Eficacia diferencial de dos formas de aplicar las tareas para casa en el tratamiento de los Trastornos Adaptativos. Terapia Emocional On line vs. formato tradicional

Introducción. Los Trastornos Adaptativos (TA) son un importante problema de salud pública. Un componente central en la Terapia Cognitivo-Conductual (TCC) es la asignación de tareas para casa, sin embargo, no existen estudios que utilicen las tecnologías de la información y la comunicación para aplicar este componente terapéutico. teo (Terapia Emocional On line) es un sistema web que permite crear y enviar material terapéutico personalizado a los pacientes vía Internet. El objetivo de este trabajo es presentar el estudio controlado que se realizará, en el que se comparará la eficacia y eficiencia diferencial de dos formas de aplicar las tareas para casa. Método. Se utilizará un diseño entre grupos con dos condiciones experimentales: 1) las tareas para casa serán aplicadas mediante el sistema TEO; 2) tareas para casa serán aplicadas de forma tradicional (lecturas, audios de las sesiones grabadas). Cuarenta personas con diagnóstico de TA recibirán 6-8 sesiones de TCC y se evaluará la autoeficacia para superar el problema, el estado de ánimo, así como, las expectativas, la opinión y la satisfacción de ambos formatos de aplicación de las tareas para casa. Resultados. Se espera que la condición que utilice teo se muestre igual de eficaz, y más eficiente que la condición que aplique las tareas para casa de forma tradicional. Además, será mejor valorada por los pacientes y por los terapeutas. Discusión. Un sistema como TEO puede facilitar el trabajo del terapeuta en la asignación de tareas para casa, y aumentar la adherencia del paciente al tratamiento.Introduction. Adjustment disorders (AD) are an important public health problem. Cognitive- behavioural Therapy (CBT) approach gives a crucial role to homework assignments, however, no study is available that uses the Information and Communication Technologies to apply this therapeutic component. TEO (Online Emotional Therapy) is a Web based system that allows creating personalized therapeutic material to present to the patient over the Internet. The aim of this work is present the controlled study that will be conducted, which we will compare the effectiveness and efficiency differential of two ways to apply the homework assignments. Method. We will use a between-group design with two experimental conditions; 1) Homework assignments will be applied using TEO system; 2) Homework assignments will be applied in the traditional way (reading materials, session audio record). 40 people diagnosed with TA will receive 6-8 CBT sessions and the efficacy to overcome the problem, the mood state and the expectations, opinion and satisfaction with both modalities of applying homework assignments will be assessed. Results. We expect that TEO condition will be equally effective and more efficient than the condition which applies homework assignments in the traditional way. In addition, it will better valued by patients and therapists. Discussion. A system like TEO can facilitate the therapist’s work in designing homework assignments and the patient’s treatment adherence

Tratamientos psicológicos para los trastornos adaptativos: una revisión

III Jornades d’Investigació per a l’Alumnat de la Facultat de Ciències de la SalutIntroducción: El trastorno adaptativo (ta) es clasificado en el dsm-v en la categoría de trastornos relacionados con el trauma y factores de estrés. A pesar del cambio en la conceptualización, todavía existen problemas de diagnóstico. Paradójicamente, cuenta con una alta prevalencia, siendo de los más frecuentes en atención primaria y hospitalaria. Causa gran sufrimiento personal ya que se produce un deterioro signifi- cativo del funcionamiento social u ocupacional. Sin embargo, se observa escasez de investigaciones y ausencia de manuales de evaluación y tratamiento que lo incluyan. En cuanto a la intervención, no existen en la actualidad tratamientos psicológicos ba- sados en la evidencia (tpbe). Método: Se realizó una búsqueda en Psycnet, Science- Direct, PubMed y PsycArticles. En una primera fase, se revisaron los artículos exis- tentes relacionados con el ta. En una segunda fase, se profundizó en los tratamientos psicológicos utilizados para el ta. Resultados: En primer lugar, se puso de manifiesto una escasez de estudios tratándose de recomendaciones generales, sugerencias e investigaciones aisladas. En cuanto a estudios específicos sobre el tratamiento psico- lógico, encontramos estudios de casos no controlados y 6 estudios experimentales variados y con diferentes enfoques terapéuticos, incluyendo algunos el uso de las tic. Discusión: Es necesario desarrollar tpbe para el ta dado que los estudios encontra- dos presentan limitaciones metodológicas y de validez externa. Para futuras investiga- ciones, el uso de las tic como tratamiento puede ser útil ya que estudios hallados hasta la fecha han demostrado ser prometedores y beneficiosos.Introduction: Adjustment Disorders (ad) are classified in the dsm-5 as the trauma- related disorders and stress factors category. Despite the change in conceptualisa- tion, diagnostic problems still exist. Paradoxically, it has a high prevalence and is the most frequent in primary and hospital care. It causes great personal suffering given the significant impairment of social or occupational functioning. Research into it, evaluations, and treatment manuals that include it, are lacking. Currently there are no evidence-based psychological treatments (ebpt) for intervention. Method: A search in Psycnet, ScienceDirect, PubMed and Psycarticles was performed. Firstly, exist- ing ad-related articles were reviewed. Secondly, we profoundly examined the psycho- logical treatments used for ad. Results: Firstly, the search revealed a shortage of case studies of general recommendations, suggestions and isolated research. Among specific studies on psychological treatment, we found no controlled studies and six varied experimental studies with different therapeutic approaches, of which some have used icts. Discussion: It is necessary to develop ebpt for ad as the found stud- ies show methodological limitations and external validity. Employing icts as treatment may be useful for future research since the studies found to date have being promis- ing and beneficial

