in negative consequences resulting from pandemic-related school closures between autistic and neurotypical children. We predicted that more negative consequences overall would be reported for children with autism compared to neurotypical children. We also expected to observe differences in the types of stressors reported between these two groups, with disruptions to daily routines more commonly reported for children with autism and stress due to social isolation more commonly reported for neurotypical children. Participants were parents of school-aged children, ages of 4–15 years old, who responded to an online survey (N = 250). Parental perspectives were collected using the Covid-19 Adolescent Symptom and Psychological Experience Questionnaire (CASPE). Parents in the autism group were additionally asked to respond to a survey about autism-specific stressors which may have increased during the pandemic, such as behavioral concerns, therapy disruptions, and hygiene issues. The majority of the respondents (65%) were parents of children with autism and 35% were parents of neurotypical children. Parents of autistic children were more likely to report that their child was negatively affected by routine changes, whereas parents of neurotypical children were more likely to report that their child was affected by social isolation. Overall, parents of children with autism were more than three times as likely to report negative changes in their child compared to parents of neurotypical children. When asked about autism-specific stressors, parents of autistic children reported concerns related to hygiene, behavioral regression, therapy disruption, meltdowns, and returning to school. The effects of the COVID-19 pandemic and prolonged school closures have disrupted the lives of children. Our results indicate that children with autism are at greater risk for negative outcomes due to emergency-related school disruptions. These findings have implications for educational planning for this vulnerable population for future public health crises.
This study aimed to examine research findings related to depression, anxiety, stress, and insomnia during the COVID-19 pandemic. This study also explored periodic changes in the prevalence of depression, anxiety, stress, and insomnia among the general people during this pandemic. We performed a meta-analysis by searching articles from several sources (PubMed, MEDLINE, and Google Scholar). We used the random-effects models, subgroup analysis, and heterogeneity test approaches. Results show that the prevalence of depression, stress, and insomnia increased during March to April 2020 (30.51%, 29.4%, and 25%, respectively) compared to the study period before February 2020 (25.25%, 16.27%, and 22.63%, respectively) and followed in May to June 2020 (16.47%, 5.1%, and 19.86, respectively). The prevalence of depression and anxiety from k = 30 studies was 28.18% (95% CI: 23.81–32.54) and 29.57% (95% CI: 24.67–34.47), respectively. And the prevalence of stress (k = 13) was 25.18% (95% CI: 14.82–35.54), and the prevalence of insomnia (k = 12) was 23.50% (95% CI: 16.44–30.57). These prevalence estimates during the pandemic are very high compared to normal times. Hence, the governments and policymakers should apply proven strategies and interventions to avoid psychological adversity and improve overall mental health during the COVID-19 pandemic.
This article has two objectives.
The first is to provide a culturally sensitive perspective to treatment outcome research as a resource to augment the ecological validity of treatment research. The relationships between external validity, ecological validity, and culturally sensitive research are reviewed.
The second objective is to present a preliminary framework for culturally sensitive interventions that strengthen ecological validity for treatment outcome research.
The framework, consisting of eight dimensions of treatment interventions (language, persons, metaphors, content, concepts, goals, methods, and context) can serve as a guide for developing culturally sensitive treatments and adapting existing psychosocial treatments to specific ethnic minority groups. Examples of culturally sensitive elements for each dimension of the intervention are offered. Although the focus of the article is on Hispanic populations, the framework may be valuable to other ethnic and minority groups.
Cognitive Behavioral Therapy (CBT) is a form of talk therapy that works by challenging and changing current cognitive distortions. While therapy is evidently effective, a major bottleneck remains the fact that it is not accessible for a large part of the population, due to geographical, social, or financial reasons. CBT delivered online (eCBT) offers a potential solution to this problem.
The efficacy of eCBT for Insomnia (eCBT-I) is assessed in this study. The study reviews eleven randomized controlled trials examining a total of 1460 participants. Results showed that eCBT-I improved insomnia severity, sleep efficiency, subjective sleep quality, wake after sleep onset, sleep onset latency, total sleep time, and number of nocturnal awakenings at post-treatment, with effect sizes (Hedges's g) ranging from 0.21 to 1.09.
The effects were comparable to those found for face-to-face CBT-I, and were generally maintained at 4–48 wk follow-up. Moderator analyses showed that longer treatment duration and higher degree of personal clinical support were associated with larger effect sizes, and that larger study dropout in the intervention group was associated with smaller effect sizes. In conclusion, internet-delivered CBT-I appears efficacious and can be considered a viable option in the treatment of insomnia.
Anxiety disorders are associated with disruptions in both emotional processing and decision making. As a result, anxious individuals often make decisions that favor harm avoidance. However, this bias could be driven by enhanced aversion to uncertainty about the decision outcome (e.g., risk) or aversion to negative outcomes (e.g., loss). Distinguishing between these possibilities may provide a better cognitive understanding of anxiety disorders and hence inform treatment strategies.
