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  • 1.
    Andersson, Gerhard
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Paxling, Björn
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Wiwe, Maria
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Vernmark, Kristofer
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Psykologpartners, Private Practice, Linköping.
    Felix, Christina Bertholds
    Uppsala University.
    Lundborg, Lisa
    Uppsala University.
    Furmark, Tomas
    Uppsala University.
    Cuijpers, Pim
    VU University Amsterdam, and EMGO Institute, The Netherlands.
    Carlbring, Per
    Umeå University.
    Therapeutic alliance in guided internet-delivered cognitive behavioural treatment of depression, generalized anxiety disorder and social anxiety disorder2012Ingår i: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 50, nr 9, s. 544-550Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in several controlled trials, but the mechanisms of change are largely unknown. Therapeutic alliance is a factor that has been studied in many psychotherapy trials, but the role of therapeutic alliance in ICBT is less well known. The present study investigated early alliance ratings in three separate samples. Participants from one sample of depressed individuals (N = 49), one sample of individuals with generalized anxiety disorder (N = 35), and one sample with social anxiety disorder (N = 90) completed the Working Alliance Inventory (WAI) modified for ICBT early in the treatment (weeks 3-4) when they took part in guided ICBT for their conditions. Results showed that alliance ratings were high in all three samples and that the WAI including the subscales of Task, Goal and Bond had high internal consistencies. Overall, correlations between the WAI and residualized change scores on the primary outcome measures were small and not statistically significant. We conclude that even if alliance ratings are in line with face-to-face studies, therapeutic alliance as measured by the WAI is probably less important in ICBT than in regular face-to-face psychotherapy.

  • 2.
    Dahlin, Mats
    et al.
    Psykologpartners, Private practice, Linköping, Sweden.
    Ryberg, Marielle
    Psykologpartners, Private practice, Linköping, Sweden.
    Vernmark, Kristofer
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Psykologpartners, Private practice, Linköping, Sweden.
    Annas, Nina
    Psykiatripartners, Private practice, Linköping, Sweden.
    Carlbring, Per
    Division of Clinical Psychology, Department of Psychology, Stockholm University, Stockholm, Sweden.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institute, Stockholm, Sweden.
    Internet-delivered acceptance-based behavior therapy for generalized anxiety disorder: A pilot study2016Ingår i: Internet Interventions, ISSN 2214-7829, Vol. 6, s. 16-21Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    Internet-delivered cognitive behavior therapy (ICBT) has been developed and tested for treating persons with generalized anxiety disorder (GAD). A new form of CBT focuses on acceptance (of internal experiences or difficult psychological content), mindfulness and valued actions. To date this form of CBT has not been delivered via the internet for persons with GAD. The aim of this study was to describe the functionality of a new internet-delivered acceptance-based behavior therapy for GAD, and to test the effect of the intervention in an open pilot trial.

    Methods

    Following exclusion of two patients we included 14 patients diagnosed with GAD from two primary care clinics. At 2–3 months follow-up after treatment 10 patients completed the outcome measures. The treatment lasted for an average of 15 weeks and consisted of acceptance-based techniques, behavior therapy components and homework assignments.

    Results

    A majority of participants completed all modules during the treatment. Findings on the Penn State Worry Questionnaire showed a within-group improvement of Cohen's d = 2.14 at posttreatment. At the follow-up results were maintained. Client satisfaction ratings were high.

    Conclusions

    We conclude that internet-delivered acceptance-based behavior therapy potentially can be a promising new treatment for GAD. A controlled trial of the program has already been completed.