Cognitive remediation therapy in anorexia nervosa: implications for treatment developments and research trials

Though Cognitive Remediation Therapy (CRT) for anorexia nervosa shows promising evidence, questions remain regarding specific mechanisms of change. This mixed methods study aimed to explore both longitudinal patient data (neuropsychological and self-report measures, before and after CRT) and therapist experiences of delivering CRT and their perceptions regarding what it offers. All patients had received treatment in a specialist inpatient unit. Complete data were available for both individual (n=56) and group (n=43) CRT; clinical audit data were also available. Semi-structured interviews of 11 therapists were analysed using Thematic Analysis. Statistically significant improvements were found in cognitive flexibility task performance for individual CRT (medium effect) and in self-reported cognitive flexibility for group CRT (medium effect). Three main themes were identified from the therapist interviews: “Anorexia and its treatment”, “CRT - its characteristics and delivery” and “CRT and its effectiveness”. The quantitative findings replicated some previous results and the therapist interviews provided insights regarding not only CRT’s delivery but adaptations made according to individual need and complexity. Both individual and group CRT appear to be feasible interventions for future trials but questions remain around CRT’s specific effects. Recommendations are made for future research studies on this complex intervention

An adaptive virtual reality system for the treatment of adjustment disorder and complicated grief: 1‐year follow‐up efficacy data

This is the pre-peer reviewed version of the following article: An adaptive virtual reality system for the treatment of adjustment disorder and complicated grief: 1‐year follow‐up efficacy data, which has been published in final form at https://doi.org/10.1002/cpp.2342. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.Adjustment disorder (AD) and complicated grief (CG) are serious mental conditions that have a high prevalence and are associated with significant impairments in social and work functioning. Recently, these categories have been better specified in the new ICD‐11 proposal. Empirical research on the efficacy of treatments for these problems is scarce. This study aims to offer long‐term efficacy data from a between‐groups controlled study that compares two treatment conditions (AD‐protocol applied in a traditional way: N = 18 and the same protocol supported by virtual reality (VR); VR‐protocol applied in a traditional way: N = 18) and a waiting list (WL) control group (N = 18). Both treatment conditions resulted in statistically significant improvements on both primary and secondary outcome measures, with large effect sizes, and this improvement did not occur in the WL. These changes were maintained in both treatment conditions in the medium (6‐month) and long‐term (12‐month follow‐up). Larger effect sizes were achieved in the VR condition in the long term. Furthermore, clinically significant change estimations on the primary outcome measures showed an advantage for the VR condition This is the first controlled study to compare a traditional face‐to‐face protocol for the treatment of stress‐related disorders with the same protocol supported by VR and a WL control group

EARTH of Well-Being System: A pilot study of an Information and Communication Technology-based positive psychology intervention

The positive technology field combines the objectives of positive psychology with enhancements from information and communication technologies. Following this approach, our team developed the ‘EARTH of Well-Being,’ a system designed to induce positive emotions and reinforce psychological resources through a self-guided positive psychology internet intervention. This paper describes the EARTH system and presents the results of a pilot study that assesses users’ acceptance and perceived usefulness of the system and provides preliminary evidence of its efficacy in providing users with positive experiences. Thirty-eight volunteers used the application in six sessions distributed over two weeks. They reported high levels of acceptability and perceived usefulness. Moreover, participants reported increased positive mood after each session. Overall, results support the future use and investigation of this system as a positive psychology intervention, and suggest that it could be useful for increasing positive mood

Utilizing Cognitive Behavioral Therapy among Older Adults with Generalized Anxiety Disorder in Long-Term Care

Abstract Background: Generalized anxiety disorder (GAD) among the older adults is characterized by excessive worries and major anxiety. The impairment and disability resulting from GAD indicates a significant mental health problem in long term care settings. In the United States, the lifetime prevalence of The Diagnostic Statistical Manual of Mental Disorders, Fourth Edition (DSM-1V) GAD is 5.1% to 11.9%. Evidence-based treatment for GAD in the older adult becomes a challenge due to the concern of frailty, comorbidity and drug side effects. Purpose: To implement the utilization of Cognitive-Behavioral Therapy (CBT) in the older adult population with GAD in a long-term care setting. Method: Based on an extensive review of research, a project was designed and conducted to offer the basic knowledge of CBT to nurses for the treatment of GAD. Outcome evaluation was based on post-implementation questionnaire. Conclusion: The nurse participants were clear that they valued CBT and perceived it helpful for the older adult with GAD, but they needed to be trained proper and increase utilization of CBT. Keywords: Generalized anxiety disorder, older adult, cognitive-behavioral therapy

