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  • 1.
    Alfonsson, Sven
    et al.
    Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden; Uppsala Univ, Sweden.
    Parling, Thomas
    Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden.
    Spännargård, Asa
    Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden.
    Lundgren, Tobias
    Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden.
    The effects of clinical supervision on supervisees and patients in cognitive behavioral therapy: a systematic review2018In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 47, no 3, p. 206-228Article, review/survey (Refereed)
    Abstract [en]

    Clinical supervision is a central part of psychotherapist training but the empirical support for specific supervision theories or features is unclear. The aims of this study were to systematically review the empirical research literature regarding the effects of clinical supervision on therapists competences and clinical outcomes within Cognitive Behavior Therapy (CBT). A comprehensive database search resulted in 4103 identified publications. Of these, 133 were scrutinized and in the end 5 studies were included in the review for data synthesis. The five studies were heterogeneous in scope and quality and only one provided firm empirical support for the positive effects of clinical supervision on therapists competence. The remaining four studies suffered from methodological weaknesses, but provided some preliminary support that clinical supervision may be beneficiary for novice therapists. No study could show benefits from supervision for patients. The research literature suggests that clinical supervision may have some potential effects on novice therapists competence compared to no supervision but the effects on clinical outcomes are still unclear. While bug-in-the-eye live supervision may be more effective than standard delayed supervision, the effects of specific supervision models or features are also unclear. There is a continued need for high-quality empirical studies on the effects of clinical supervision in psychotherapy.

  • 2.
    Alfonsson, Sven
    et al.
    Karolinska Institutet, Sweden; Stockholm Health Care Services, Sweden; Uppsala University, Uppsala, Sweden.
    Spännargård, Åsa
    Karolinska Institutet, Sweden; Stockholm Health Care Services, Sweden.
    Parling, Thomas
    Karolinska Institutet, Sweden; Stockholm Health Care Services, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institutet, Sweden; Stockholm Health Care Services, Sweden.
    Lundgren, Tobias
    Karolinska Institutet, Sweden; Stockholm Health Care Services, Sweden.
    The effects of clinical supervision on supervisees and patients in cognitive-behavioral therapy: a study protocol for a systematic review.2017In: Systematic Reviews, E-ISSN 2046-4053, Vol. 6, no 1, article id 94Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Clinical supervision by a senior therapist is a very common practice in psychotherapist training and psychiatric care settings. Though clinical supervision is advocated by most educational and governing institutions, the effects of clinical supervision on the supervisees' competence, e.g., attitudes, behaviors, and skills, as well as on treatment outcomes and other patient variables are debated and largely unknown. Evidence-based practice is advocated in clinical settings but has not yet been fully implemented in educational or clinical training settings. The aim of this systematic review is to synthesize and present the empirical literature regarding effects of clinical supervision in cognitive-behavioral therapy.

    METHODS: This study will include a systematic review of the literature to identify studies that have empirically investigated the effects of supervision on supervised psychotherapists and/or the supervisees' patients. A comprehensive search strategy will be conducted to identify published controlled studies indexed in the MEDLINE, EMBASE, PsycINFO, and Cochrane Library databases. Data on supervision outcomes in both psychotherapists and their patients will be extracted, synthesized, and reported. Risk of bias and quality of the included studies will be assessed systematically.

    DISCUSSION: This systematic review will rigorously follow established guidelines for systematic reviews in order to summarize and present the evidence base for clinical supervision in cognitive-behavioral therapy and may aid further research and discussion in this area.

    SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016046834.

  • 3.
    Almlov, Jonas
    et al.
    Umea University.
    Kallqvist, Karin
    Vrije University Amsterdam.
    Cuijpers, Pim
    Vrije University Amsterdam.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Therapist Effects in Guided Internet-Delivered CBT for Anxiety Disorders2011In: BEHAVIOURAL AND COGNITIVE PSYCHOTHERAPY, ISSN 1352-4658, Vol. 39, no 3, p. 311-322Article in journal (Refereed)
    Abstract [en]

    Background: Guided internet-delivered CBT for anxiety disorders has received increasing empirical support, but little is known regarding the role of the therapist. Aims: This study addressed therapist factors in guided internet-delivered cognitive behavioural therapy for anxiety disorders. Method: Data from three controlled trials with a total N of 119 were analyzed with attention to differences between eight therapists. Results: No significant mean level differences between therapists appeared in the dataset. However, one significant intraclass correlation between participants was found, suggesting that the outcome on the Beck Anxiety Inventory might have been influenced by the impact of the individual therapists. Conclusion: The therapist can possibly have some influence on the outcome of guided internet-delivered CBT for anxiety disorders, but studies with more statistical power are needed to establish whether therapist effects are present in this modality of psychological treatment. The present study was underpowered to detect minor therapist effects.

  • 4.
    Almlöv, J
    et al.
    CS / IBL LiU.
    Paxling, B
    CS / IBL LiU.
    Dahlin, M
    CS / IBL LiU.
    Carlbring, Per
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology.
    Breitholtz, E
    Psyk Inst Stockholms universitet.
    Eriksson, T
    Specialistläkarna Specialistläkarna.
    Andersson, Gerhard
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology.
    A randomized controlled study of the effficacy of a web-administered guided self-help treatment for generalized anxiety disorder2007In: The third meeting of the International Society for Research on Internet Interventions,2007, Charlottesville: ISRII , 2007Conference paper (Refereed)
  • 5.
    Andersson , Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Using the Internet to provide cognitive behaviour therapy2009In: BEHAVIOUR RESEARCH AND THERAPY, ISSN 0005-7967 , Vol. 47, no 3, p. 175-180Article in journal (Refereed)
    Abstract [en]

    A new treatment form has emerged that merges cognitive behaviour therapy with the Internet. By delivering treatment components, mainly in the form of texts presented via web pages, and provide ongoing support using e-mail promising outcomes can be achieved. The literature on this novel form of treatment has grown rapidly over recent years with several controlled trials in the field of anxiety disorders, mood disorders and behavioural medicine. For some of the conditions for which Internet-delivered CBT has been tested, independent replications have shown large effect sizes, for example in the treatment of social anxiety disorder. In some studies, Internet-delivered treatment can achieve similar outcomes as in face-to-face CBT, but the literature thus far is restricted mainly to efficacy trials. This article provides a brief summary of the evidence, comments on the role of the therapist and for which patient and therapist this is suitable. Areas of future research and exploration are identified.