To address this question, unmedicated individuals with pathological anxiety (n = 25) and matched healthy control subjects (n = 23) completed a gambling task featuring a decision between a gamble and a safe (certain) option on every trial. Choices on one type of gamble—involving weighing a potential win against a potential loss (mixed)—could be driven by both loss and risk aversion, whereas choices on the other type—featuring only wins (gain only)—were exclusively driven by risk aversion. By fitting a computational prospect theory model to participants’ choices, we were able to reliably estimate risk and loss aversion and their respective contribution to gambling decisions.
Relative to healthy control subjects, pathologically anxious participants exhibited enhanced risk aversion but equivalent levels of loss aversion.
Individuals with pathological anxiety demonstrate clear avoidance biases in their decision making. These findings suggest that this may be driven by a reduced propensity to take risks rather than a stronger aversion to losses. This important clarification suggests that psychological interventions for anxiety should focus on reducing risk sensitivity rather than reducing sensitivity to negative outcomes per se
Drug overdoses surged during the COVID-19 pandemic, underscoring the need for expanded and accessible substance use disorder (SUD) treatment. Relatively little is known about the experiences of patients receiving treatment during the pandemic.
We worked with 21 harm reduction and drug treatment programs in nine states and the District of Columbia from August 2020 to January 2021. Programs distributed study recruitment cards to clients. Clients responded to the survey by calling a study hotline and providing a unique study identification number. Our survey included detailed questions about use of SUD treatment prior to and since the COVID-19 pandemic. We identified settings where individuals received treatment and, for those treated for opioid use disorder, we examined use of medications for opioid use disorder. Individuals also reported whether they had received telehealth treatment and pandemic related treatment changes (e.g., more take-home methadone). We calculated p-values for differences pre and since COVID-19.
We interviewed 587 individuals of whom 316 (53.8%) were in drug treatment both before and during the COVID-19 pandemic. Individuals in treatment reported substantial reductions in in-person service use since the start of the pandemic, including a 27 percentage point reduction (p<.001) in group counseling sessions and 28 percentage point reduction in mutual aid group participation (p<.001). By contrast, individuals reported a 21 percentage point increase in receipt of overdose education (p<.001). Most people receiving medications for opioid use disorder reported taking methadone and had high continuity of treatment (86.1% received methadone pre-COVID and 87.1% since-COVID, p=.71). Almost all reported taking advantage of new policy changes such as counseling by video/phone, increased take-home medication, or fewer urine drug screens. Overall, respondents reported relatively high satisfaction with their treatment and with telehealth adaptations (e.g., 80.2% reported “I'm able to get all the treatment that I need”).
Accommodations to treatment made under the federal public health emergency appear to have sustained access to treatment in the early months of the pandemic. Since these changes are set to expire after the official public health emergency declaration, further action is needed to meet the ongoing need.
Healthcare workers play a critical role in the health of a nation, yet rates of healthcare worker stress are disproportionately high. We evaluated whether mindfulness-based cognitive therapy for life (MBCT-L), could reduce stress in healthcare workers and target a range of secondary outcomes. Method: This is the first parallel randomised controlled trial of MBCT-L. Participants were NHS workers, who were randomly assigned (1:1) to receive either MBCT-L or wait-list. The primary outcome was self-reported stress at post-intervention. Secondary variables were well-being, depression, anxiety, and work-related outcomes. Mixed regressions were used. Mindfulness and self/other-compassion were explored as potential mechanisms of effects on stress and wellbeing. Results: We assigned 234 participants to MBCT-L (n = 115) or to wait-list (n = 119). 168 (72%) participants completed the primary outcome and of those who started the MBCT-L 73.40% (n = 69) attended the majority of the sessions. MBCT-L ameliorated stress compared with controls (B = 2.60, 95% CI = 1.63‒3.56; d = -0.72; p < .0001). Effects were also found for well-being, depression and anxiety, but not for work-related outcomes. Mindfulness and self-compassion mediated effects on stress and wellbeing. Conclusions: MBCT-L could be an effective and acceptable part of a wider healthcare workers well-being and mental health strategy.
This study aimed to examine how adolescents view artificial intelligence (AI) and its development and create a tool to measure cynical hostility towards AI. Previous studies showed people have mixed feelings about AI, yet interest in AI and its development grows. As AI is central to technological progress, creating a tool that measures the attitude towards it is necessary. Six hundred and fifty-nine high school students took part in the study. The results showed that Cynical Hostility Towards AI Scale (CHTAIS) is a valid and reliable measure and that cynical hostility towards AI is a separate construct from cynical hostility towards humans. The results showed that people are more distrustful of AI when it is perceived as more hostile and less governed by emotions. Cynical hostility towards AI may be a valuable construct, meriting further investigation and theoretical considerations.