PROMOTING WELL-BEING AMONG COLLEGE STUDENTS: THE EFFECTS OF A POSITIVE PSYCHOLOGY COURSE

College students report high rates of mental distress, including depression, high stress, anxiety, lack of social support, and physical ailments. College campuses use a variety of approaches to address the well-being of students. However, existing interventions have mixed results and do not always reach all students who may need mental health support. Positive psychology courses and positive psychology interventions have shown promise in promoting well-being. In this quantitative, quasi-experimental, pretest-posttest archival study, I examined the effects of a semester-long happiness and positive psychology course (COUN 195) on students’ well-being and mental health. This innovative happiness course included didactic lectures, small group and lab work, and one-on-one happiness consultations with counselors in training. Students who took COUN 195 reported higher levels of positive affect, hope, social support, and physical health as compared to the control group. The results indicate that semester long happiness courses may be useful in promoting positive mental health among college students. Conclusions and recommendations for future research are provided

Moderators of Guided and Unguided Self-Help for Depression: The Role of Self-Regulation

Self-help interventions for depression have been used to help reduce the gap inthe need for treatment and the availability of resources. However, not everyone benefits from self-help and unguided self-help tends to have poorer treatment response and higher dropout than guided self-help. Nonetheless, some people still benefit from unguided self- help. Unguided self-help leans heavily on the individual to initiate and maintain change and those with self-regulation are more like to engage in change on their own. The purpose of this study was to understand the self-regulatory processes that may be used to stratify patients into guided and unguided interventions. Using theories of self-regulation, we proposed four self-regulatory processes that impact change, are known to be variable in depressive disorders, and might affect whom benefits from guided versus unguided self-help: autonomous motivation, goal specificity, response inhibition, and delay discounting. After enrolling 336 participants and included 184 in our primary analyses, we observed significant treatment effects of our two self-help groups. We did not observe a significant difference between our two experimental groups on any outcomes (e.g., treatment response, odds of completing, etc.). Significant interactions between these self- regulatory variables and our group term were seldom observed. Some self-regulatory processes did predict outcomes for our entire sample. Implications for future research are discussed

Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments

BACKGROUND: The number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp developers rarely conduct or publish trial-based experimental validation of their apps. Indeed, a previous systematic review revealed a complete lack of trial-based evidence for many of the hundreds of MHapps available. OBJECTIVE: To guide future MHapp development, a set of clear, practical, evidence-based recommendations is presented for MHapp developers to create better, more rigorous apps. METHODS: A literature review was conducted, scrutinizing research across diverse fields, including mental health interventions, preventative health, mobile health, and mobile app design. RESULTS: Sixteen recommendations were formulated. Evidence for each recommendation is discussed, and guidance on how these recommendations might be integrated into the overall design of an MHapp is offered. Each recommendation is rated on the basis of the strength of associated evidence. It is important to design an MHapp using a behavioral plan and interactive framework that encourages the user to engage with the app; thus, it may not be possible to incorporate all 16 recommendations into a single MHapp. CONCLUSIONS: Randomized controlled trials are required to validate future MHapps and the principles upon which they are designed, and to further investigate the recommendations presented in this review. Effective MHapps are required to help prevent mental health problems and to ease the burden on health systems

Effectiveness of a smartphone app as an adjunct to therapy for depression

Over the years, depression and treatments for depression have been extensively researched. However, as times have changed and technology has become an integrated aspect into many indivdiual’s lives, including those with depression, researched mental health treatments have been slow to appreciate technological advances such as the smartphone app. The purpose of this study was to examine the effectiveness of a smartphone app in addition to CBT as compared to CBT with paper homework when treating depression. Using a single-case design, as described by Kazdin (2011), with two participants this study found that both participants experienced a decrease in depression scores with the individual in the app condition scoring lower throughout the study; however, the exact contribution that the app had in decreasing depression scores is unclear. The client using the app enjoyed it and found it easy to use and helpful, while the provider was uncertain about including the app in future clinical work. Despite investing more time into her homework, the participant using the app scored lower on a measure of outside engagement than the control participant. As predicted, the participant utilizing the app experienced fewer barriers to homework completion. Due to a small sample size, lack of psychometrically sound instruments and limitations of the design methodology, the findings of this study are limited in scope and generalizability. The causality or influence of the interventions examined on the outcome measures studied is unknown. However, this study adds to the literature on using a depression app as an adjunctive tool to CBT, client and provider attitudes toward the incorporation of an app into psychotherapy, and differences in levels of outside engagement and barriers to homework completion when comparing the mediums of pen and paper versus an app