  • 6.
    Andersson, E
    et al.
    Karolinska Institute, Sweden .
    Enander, J
    Karolinska Institute, Sweden Uppsala University, Sweden .
    Andren, P
    Uppsala University, Sweden .
    Hedman, E
    Karolinska Institute, Sweden .
    Ljotsson, B
    Karolinska Institute, Sweden .
    Hursti, T
    Uppsala University, Sweden .
    Bergstrom, J
    Karolinska Institute, Sweden Stockholm University, Sweden .
    Kaldo, V
    Karolinska Institute, Sweden .
    Lindefors, N
    Karolinska Institute, Sweden .
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Ruck, C
    Karolinska Institute, Sweden .
    Internet-based cognitive behaviour therapy for obsessive-compulsive disorder: a randomized controlled trial2012In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 42, no 10, p. 2193-2203Article in journal (Refereed)
    Abstract [en]

    Background. Cognitive behaviour therapy (CBT) is an effective treatment for obsessive-compulsive disorder (OCD) but access to CBT is limited. Internet-based CBT (ICBT) with therapist support is potentially a more accessible treatment. There are no randomized controlled trials testing ICBT for OCD. The aim of this study was to investigate the efficacy of ICBT for OCD in a randomized controlled trial. less thanbrgreater than less thanbrgreater thanMethod. Participants (n=101) diagnosed with OCD were randomized to either 10 weeks of ICBT or to an attention control condition, consisting of online supportive therapy. The primary outcome measure was the Yale-Brown Obsessive Compulsive Scale (YBOCS) administered by blinded assessors. less thanbrgreater than less thanbrgreater thanResults. Both treatments lead to significant improvements in OCD symptoms, but ICBT resulted in larger improvements than the control condition on the YBOCS, with a significant between-group effect size (Cohens d) of 1.12 (95% CI 0.69-1.53) at post-treatment. The proportion of participants showing clinically significant improvement was 60% (95% CI 46-72) in the ICBT group compared to 6% (95% CI 1-17) in the control condition. The results were sustained at follow-up. less thanbrgreater than less thanbrgreater thanConclusions. ICBT is an efficacious treatment for OCD that could substantially increase access to CBT for OCD patients. Replication studies are warranted.

  • 7.
    Andersson, E
    et al.
    Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden .
    Steneby, S
    Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden .
    Karlsson, K
    Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden .
    Ljótsson, B
    Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
    Hedman, E
    Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden, Osher Center for Integrative Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Enander, J
    Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden.
    Kaldo, V
    Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden.
    Lindefors, N
    Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden.
    Rück, C
    Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden.
    Long-term efficacy of Internet-based cognitive behavior therapy for obsessive-compulsive disorder with or without booster: a randomized controlled trial.2014In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 44, no 13, p. 2877-2887Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: As relapse after completed cognitive behavior therapy (CBT) for obsessive-compulsive disorder (OCD) is common, many treatment protocols include booster programs to improve the long-term effects. However, the effects of booster programs are not well studied. In this study, we investigated the long-term efficacy of Internet-based CBT (ICBT) with therapist support for OCD with or without an Internet-based booster program.

    METHOD: A total of 101 participants were included in the long-term follow-up analysis of ICBT. Of these, 93 were randomized to a booster program or no booster program. Outcome assessments were collected at 4, 7, 12 and 24 months after receiving ICBT.

    RESULTS: The entire sample had sustained long-term effects from pre-treatment to all follow-up assessments, with large within-group effect sizes (Cohen's d = 1.58-2.09). The booster group had a significant mean reduction in OCD symptoms compared to the control condition from booster baseline (4 months) to 7 months, but not at 12 or 24 months. Participants in the booster group improved significantly in terms of general functioning at 7, 12 and 24 months, and had fewer relapses. Kaplan-Meier analysis also indicated a significantly slower relapse rate in the booster group.

    CONCLUSIONS: The results suggest that ICBT has sustained long-term effects and that adding an Internet-based booster program can further improve long-term outcome and prevent relapse for some OCD patients.

  • 8.
    Andersson, Erik
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Hedman, Erik
    Karolinska Institutet, Stockholm, Sweden.
    Enander, Jesper
    Karolinska Institutet, Stockholm, Sweden.
    Radu Djurfeldt, Diana
    Karolinska Institutet, Stockholm, Sweden.
    Ljótsson, Brjánn
    Karolinska Institutet, Stockholm, Sweden.
    Cervenka, Simon
    Karolinska Institutet, Stockholm, Sweden.
    Isung, Josef
    Karolinska Institutet, Stockholm, Sweden.
    Svanborg, Cecilia
    Karolinska Institutet, Stockholm, Sweden.
    Mataix-Cols, David
    Karolinska Institutet, Stockholm, Sweden.
    Kaldo, Viktor
    Karolinska Institutet, Stockholm, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden.
    Lindefors, Nils
    Karolinska Institutet, Stockholm, Sweden.
    Rück, Christian
    Karolinska Institutet, Stockholm, Sweden.
    D-Cycloserine vs Placebo as Adjunct to Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder and Interaction With Antidepressants: A Randomized Clinical Trial.2015In: JAMA psychiatry, ISSN 2168-6238, E-ISSN 2168-622X, Vol. 72, no 7, p. 659-667Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE: It is unclear whether d-cycloserine (DCS), a partial N-methyl-d-aspartate agonist that enhances fear extinction, can augment the effects of exposure-based cognitive behavioral therapy (CBT) for obsessive-compulsive disorder (OCD).

    OBJECTIVES: To examine whether DCS augments the effects of CBT for OCD and to explore (post hoc) whether concomitant antidepressant medication moderates the effects of DCS.

    DESIGN, SETTING, AND PARTICIPANTS: A 12-week, double-blind randomized clinical trial with 3-month follow-up conducted at an academic medical center between September 4, 2012, and September 26, 2013. Participants included 128 adult outpatients with a primary diagnosis of OCD and a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score of 16 or higher. Concurrent antidepressant medication was permitted if the dose had been stable for at least 2 months prior to enrollment and remained unchanged during the trial. The main analysis was by intention-to-treat population.

    INTERVENTIONS: All participants received a previously validated Internet-based CBT protocol over 12 weeks and were randomized to receive either 50 mg of DCS or placebo, administered 1 hour before each of 5 exposure and response prevention tasks.

    MAIN OUTCOMES AND MEASURES: Clinician-administered Y-BOCS score at week 12 and at 3-month follow-up. Remission was defined as a score of 12 or lower on the Y-BOCS.

    RESULTS: In the primary intention-to-treat analyses, DCS did not augment the effects of CBT compared with placebo (mean [SD] clinician-rated Y-BOCS score, DCS: 13.86 [6.50] at week 12 and 12.35 [7.75] at 3-month follow-up; placebo: 11.77 [5.95] at week 12 and 12.37 [6.68] at 3-month follow-up) but showed a significant interaction with antidepressants (clinician-rated Y-BOCS, B = -1.08; Z = -2.79; P = .005). Post hoc analyses revealed that antidepressants significantly impaired treatment response in the DCS group but not the placebo group, at both posttreatment and follow-up (clinician-rated Y-BOCS: t62 = -3.00; P = .004; and t61 = -3.49; P < .001, respectively). In the DCS group, a significantly greater proportion of antidepressant-free patients achieved remission status at follow-up (60% [95% CI, 45%-74%]) than antidepressant-medicated patients (24% [95% CI, 9%-48%]) (P = .008). Antidepressants had no effect in the placebo group (50% [95% CI, 36%-64%] remission rate in both groups).

    CONCLUSIONS AND RELEVANCE: The findings suggest that antidepressants may interact with DCS to block its facilitating effect on fear extinction. Use of DCS may be a promising CBT augmentation strategy but only in antidepressant-free patients with OCD.

    TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01649895.

  • 9.
    Andersson, Erik
    et al.
    Karolinska Institute, Sweden; Karolinska Institute, Sweden.
    Hedman, Erik
    Karolinska Institute, Sweden; Karolinska Institute, Sweden.
    Ljotsson, Brjann
    Karolinska Institute, Sweden.
    Wikstrom, Maja
    Karolinska Institute, Sweden.
    Elveling, Elin
    Karolinska Institute, Sweden.
    Lindefors, Nils
    Karolinska Institute, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Kaldo, Viktor
    Karolinska Institute, Sweden.
    Ruck, Christian
    Karolinska Institute, Sweden.
    Cost-effectiveness of internet-based cognitive behavior therapy for obsessive-compulsive disorder: results from a randomized controlled trial2015In: Journal of Obsessive-Compulsive and Related Disorders, ISSN 2211-3649, E-ISSN 2211-3657, Vol. 4, p. 47-53Article in journal (Refereed)
    Abstract [en]

    Obsessive-compulsive disorder (OCD) is a common and disabling disorder. Although evidence-based psychological treatments exists, such as cognitive behavior therapy (CBT), the cost-effectiveness of CBT has not been properly investigated. In this trial, we used health economic data from a recently conducted randomized controlled trial, where 101 OCD patients were allocated to either internet-based CBT (ICBT) or control condition (online support therapy). We analyzed treatment effectiveness in relation to costs, using both a societal- (including all direct and indirect costs) and a health care unit perspective (including only the direct treatment costs). Bootstrapped net benefit regression analyses were also conducted, comparing the difference in costs and effects between ICBT and control condition, with different willingness-to-pay scenarios. Results showed that ICBT produced one additional remission for an average societal cost of $931 and this figure was even lower ($672) when narrowing the perspective to treatment costs only. The cost-utility analysis also showed that ICBT generated one additional QALY to an average price of $7186 from a societal perspective and $4800 when just analyzing the treatment costs. We conclude that ICBT is a cost-effective treatment and the next step in this line of research is to compare the cost-effectiveness of ICBT with face-to-face CBT. (C) 2014 Elsevier Inc. All rights reserved.

  • 10.
    Andersson, Erik
    et al.
    Karolinska Institute, Sweden; Karolinska Institute, Sweden.
    Ljotsson, Brjann
    Karolinska Institute, Sweden.
    Hedman, Erik
    Karolinska Institute, Sweden; Karolinska Institute, Sweden.
    Enander, Jesper
    Karolinska Institute, Sweden.
    Kaldo, Viktor
    Karolinska Institute, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Lindefors, Nils
    Karolinska Institute, Sweden.
    Ruck, Christian
    Karolinska Institute, Sweden.
    Predictors and moderators of Internet-based cognitive behavior therapy for obsessive-compulsive disorder: Results from a randomized trial2015In: Journal of Obsessive-Compulsive and Related Disorders, ISSN 2211-3649, E-ISSN 2211-3657, Vol. 4Article in journal (Refereed)
    Abstract [en]

    Internet-based cognitive behavior therapy (ICBT) for obsessive-compulsive disorder (OCD) has shown efficacy in randomized trials but many patients do not respond to the treatment, we therefore need to find predictors and moderators of treatment response. In this study, we analyzed predictors of ICBT response using both post-treatment as well as 24-month outcome data. As half of the participants were randomized to receive an Internet-based booster program as an adjunct to ICBT, we also investigated moderators of ICBT with or without booster. Results showed that more severe baseline OCD symptoms predicted worse end state outcome but also higher degree of change. Furthermore, high degree of working alliance predicted better outcome but patients with primary disgust emotions had worse treatment effects. The moderator analysis also indicated that scoring high on the obsessing subscale on the Obsessive-Compulsive Inventory-Revised predicted worse treatment outcome in the booster group. In conclusion, there are some possible predictors and moderators of ICBT for OCD but more research is needed with larger and clinically representative samples. (C) 2014 Elsevier Inc. All rights reserved.

  • 11.
    Andersson, Erik
    et al.
    Karolinska Institute, Sweden.
    Ljotsson, Brjann
    Karolinska Institute, Sweden.
    Hedman, Erik
    Karolinska Institute, Sweden.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Enander, Jesper
    Karolinska Institute, Sweden.
    Kaldo, Viktor
    Karolinska Institute, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Lindefors, Nils
    Karolinska Institute, Sweden.
    Ruck, Christian
    Karolinska Institute, Sweden.
    Testing the Mediating Effects of Obsessive Beliefs in Internet-Based Cognitive Behaviour Therapy for Obsessive-Compulsive Disorder: Results from a Randomized Controlled Trial2015In: Clinical Psychology and Psychotherapy, ISSN 1063-3995, E-ISSN 1099-0879, Vol. 22, no 6, p. 722-732Article in journal (Refereed)
    Abstract [en]

    Although cognitive interventions for obsessive-compulsive disorder (OCD) have been tested in randomized trials, there are few trials that have tested the specific mechanisms of cognitive interventions, i.e. how they achieve their effects. In this study, we aimed to investigate the mediating effects of a short cognitive intervention in the treatment of OCD and used data from a recently conducted randomized controlled trial where 101 participants were allocated to either Internet-based CBT (ICBT) or to a control condition. Obsessive beliefs were measured at pre-treatment, at the time they had received the cognitive intervention, and also at post-treatment. Weekly OCD symptoms were measured throughout the 10 weeks of treatment. We hypothesized that (1) the ICBT group would have greater reductions in obsessive beliefs (controlling for change in OCD symptoms) after completing the cognitive intervention, and that (2) this reduction would, in turn, predict greater OCD symptom reduction throughout the rest of the treatment period. Contrary to our expectations, the longitudinal mediation analysis indicated that (1) being randomized to ICBT actually increased the degree of obsessive beliefs after receiving the cognitive intervention at weeks 1-3, and (2) increase in obsessive beliefs predicted better outcome later in treatment. However, when repeating the analysis using cross-sectional data at post-treatment, the results were in line with the initial hypotheses. Results were replicated when the control condition received ICBT. We conclude that, although obsessive beliefs were significantly reduced at post-treatment for the ICBT group, early increase rather than decrease in obsessive beliefs predicted favourable outcome. Copyright (C) 2014 John Wiley & Sons, Ltd.

