Interventions of computerized psychotherapies for depression in Primary Care in Spain

Currently, depression is a global health problem recognized by the WHO. The prevalence of this pathology in Primary Care is estimated at 19.5% worldwide, and 20.2% in Spain. In addition, the current intervention policies and protocols involve significant costs, both personal and economic, for people suffering from this disorder, as well as for society in general. On the other hand, the relapse rates after pharmacological interventions that are currently applied and the lack of effective specialized attention in mental health services reflect the need to develop new therapeutic strategies that are more accessible and profitable. Therefore, one of the proposals that are being investigated in different parts of the world is the design and evaluation of therapeutic protocols applied through Information and Communication Technologies, especially through the Internet and computer programs. The objective of this work was to present the current situation in Spain regarding the use of these interventions for the treatment of depression in Primary Care. The main conclusion is that although there is scientific evidence on the effectiveness of these programs, there are still important barriers that hinder their application in the public system, and also the need to develop implementation studies that facilitate the transition from research to clinical practice

A computerized intervention for depression : a randomized clinical trial

textOne in ten adults in the U.S. report depression, and thirty-eight percent of those receiving treatment are receiving minimally adequate treatment. Studies show that evidence-based Internet interventions are highly effective in treating depression at a low cost. The aim of this study was to reduce symptoms of depression in subjects through the use of a new, electronic Problem Solving Treatment (ePST). Adult participants with moderate to severe depression symptoms were randomly assigned to either treatment or a wait-list condition. The Beck Depression Inventory-II was used as the primary outcome measure. A Repeated Measure Design with one factor in the between (treatment vs control) and one factor in the within (pre, mid-point, and post-treatment) was used in the analysis. Study results showed that participants in the ePST group improved their depression symptoms (from Moderate to Mild levels of depression) after receiving 3 session of ePST, as well as after receiving six session of ePST (from moderate to minimal levels of depression). On the other hand, participants assigned to the control group remained with Moderate levels of depression.Educational Psycholog

Closing the treatment gap in low-income countries: outlining a culturally sensitive digital self-guided intervention for adolescents with anxiety disorder

Hovedoppgave psykologprogrammetPROPSY317PRPSY

Is behavioural activation effective in the treatment of depression in young people? : A systematic review and meta-analysis

PURPOSE: Depression is currently the leading cause of illness and disability in young people. Evidence suggests that behavioural activation (BA) is an effective treatment for depression in adults but less research focuses on its application with young people. This review therefore examined whether BA is effective in the treatment of depression in young people. METHODS: A systematic review (International Prospective Register of Systematic Reviews reference: CRD42015020453), following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, was conducted to examine studies that had explored behavioural interventions for young people with depression. The electronic databases searched included the Cochrane Library, EMBASE, MEDLINE, CINAHL Plus, PsychINFO, and Scopus. A meta-analysis employing a generic inverse variance, random-effects model was conducted on the included randomized controlled trials (RCTs) to examine whether there were overall effects of BA on the Children's Depression Rating Scale - Revised. RESULTS: Ten studies met inclusion criteria: three RCTs and seven within-participant designs (total n = 170). The review showed that BA may be effective in the treatment of depression in young people. The Cochrane risk of bias tool and the Moncrieff scale used to assess the quality of the included studies revealed a variety of limitations within each. CONCLUSIONS: Despite demonstrating that BA may be effective in the treatment of depression in young people, the review indicated a number of methodological problems in the included studies meaning that the results and conclusions should be treated with caution. Furthermore, the paucity of studies in this area highlights the need for further research. PRACTITIONER POINTS: Currently BA is included within National Institute for Health and Clinical Excellence (NICE, 2009) guidelines as an evidence-based treatment for depression in adults with extensive research supporting its effectiveness. It is important to investigate whether it may also be effective in treating young people. Included studies reported reductions in depression scores across a range of measures following BA. BA may be an effective treatment of depression in young people

Use of Serious games in Treatment of Depression

The purpose of this study was to investigate the concept of gamification as an alternative to treatment of Depression. The aim was to find out how serious games also known as Health games or Educational games are used in the treatment of depression globally. The study was implemented using a systematic literature review approach and eight selected articles were thematically analyzed. Sentences that answered the research question were highlighted then organized into themes. Two main themes deduced were Personalized patient support and self-help therapy. Under personalized patient support, the sub-themes included self-empowerment, Engagement and an adjunct to treatment of other illnesses. Self-help therapy entailed easy accessibility to treatment and privacy. The study established that serious games are a promising alternative to treatment of depression either solely or as an adjunct. However, more studies should be done in other parts of the world. So far, most of the studies have been done in Australia and New Zealand which is a very small portion to be fully relied on

Attitudes towards digital treatment for depression: A European stakeholder survey