  • 12.
    Andersson, Erik
    et al.
    Karolinska Institute.
    Ljotsson, Brjann
    Karolinska Institute.
    Hedman, Erik
    Karolinska Institute.
    Kaldo, Viktor
    Karolinska Institute.
    Paxling, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Lindefors, Nils
    Karolinska Institute.
    Ruck, Christian
    Karolinska Institute.
    Internet-based cognitive behavior therapy for obsessive compulsive disorder: A pilot study2011In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 11, no 125Article in journal (Refereed)
    Abstract [en]

    Background: Cognitive behavior therapy (CBT) is widely regarded as an effective treatment for obsessive compulsive disorder (OCD), but access to CBT therapists is limited. Internet-based CBT (ICBT) with therapist support is a way to increase access to CBT but has not been developed or tested for OCD. The aim of this study was to evaluate ICBT for OCD. less thanbrgreater than less thanbrgreater thanMethod: An open trial where patients (N = 23) received a 15-week ICBT program with therapist support consisting of psychoeducation, cognitive restructuring and exposure with response prevention. The primary outcome was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), which was assessed by a psychiatrist before and immediately after treatment. Secondary outcomes were self-rated measures of OCD symptoms, depressive symptoms, general functioning, anxiety and quality of life. All assessments were made at baseline and post-treatment. less thanbrgreater than less thanbrgreater thanResults: All participants completed the primary outcome measure at all assessment points. There were reductions in OCD symptoms with a large within-group effect size (Cohens d = 1.56). At post-treatment, 61% of participants had a clinically significant improvement and 43% no longer fulfilled the diagnostic criteria of OCD. The treatment also resulted in statistically significant improvements in self-rated OCD symptoms, general functioning and depression. less thanbrgreater than less thanbrgreater thanConclusions: ICBT with therapist support reduces OCD symptoms, depressive symptoms and improves general functioning. Randomized trials are needed to confirm the effectiveness of this new treatment format.

  • 13.
    Andersson, Erik
    et al.
    Karolinska Institute, Sweden; Karolinska Institute, Sweden.
    Ljotsson, Brjann
    Karolinska Institute, Sweden.
    Hedman, Erik
    Karolinska Institute, Sweden; Karolinska Institute, Sweden.
    Mattson, Simon
    Karolinska Institute, Sweden.
    Enander, Jesper
    Karolinska Institute, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Kaldo, Viktor
    Karolinska Institute, Sweden.
    Lindefors, Nils
    Karolinska Institute, Sweden.
    Ruck, Christian
    Karolinska Institute, Sweden.
    Cost-effectiveness of an internet-based booster program for patients with obsessive-compulsive disorder: Results from a randomized controlled trial2015In: Journal of Obsessive-Compulsive and Related Disorders, ISSN 2211-3649, E-ISSN 2211-3657, Vol. 4, p. 14-19Article in journal (Refereed)
    Abstract [en]

    Cognitive behavior therapy (CBT) is an effective treatment for OCD when delivered face-to-face, in group-format and also via the internet. However, despite overall large effect sizes, a considerable amount of the patients relapse. One intervention that has the potential to reduce these relapse rates is booster programs, but if booster program is a cost-effective method of preventing relapse is still unknown. We used health economical data from a recent randomized controlled trial, where patients who had undergone an internet-based CBT were randomly allocated to receive an additional booster program. Assessment points were 4-, 7-, 12- and 24-month. Health economical data were primarily analyzed using a societal perspective. Results showed that the booster program was effective in preventing relapse, and the cost of one avoided relapse was estimated to $1066-1489. Cost-effectiveness acceptability curves showed that the booster program had a 90% probability of being cost-effective given a willingness to pay of $1000-1050 the first year, but this figure grew considerably after two years ($2500-5500). We conclude that internet-based booster programs are probably a cost-effective alternative within one-year time frame and that more treatment may be needed to maintain adequate cost-effectiveness up to two years. (C) 2014 Elsevier Inc. All rights reserved.

  • 14.
    Andersson, Erik
    et al.
    Karolinska Institute.
    Ljotsson, Brjann
    Karolinska Institute.
    Smit, Filip
    Vrije University Amsterdam Med Centre.
    Paxling, Björn
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Hedman, Erik
    Karolinska Institute.
    Lindefors, Nils
    Karolinska Institute.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Ruck, Christian
    Karolinska Institute.
    Cost-effectiveness of internet-based cognitive behavior therapy for irritable bowel syndrome: results from a randomized controlled trial2011In: BMC PUBLIC HEALTH, ISSN 1471-2458, Vol. 11, no 215Article in journal (Refereed)
    Abstract [en]

    Background: Irritable Bowel Syndrome (IBS) is highly prevalent and is associated with a substantial economic burden. Cognitive behavior therapy (CBT) has been shown to be effective in treating IBS. The aim of this study was to evaluate the cost-effectiveness of a new treatment alternative, internet-delivered CBT based on exposure and mindfulness exercises. Methods: Participants (N = 85) with IBS were recruited through self-referral and were assessed via a telephone interview and self-report measures on the internet. Participants were randomized to internet-delivered CBT or to a discussion forum. Economic data was assessed at pre-, post- and at 3-month and 1 year follow-up. Results: Significant cost reductions were found for the treatment group at $16,806 per successfully treated case. The cost reductions were mainly driven by reduced work loss in the treatment group. Results were sustained at 3-month and 1 year follow-up. Conclusions: Internet-delivered CBT appears to generate health gains in IBS treatment and is associated with cost-savings from a societal perspective.

  • 15.
    Andersson, Erik
    et al.
    Karolinska Institute.
    Walen, Christian
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Hallberg, Jonas
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Paxling, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Dahlin, Mats
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Almlöv, Jonas
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Källström, Reidar
    Linköping University, Department of Clinical and Experimental Medicine, Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Östergötland.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Carlbring, Per
    Umeå University, Department Psychol, S-90187 Umeå, Sweden .
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    A Randomized Controlled Trial of Guided Internet-delivered Cognitive Behavioral Therapy for Erectile Dysfunction2011In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 8, no 10, p. 2800-2809Article in journal (Refereed)
    Abstract [en]

    Introduction. Men with erectile dysfunction are often worried about their condition, have interpersonal difficulties, and have a reduced quality of life. Internet-delivered cognitive behavior therapy (ICBT) has been shown effective for a number of health problems but evidence is limited concerning the treatment of erectile dysfunction. less thanbrgreater than less thanbrgreater thanAim. The study investigated the effects of ICBT for erectile dysfunction. less thanbrgreater than less thanbrgreater thanMethods. Seventy-eight men were included in the study and randomized to either ICBT or to a control group, which was an online discussion group. Treatment consisted of a 7-week Web-based program with e-mail-based therapist support. Each therapist spent an average of 55 minutes per participant. less thanbrgreater than less thanbrgreater thanMain Outcome Measure. The International Index of Erectile Functioning five-item version was administered via the telephone at pretreatment, post-treatment, and 6 months after receiving ICBT. less thanbrgreater than less thanbrgreater thanResults. At post-treatment, the treatment group had significantly greater improvements with regard to erectile performance compared with the control group. Between-group differences at post-treatment were small (d = 0.1), but increased at the 6-month follow-up (d = 0.88). less thanbrgreater than less thanbrgreater thanConclusions. This study provides support for the use of ICBT as a possible treatment format for erectile dysfunction.

  • 16.
    Andersson, Evelyn
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Rück, Christian
    Karolinska Institutet, Stockholm, Sweden.
    Lavebratt, Catharina
    Karolinska Institutet, Stockholm, Sweden.
    Hedman, Erik
    Karolinska Institutet, Stockholm, Sweden.
    Schalling, Martin
    Karolinska Institutet, Stockholm, Sweden.
    Lindefors, Nils
    Karolinska Institutet, Stockholm, Sweden.
    Eriksson, Elias
    Sahlgrenska Academy, University of Gothenburg, Sweden.
    Carlbring, Per
    Stockholm University, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institutet, Stockholm, Sweden.
    Furmark, Tomas
    Uppsala University, Sweden.
    Genetic polymorphisms in monoamine systems and outcome of cognitive behavior therapy for social anxiety disorder2013In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 11, p. e79015-Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The role of genetics for predicting the response to cognitive behavior therapy (CBT) for social anxiety disorder (SAD) has only been studied in one previous investigation. The serotonin transporter (5-HTTLPR), the catechol-o-methyltransferase (COMT) val158met, and the tryptophan hydroxylase-2 (TPH2) G-703Tpolymorphisms are implicated in the regulation of amygdala reactivity and fear extinction and therefore might be of relevance for CBT outcome. The aim of the present study was to investigate if these three gene variants predicted response to CBT in a large sample of SAD patients.

    METHOD: Participants were recruited from two separate randomized controlled CBT trials (trial 1: n = 112, trial 2: n = 202). Genotyping were performed on DNA extracted from blood or saliva samples. Effects were analyzed at follow-up (6 or 12 months after treatment) for both groups and for each group separately at post-treatment. The main outcome measure was the Liebowitz Social Anxiety Scale Self-Report.

    RESULTS: At long-term follow-up, there was no effect of any genotype, or gene × gene interactions, on treatment response. In the subsamples, there was time by genotype interaction effects indicating an influence of the TPH2 G-703T-polymorphism on CBT short-term response, however the direction of the effect was not consistent across trials.

    CONCLUSIONS: None of the three gene variants, 5-HTTLPR, COMTval158met and TPH2 G-703T, was associated with long-term response to CBT for SAD.

     

  • 17.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Stockholm, Sweden .
    Age may moderate response to different unguided Internet-delivered interventions for depression2014In: Evidence-Based Mental Health, ISSN 1362-0347, E-ISSN 1468-960X, Vol. 17, no 1, p. 29-Article in journal (Refereed)
  • 18.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Atheism and how it is perceived: Manipulation of, bias against and ways to reduce the bias2016In: Nordic Psychology, ISSN 1901-2276, E-ISSN 1904-0016, Vol. 68, no 3, p. 194-203Article, review/survey (Refereed)
    Abstract [en]

    In recent years, there has been an increased interest in the cognitive foundations of religion and experimental methods have been used to explain religious behaviours. However, in the world, there are a substantial number of non-believers (atheists), and this has been a largely unknown field for experimental and more basic research informed by cognitive science. This has now changed and in this review, I cover three domains of study. First, studies in which belief in God has been manipulated in the direction of showing less belief are reviewed. For example, it is shown that analytical thinking reduces religious belief. Second, recent studies on cognitive bias against atheists are covered showing that atheists are distrusted, elicit disgust and are viewed as immoral both explicitly and implicitly. Third, I review studies in which prejudice against atheists has been experimentally manipulated showing that it is possible to reduce bias against atheists. I conclude the paper arguing that the bias against atheists need to be investigated in the Scan-dinavian countries.

  • 19.
    Andersson, Gerhard
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Arts and Sciences.
    Chronic pain and praying to a higher power: useful or useless?2008In: Journal of religion and health, ISSN 1573-6571, Vol. 47, no 2, p. 176-87Article in journal (Refereed)
    Abstract [en]

    In the present study a Swedish sample of 118 persons with chronic pain completed online tests on two occasions in association with treatment trials. A three item subscale measuring praying as a coping strategy was derived from the Coping Strategies Questionnaire (CSQ), but adapted to refer to "a higher power" instead of "God". Measures of pain and anxiety/depression were also included. Results revealed significant associations between praying and pain interference and impairment. Praying was also associated with anxiety and depression scores. Results also showed that prayer predicted depression scores at follow-up, and that follow-up prayer was predicted by pain interference at first measurement occasion. Overall, if prayer had any relation with the other variables it was in the negative direction of more distress being associated with more praying both concurrently and prospectively.

  • 20.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Clinician-Supported Internet-Delivered Psychological Treatment of Tinnitus2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 299-301Article in journal (Refereed)
    Abstract [en]

    Purpose: Internet-delivered psychological treatments for tinnitus distress have existed for more than 15 years, and there are a slowly growing number of studies. The aim of this brief report is to review the evidence and to comment on the future potentials of Internet treatments for tinnitus. Method: Studies were retrieved, and in total 6 controlled studies were included in the review with 9 different comparisons (6 in which the treatment was compared against a control group and 3 in which Internet treatment was compared against group treatment). Moreover, 2 open studies based on clinical samples in regular care were also included in the review. The outcomes for the 2 controlled sets of studies were analyzed using meta-analytic methods. Results: For the 6 studies comparing Internet treatment against a no-treatment control condition, a moderate effect size was found (Hedgess g = 0.58). The 3 studies comparing Internet treatment against face-to-face group treatments showed a small difference of Hedgess g = 0.13. Conclusions: Internet-delivered psychological treatment holds promise as a treatment alternative to other standard forms of treatment delivery, including group treatment. Larger studies are needed as well as ways to blend information technology with regular services.

  • 21.
    Andersson, Gerhard
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Clinical and Social Psychology.
    Fakta och fiktion i psykoterapiforskning2005In: Sokraten, no 4Article in journal (Other academic)
    Abstract [sv]

       

  • 22.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Guided internet treatment for anxiety disorders. As effective as face-to-face therapies?2012In: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 181, p. 3-7Article in journal (Refereed)
    Abstract [en]

    Introduction: Guided Internet-delivered treatments were developed in the late 1990s and have since been tested in numerous controlled trials. While promising, there are yet few direct comparisons between Internet treatments and traditional face-to-face treatments. The aim of the present study is to present an overview of the evidence in the field of anxiety disorders. Method: Studies were located, including unpublished trials from our research group in Sweden. Results: Results of direct comparative trials on panic disorder (n=3) and social anxiety disorder (n=3) show equivalent outcomes. One study on specific phobia did not show equivalent outcomes with an advantage for face-to-face treatment. However, a systematic review by Cuijpers et al. (2010) found equivalent outcomes across several self-help formats, suggesting that guided self-help overall can be as affective as face-to-face treatments. Conclusion: Overall, there are still few large-scale trials and statistical power is often limited. A preliminary conclusion is that guided Internet treatment can be as effective as face-to-face treatments, but there is a need to investigate moderators and mediators of the outcome.