The integration of digital treatments into national mental health services is on the agenda in the European Union. The E-COMPARED consortium conducted a survey aimed at exploring stakeholders' knowledge, acceptance and expectations of digital treatments for depression, and at identifying factors that might influence their opinions when considering the implementation of these approaches. An online survey was conducted in eight European countries: France, Germany, Netherlands, Poland, Spain, Sweden, Switzerland and The United Kingdom. Organisations representing government bodies, care providers, service-users, funding/insurance bodies, technical developers and researchers were invited to participate in the survey. The participating countries and organisations reflect the diversity in health care infrastructures and e-health implementation across Europe. A total of 764 organisations were invited to the survey during the period March–June 2014, with 175 of these organisations participating in our survey. The participating stakeholders reported moderate knowledge of digital treatments and considered cost-effectiveness to be the primary incentive for integration into care services. Low feasibility of delivery within existing care services was considered to be a primary barrier. Digital treatments were regarded more suitable for milder forms of depression. Stakeholders showed greater acceptability towards blended treatment (the integration of face-to-face and internet sessions within the same treatment protocol) compared to standalone internet treatments. Organisations in countries with developed e-health solutions reported greater knowledge and acceptability of digital treatments. Mental health stakeholders in Europe are aware of the potential benefits of digital interventions. However, there are variations between countries and stakeholders in terms of level of knowledge about such interventions and their feasibility within routine care services. The high acceptance of blended treatments is an interesting finding that indicates a gradual integration of technology into clinical practice may fit the attitudes and needs of stakeholders. The potential of the blended treatment approach, in terms of enhancing acceptance of digital treatment while retaining the benefit of cost-effectiveness in delivery, should be further explored. The E-COMPARED project has received funding from the European Union Seventh Framework Programme (FP7/2007–2013) under grant agreement no. 603098

Mental Health Teletherapy: An Essential Mental Health Resource After COVID-19

The purpose of this paper is to present an exceptional summation of knowledge in human services while focusing on the specific aspect of online mental therapy. This thoroughly investigated paper discusses the challenges our society currently faces with mental healthcare amidst COVID-19 and how online therapy is one venue that we have, for a long time, chosen not to utilize in the past, but must now recognize its viability as a solid, therapeutic resource for the mental healthcare industry. This paper seeks to confront the various reasons for opposing online therapy and share evidence of ongoing programs that have embraced online therapy and are thriving in their communities. It also lays the groundwork for how therapists today may incorporate online mental therapy as an essential mental health tool for the benefit their clients in the future. Keywords: mental health, teletherapy, psychotherapy, COVID-19, online, direct access, advancements, stigm

Interactive voice response technology for symptom monitoring and as an adjunct to the treatment of chronic pain

Chronic pain is a medical condition that severely decreases the quality of life for those who struggle to cope with it. Interactive voice response (IVR) technology has the ability to track symptoms and disease progression, to investigate the relationships between symptom patterns and clinical outcomes, to assess the efficacy of ongoing treatments, and to directly serve as an adjunct to therapeutic treatment for chronic pain. While many approaches exist toward the management of chronic pain, all have their pitfalls and none work universally. Cognitive behavioral therapy (CBT) is one approach that has been shown to be fairly effective, and therapeutic interactive voice response technology provides a convenient and easy-to-use means of extending the therapeutic gains of CBT long after patients have discontinued clinical visitations. This review summarizes the advantages and disadvantages of IVR technology, provides evidence for the efficacy of the method in monitoring and managing chronic pain, and addresses potential future directions that the technology may take as a therapeutic intervention in its own right

Effectiveness of cognitive behavioral therapy versus therapeutic play for hospitalized children diagnosed with cancer: an integrative systematic review

Psychotherapy provides essential coping mechanisms and strategies for children who are diagnosed with cancer, as they experience the extraordinary burden of physical, emotional, and mental strains. While many medical advancements have been made within the past few decades, progress related to psychotherapy for pediatric cancer patients has not been commensurate, evidenced by the limited current literature. Given the sparsity of relevant research, it is presently difficult to compare and evaluate the various psychotherapeutic interventions available for pediatric oncology patients. Additionally, there are significant challenges in providing psychotherapeutic care for patients and their families, including lack of consistency, disruption of care, and unique considerations regarding the medical setting. This systematic review conducted a comprehensive search through four electronic databases to compile a list of studies that examined the effectiveness of CBT-based and therapeutic play-based interventions for children with cancer within the medical setting. Three main research questions were addressed: (1) Which is the more effective psychotherapeutic intervention between cognitive behavioral therapy and therapeutic play for this population? (2) What are the factors to take into consideration when providing psychotherapy for children who are diagnosed with cancer? (3) What are the unique aspects of the inpatient setting to consider for therapeutic interventions? After two screening phases, thirteen studies were included for final selection. Considerable differences among studies made it difficult to make comparisons between the diverse psychotherapeutic interventions. However, seven themes emerged throughout the review: (a) modifications to intervention, (b) developmental stage, (c) health, physical, and cognitive limitations, (d) emphasis on pain, (e) scheduling and space, (f) multidisciplinary team, and (g) social isolation. Therefore, the aim of the study shifted from comparing two psychotherapeutic interventions to exploring the benefits of a variety of interventions and providing a discussion of the substantial factors when working with this population. Identified features for cost-effective and appropriate psychotherapeutic treatment included shorter timeframe, flexible administration, portability, and comprehensible techniques. However, more research needs to be done for this specialized population and unique setting. Recommendations include conducting more studies that pertain to specific interventions, include larger sample sizes, and utilize the same tool for measuring similar psychological outcomes