  • 23.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Internet interventions: Past, present and future2018In: Internet Interventions, ISSN 2214-7829, Vol. 12, p. 181-188Article in journal (Refereed)
    Abstract [en]

    Internet interventions have been around now for about 20 years. While the field still suffers from a scattered terminology a large number of programs and studies exist. In the present paper I present an overview of my experiences of studying internet-supported cognitive-behaviour therapy (ICBT), but also mention other approaches including the use of smartphones. The paper covers the history of ICBT, short-term effects in controlled trials for a range of conditions, long-term effects, comparisons against face-to-face therapy, effectiveness studies, prediction studies, how the treatment is perceived, critique, and finally future directions. I conclude that we have now reached a stage in which we have numerous evidence-based treatments and procedures, and increasingly internet interventions including ICBT are disseminated.

  • 24.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Internet-based CBT improves fatigue severity, physical function and school attendance in adolescents with chronic fatigue syndrome2012In: Evidence-Based Mental Health, ISSN 1362-0347, E-ISSN 1468-960X, Vol. 15, no 3, p. 81-Article in journal (Refereed)
  • 25.
    Andersson, Gerhard
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology.
    Internet-based cognitive-behavioral self help for depression2006In: Expert Review of Neurotherapeutics, ISSN 1473-7175, Vol. 6, no 11, p. 1637-1642Article in journal (Refereed)
    Abstract [en]

    Depression is a common condition that can be treated in many different ways. Accumulating evidence suggests that self help, based on cognitive-behavioral principles, is an evidence-based treatment for mild-to-moderate depression. Self help commonly requires some form of guidance, but can still be cost effective and the results are often similar to what can be observed in face-to-face therapy. Recently, the possibility of administering cognitive-behavioral treatment via the internet has been explored. There are several advantages to using the internet, the main one being that it bridges distances and is readily available for an increasing number of people in the world. While few controlled studies have examined the effects of internet-delivered self help for depression, the results are promising for applications that involve brief therapist input. Future possible applications of internet-based self help are discussed. © 2006 Future Drugs Ltd.

  • 26.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Internet-Delivered Psychological Treatments.2016In: Annual Review of Clinical Psychology, ISSN 1548-5943, E-ISSN 1548-5951, Vol. 12, p. 157-179Article in journal (Refereed)
    Abstract [en]

    During the past 15 years, much progress has been made in developing and testing Internet-delivered psychological treatments. In particular, therapist-guided Internet treatments have been found to be effective for a wide range of psychiatric and somatic conditions in well over 100 controlled trials. These treatments require (a) a secure web platform, (b) robust assessment procedures, (c) treatment contents that can be text based or offered in other formats, and (d) a therapist role that differs from that in face-to-face therapy. Studies suggest that guided Internet treatments can be as effective as face-to-face treatments, lead to sustained improvements, work in clinically representative conditions, and probably are cost-effective. Despite these research findings, Internet treatment is not yet disseminated in most places, and clinical psychologists should consider using modern information technology and evidence-based treatment programs as a complement to their other services, even though there will always be clients for whom face-to-face treatment is the best option.

  • 27.
    Andersson, Gerhard
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology.
    Is "stepped care" the right format for Internet delivered cognitive behaviour therapy for anxiety disorders and depression?2007In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 22 Suppl. 1, p. 61-61Article in journal (Other academic)
  • 28.
    Andersson, Gerhard
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Clinical and Social Psychology.
    Många framsteg i tinnitusforskningen2005In: Audionytt, ISSN 0347-6308, Vol. 32, p. 14-15Article in journal (Refereed)
  • 29.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Psykologisk behandling vid depression: teorier, terapimetoder och forskning2012 (ed. 1)Book (Other academic)
    Abstract [sv]

    Unikt för depressionsområdet är att flera psykologiska behandlingsmetoder visat sig hjälpsamma. Den här boken ger en fördjupning i de mest etablerade psykoterapiformerna  psykodynamisk, humanistisk och interpersonell psykoterapi, samt kognitiv beteendeterapi. För varje metod beskrivs teoribakgrund, behandlingens upplägg, forskningseffekter och vem metoden passar för. Boken är skriven för studenter på vårdutbildningar, de som arbetar med depressionsbehandling och alla med intresse för psykoterapiforskning.

  • 30.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Psykoterapi och psykologisk behandling2016In: Psykiatri / [ed] Jörgen Herlofson, Lund: Studentlitteratur, 2016, 2, p. 669-681Chapter in book (Other academic)
    Abstract [en]

    I den här delen av kapitlet går vi igenom psykoterapi och psykologisk behandling. Avsnittet belyser olika terapiformer och format, och en slutsats är att psykologisk behandling fungerar, samt att kombinerad behandling med samtidig läkemedelsbehandling kan vara mer effektiv än att endast erbjuda läkemedel eller psykologisk behandling. Olika psykoterapier har effekt men det finns än så länge mest stöd för kognitiv beteendeterapi.

  • 31.
    Andersson, Gerhard
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Clinical and Social Psychology.
    Religion allt viktigare i terapeutiskt arbete2006In: Psykologtidningen / utgiven av Sveriges psykologförbund, ISSN 0280-9702, Vol. 52Article in journal (Other (popular science, discussion, etc.))
  • 32.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology.
    Smartphone applications can help in treatment for alcoholism.2015In: Evidence-Based Mental Health, ISSN 1362-0347, E-ISSN 1468-960X, Vol. 18, no 1, p. 27-Article in journal (Refereed)
  • 33.
    Andersson, Gerhard
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Clinical and Social Psychology.
    Specifika minnen betydelsefulla för vår hälsa2004In: Psykologtidningen / utgiven av Sveriges psykologförbund, ISSN 0280-9702, Vol. 50Article in journal (Other (popular science, discussion, etc.))
  • 34.
    Andersson, Gerhard
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Clinical and Social Psychology.
    Specifikke erindringer vigtige for helbredet2004In: Psykolognytt : organ för Sveriges psykologförbund, ISSN 0033-3220, Vol. 58Article in journal (Other (popular science, discussion, etc.))
  • 35.
    Andersson, Gerhard
    Linköping University. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning.
    The contribution of active medication to combined treatments of psychotherapy and pharmacotherapy for adult depression: a meta-analysis.2010In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 121, no 6, p. 415-23Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Although there is sufficient evidence that combined treatments of psychotherapy and pharmacotherapy are more effective for depression in adults than each of the treatments alone, it remains unclear what the exact contribution of active medication is to the overall effects of combined treatments. This paper examines the contribution of active medication to combined psychotherapy and pharmacotherapy treatments. METHOD: Meta-analysis of randomised controlled trials comparing the combination of psychotherapy and pharmacotherapy with the combination of psychotherapy and placebo. RESULTS: Sixteen identified studies involving 852 patients met our inclusion criteria. The standardised mean difference indicating the differences between the combination of psychotherapy and pharmacotherapy and the combination of psychotherapy and placebo was 0.25 (95% CI: 0.03-0.46), which corresponds to a numbers-needed-to-be-treated of 7.14. No significant differences between subgroups of studies were found. CONCLUSION: Active medication has a small but significant contribution to the overall efficacy of combined treatments.

  • 36.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    The internet and CBT: a clinical guide2014 (ed. 1)Book (Refereed)
    Abstract [en]

    Comprehensive and practical, The Internet and CBT: A Clinical Guide describes how cognitive behavioural therapy can be delivered via the Internet, email, open access programmes, online communities and via smartphone. Detailing how these alternative methods of CBT support can be integrated within a busy practice, it is invaluable for all CBT clinicians and students wishing to find out more about assessing and supporting people in innovative ways. This book enables you to:

    • Learn how to best give advice concerning online support communities and when to recommend guided self help online
    • Understand how to integrate online and smartphone CBT delivery into your daily practice
    • Explore the resources and treatment programmes available
    • Perform online assessments
    • Guide and supervise the people in your care
    • Comprehend issues of patient confidentiality and what you need to do to ensure safe and ethical practice

    With its no-nonsense and down-to-earth approach, this book covers the dos and don'ts of CBT delivery online and via smartphone and provides a highly accessible guide for students and practitioners wishing to incorporate online CBT into their work. It will be of great interest to CBT clinicians, psychologists, psychotherapists, counsellors and mental health nurses.

  • 37.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    The promise and pitfalls of the internet for cognitive behavioral therapy2010In: BMC Medicine, ISSN 1741-7015, E-ISSN 1741-7015, Vol. 8, no 82Article in journal (Other academic)
    Abstract [en]

    Internet-administered cognitive behavior therapy is a promising new way to deliver psychological treatment. There are an increasing number of controlled trials in various fields such as anxiety disorders, mood disorders and health conditions such as headache and insomnia. Among the advantages for the field of cognitive behavior therapy is the dissemination of the treatment, being able to access treatment from a distance, and possibilities to tailor the interventions. To date, studies in which large effects have been obtained have included patient support from a clinician. Recent trials suggest that this support may come from non-clinicians and that therapist effects are minimal. Since studies also suggest that internet-delivered cognitive behavior therapy can be equally effective as face-to-face cognitive behavior therapy, this is a finding that may have implications for CBT practitioners. However, there are other aspects to consider for implementation, as while clinicians may hold positive attitudes towards internet-delivered CBT a recent study suggested that patients are more skeptical and may prefer face-to-face treatment. In the present work, I argue that internet-delivered CBT may help to increase adherence to treatment protocols, that training can be facilitated by means of internet support, and that research on internet interventions can lead to new insights regarding what happens in regular CBT. Moreover, I conclude that internet-delivered CBT works best when support is provided, leaving an important role for clinicians who can incorporate internet treatment in their services. However, I also warn against disseminating internet-delivered CBT to patients for whom it is not suitable, and that clinical skills may suffer if clinicians are trained and practice mainly using the internet.

  • 38.
    Andersson, Gerhard
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology.
    Tinnitus2007In: Cambridge Handbook of Psychology, Health & Medicine / [ed] Ayers, Susan,Andrew Baum,Chris McManus, Cambridge: Cambridge University Press , 2007, 2, p. 906-909Chapter in book (Other academic)
    Abstract [en]

    Health psychology is a rapidly expanding discipline at the interface of psychology and clinical medicine. This new edition is fully reworked and revised, offering an entirely up-to-date, comprehensive, accessible, one-stop resource for clinical psychologists, mental health professionals and specialists in health-related matters. There are two new editors: Susan Ayers from the University of Sussex and Kenneth Wallston from Vanderbilt University Medical Center.

    The prestigious editorial team and their international, interdisciplinary cast of authors have reconceptualised their much-acclaimed handbook. The book is now in two parts: part I covers psychological aspects of health and illness, assessments, interventions and healthcare practice. Part II covers medical matters listed in alphabetical order. Among the many new topics added are: diet and health, ethnicity and health, clinical inrterviewing, mood assessment, communicating risk, medical interviewing, diagnostic procedures, organ donation, IVF, MMR, HRT, sleep disorders, skin disorders, depression and anxiety disorders.

  • 39.
    Andersson, Gerhard
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Clinical and Social Psychology.
    Tinnitus2004In: MIT Encyclopedia of Communication Disorders / [ed] Raymond D. Kent, Massachusetts Institute of Technology, Cambridge: The MIT press , 2004, p. 556-558Chapter in book (Other academic)
    Abstract [en]

    A massive reference work on the scale of MITECS (The MIT Encyclopedia of Cognitive Sciences), The MIT Encyclopedia of Communication Disorders will become the standard reference in this field for both research and clinical use. It offers almost 200 detailed entries, covering the entire range of communication and speech disorders in children and adults, from basic science to clinical diagnosis.

    MITECD is divided into four sections that reflect the standard categories within the field (also known as speech-language pathology and audiology): Voice, Speech, Language, and Hearing. Within each category, entries are organized into three subsections: Basic Science, Disorders, and Clinical Management. Basic Science includes relevant information on normal anatomy and physiology, physics, psychology and psychophysics, and linguistics; this provides a scientific foundation for entries in the other subsections. The entries that appear under Disorders offer information on the definition and characterization of specific disorders, and tools for their identification and assessment. The Clinical Management subsection describes appropriate interventions, including behavioral, pharmacological, surgical, and prosthetic.

    Because the approach to communication disorders can be quite different for children and adults, many topics include separate entries reflecting this. Although some disorders that are first diagnosed in childhood may persist in some form throughout adulthood, many disorders can have an onset in either childhood or adulthood, and the timing of onset can have many implications for both assessment and intervention.

    Topics covered in MITECD include cochlear implants for children and adults, pitch perception, tinnitus, alaryngeal voice and speech rehabilitation, neural mechanisms of vocalization, holistic voice therapy techniques, computer-based approaches to children?s speech and language disorders, neurogenic mutism, regional dialect, agrammatism, global aphasia, and psychosocial problems associated with communicative disorders.

  • 40.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Tinnitus patients with cognitive problems: Causes and possible treatments2009In: Hearing Journal, ISSN 0745-7472, Vol. 62, no 11, p. 27-29Article in journal (Refereed)
    Abstract [en]

    [No abstract available]

  • 41.
    Andersson, Gerhard
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Clinical and Social Psychology.
    Transferring cognitive behavioural interventions to the Internet: Can it be done?2006In: InPsych, ISSN 1441-8754, Vol. 28, p. 10-13Article in journal (Other (popular science, discussion, etc.))
  • 42.
    Andersson, Gerhard
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Clinical and Social Psychology.
    Airikka, Marie-Louise
    Buhrman, Monica
    Kaldo, Viktor
    Dimensions of perfectionism and tinnitus distress2005In: Psychology, Health & Medicine, ISSN 1354-8506, E-ISSN 1465-3966, Vol. 10, no 1, p. 78-87Article in journal (Refereed)
    Abstract [en]

    This study investigated the relationship between perfectionism and tinnitus distress. In addition, associations between perfectionism, sleep problems and anxiety/depression were investigated. The study included 256 tinnitus patients who completed measures of perfectionism, tinnitus distress, anxiety, depression, and a measure of insomnia. Gender-differentiated multiple regression analyses showed that anxiety and depressive states were related to tinnitus distress for both genders. However, for the males, the perfectionism subscale Personal Standards was related to tinnitus distress, whereas in females, it was the Organization subscale that was most predictive of tinnitus distress.

  • 43.
    Andersson, Gerhard
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Clinical and Social Psychology.
    Asmundson, Gordon
    CBT and religion2006In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 35Article in journal (Other academic)
  • 44.
    Andersson, Gerhard
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology.
    Asmundson, Gordon
    Should CBT rest on its success?2008In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 37Article in journal (Other academic)
  • 45.
    Andersson, Gerhard
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Asmundson, Gordon
    Faculty of Kinesiology and Health Studies University of Regina Regina, Sask. S4S 0A2, Canada.
    Carlbring, Per
    Linköping University, Department of Behavioural Sciences, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Ghaderi, Ata
    Inst f Psykologi Uppsala universitet.
    Hofmann, Stefan
    Department of Psychology Boston University, Boston, MA, United States.
    Stewart, Sherry
    Department of Psychology Dalhousie University, Halifax, NS, Canada.
    Is CBT already the Dominant Paradigm in Psychotherapy Research and Practice?2005In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 34, no 1Article in journal (Refereed)
  • 46.
    Andersson, Gerhard
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Clinical and Social Psychology.
    Asmundson, Gordon J
    Denev, Johanna
    Nilsson, Johanna
    Hans-Christian, Larsen
    A controlled trial of cognitive-behavior therapy combined with vestibular rehabilitation in the treatment of dizziness2006In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 44, no 9, p. 1265-1273Article in journal (Refereed)
    Abstract [en]

    Dizziness is a common and often untreated symptom in the general population. The aim of this study was to investigate the effects of a combined cognitive-behavioral/vestibular rehabilitation (VR) program, using a randomized control design. A total of 29 participants were randomized to treatment consisting of psychoeducation, vestibular exercises, relaxation and cognitive interventions, or to serve as waiting list controls. Measures of dizziness-related handicap, dizziness-provoking movements, and daily diary registrations of dizziness symptoms at pre- and post-treatment showed statistically significant improvements in many domains, which translated to moderate effect sizes. These findings provide preliminary support for the combination of Cognitive-behavioral therapy (CBT) and VR methods in the treatment of dizziness. © 2005 Elsevier Ltd. All rights reserved.

  • 47.
    Andersson, Gerhard
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Clinical and Social Psychology.
    Baguley, David
    McKenna, Laurence
    McFerran, Don
    Tinnitus: A multidisciplinary approach2005Book (Other academic)
    Abstract [en]

    Tinnitus: A Multidisciplinary Approach provides a broad account of tinnitus and hyperacusis, detailing the latest research and developments in clinical management, incorporating insights from audiology, otology, psychology, psychiatry and auditory neuroscience. It promotes a collaborative approach to treatment that will benefit patients and clinicians alike.

  • 48.
    Andersson, Gerhard
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Department of Clinical Neuroscience, Division of Psychiatry, Karolinska InstitutetStockholm, Sweden.
    Bergman Nordgren, Lise
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Buhrman, M.
    Department of Psychology, Uppsala University, Box 12 25Uppsala, Sweden.
    Carlbring, P.
    Department of Psychology, Stockholm UniversityStockholm, Sweden.
    Psychological treatments for depression delivered via the internet and supported by a clinician: An update2014In: Revista de Psicopatologia y Psicologia Clinica, ISSN 1136-5420, Vol. 19, no 3, p. 217-225Article in journal (Refereed)
    Abstract [en]

    Guided internet-delivered cognitive behaviour therapy (ICBT) has been tested in many trials since the early studies dating back to the late 1990s. The aim of this review was to investigate the most recent literature on guided ICBT for depression. We identified 11 controlled studies published between January 2013 and September 2014. Overall, large treatment effects were observed with a few exceptions. A majority (7 studies) provided some information regarding unwanted effects such as deterioration. Three studies directly compared guided ICBT against face-to-face CBT. We added an earlier study and calculated meta-analytic summary statistics for the four studies involving a total of 336 participants. The average effect size difference was Hedges g = 0.12 (95% CI: -0.08∼0.32) in the direction of favouring guided ICBT, but with no practical importance. We conclude that guided ICBT is a promising treatment for depression and mood disorders and that the research is rapidly expanding.

  • 49.
    Andersson, Gerhard
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology.
    Bergstrom, J.
    Bergström, J., Department of Clinical Neuroscience, Section of Psychiatry, Karolinska Institute, Stockholm, Sweden.
    Hollandare, F.
    Holländare, F., Department of Psychology, Uppsala University.
    Ekselius, L.
    Department of Neuroscience, Psychiatry, Uppsala University Hospital, Sweden.
    Carlbring, P.
    Department of Psychology, Uppsala University.
    Delivering cognitive behavioural therapy for mild to moderate depression via the Internet: Predicting outcome at 6-month follow-up2004In: Verhaltenstherapie (Basel), ISSN 1016-6262, E-ISSN 1423-0402, Vol. 14, no 3, p. 185-189Article in journal (Refereed)
    Abstract [en]

    Introduction: Mild to moderate depression has been successfully treated with cognitive-behavioural (CBT) bibliotherapy, including minimal therapist contact. More recently, the Internet has been used to deliver the treatment, with obvious gains in terms of cost reduction and increased accessibility. In the present study we analysed pre-treatment predictors of improvement following Internet-based self-help treatment of mild to moderate depression. Patients and Methods: Included were 71 participants from a randomised trial who completed a 6-month follow-up. Change indexes were calculated from the Beck Depression Inventory (BDI) and the Montgomery Åsberg Depression Rating Scale (MADRS). Results: In line with the literature on depression, the number of previous episodes of depression was negatively associated with improvement after treatment. Follow-up scores on the BDI and MADRS were associated with pre-treatment levels of depression, anxiety and low levels of quality of life. Discussion: As indicated by traditional psychotherapy studies, finding predictors of outcome is a difficult task. Patients with repeated episodes of depression might benefit less from self-help over the Internet, but as the correlation is weak, no firm conclusions can be drawn.

  • 50.
    Andersson, Gerhard
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology.
    Bergström, Jan
    Buhrman, Monica
    Carlbring, Per
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology.
    Holländare, Fredrik
    Kaldo, Viktor
    Nilsson-Ihrfelt, Elisabeth
    Paxling, Björn
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning.
    Ström, Lars
    Waara, Johan
    Development of a new approach to guided self-help via the Internet. The Swedish experience.2008In: Journal of technology in human services, ISSN 1522-8835, E-ISSN 1522-8991, Vol. 26, p. 161-181Article in journal (Refereed)
    Abstract [en]

    This article describes the development and empirical status of guided Internet-delivered self-help. The treatment approach combines the benefits of bibliotherapy with book-length text materials and the support given online via web pages and e-mail. Interactive features such as online registrations, tests, and online discussion forums are also included. Cognitive behavior therapy (CBT) guided the research and clinical implementations of this approach, as it lends itself more easily to the self-help format compared with other presently available psychotherapy approaches. We include an overview of the research, current issues and research in service delivery, lessons learned through a program of research, and directions for future investigations.

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