  • 3.
    Ebert, D. D.
    et al.
    University of Erlangen Nurnberg, Germany.
    Donkin, L.
    University of Sydney, Australia; Vrije University of Amsterdam, Netherlands.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Karolinska Institute, Sweden.
    Andrews, G.
    University of New South Wales, Australia.
    Berger, T.
    University of Bern, Switzerland.
    Carlbring, P.
    Stockholm University, Sweden.
    Rozenthal, A.
    Stockholm University, Sweden.
    Choi, I.
    University of Sydney, Australia.
    Laferton, J. A. C.
    Psychol Hsch Berlin, Germany.
    Johansson, Robert
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten. Karolinska Institute, Sweden.
    Kleiboer, A.
    Vrije University of Amsterdam, Netherlands.
    Lange, A.
    University of Amsterdam, Netherlands.
    Lehr, D.
    Leuphana University of Luneburg, Germany.
    Reins, J. A.
    Leuphana University of Luneburg, Germany.
    Funk, B.
    Leuphana University of Luneburg, Germany.
    Newby, J.
    University of New South Wales, Australia.
    Perini, S.
    Macquarie University, Australia.
    Riper, H.
    Vrije University of Amsterdam, Netherlands.
    Ruwaard, J.
    Vrije University of Amsterdam, Netherlands.
    Sheeber, L.
    Oregon Research Institute, OR 97403 USA.
    Snoek, F. J.
    Vrije University of Amsterdam, Netherlands; University of Amsterdam, Netherlands.
    Titov, N.
    Macquarie University, Australia; Macquarie University, Australia.
    Unlu Ince, B.
    Vrije University of Amsterdam, Netherlands.
    van Bastelaar, K.
    Vrije University of Amsterdam, Netherlands.
    Vernmark, Kristofer
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    van Straten, A.
    Vrije University of Amsterdam, Netherlands.
    Warmerdam, L.
    Vrije University of Amsterdam, Netherlands.
    Salsman, N.
    Xavier University, OH 45207 USA.
    Cuijpers, P.
    Vrije University of Amsterdam, Netherlands.
    Does Internet-based guided-self-help for depression cause harm? An individual participant data meta-analysis on deterioration rates and its moderators in randomized controlled trials2016Ingår i: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 46, nr 13, s. 2679-2693Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background: Almost nothing is known about the potential negative effects of Internet-based psychological treatments for depression. This study aims at investigating deterioration and its moderators within randomized trials on Internet-based guided self-help for adult depression, using an individual patient data meta-analyses (IPDMA) approach.

    Method: Studies were identified through systematic searches (PubMed, PsycINFO, EMBASE, Cochrane Library). Deterioration in participants was defined as a significant symptom increase according to the reliable change index (i.e. 7.68 points in the CES-D; 7.63 points in the BDI). Two-step IPDMA procedures, with a random-effects model were used to pool data.

    Results: A total of 18 studies (21 comparisons, 2079 participants) contributed data to the analysis. The risk for a reliable deterioration from baseline to post-treatment was significantly lower in the intervention v. control conditions (3.36 v. 7.60; relative risk 0.47, 95% confidence interval 0.29-0.75). Education moderated effects on deterioration, with patients with low education displaying a higher risk for deterioration than patients with higher education. Deterioration rates for patients with low education did not differ statistically significantly between intervention and control groups. The benefit-risk ratio for patients with low education indicated that 9.38 patients achieve a treatment response for each patient experiencing a symptom deterioration.

    Conclusions: Internet-based guided self-help is associated with a mean reduced risk for a symptom deterioration compared to controls. Treatment and symptom progress of patients with low education should be closely monitored, as some patients might face an increased risk for symptom deterioration. Future studies should examine predictors of deterioration in patients with low education.

  • 4.
    Ivanova, Ekaterina
    et al.
    Stockholm University, Sweden.
    Lindner, Philip
    Stockholm University, Sweden; Karolinska Institute, Sweden.
    Ly, Kien Hoa
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Dahlin, Mats
    Psykologpartners, Linköping, Sweden.
    Vernmark, Kristofer
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Psykologpartners, Linköping, Sweden.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Karolinska Institute, Sweden.
    Carlbring, Per
    Stockholm University, Sweden.
    Guided and unguided Acceptance and Commitment Therapy for social anxiety disorder and/or panic disorder provided via the Internet and a smartphone application: A randomized controlled trial2016Ingår i: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 44, s. 27-35Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Acceptance and Commitment Therapy (ACT) can be effective in treating anxiety disorders, yet there has been no study on Internet-delivered ACT for social anxiety disorder (SAD) and panic disorder (PD), nor any study investigating whether therapist guidance is superior to unguided self-help when supplemented with a smartphone application. In the current trial, n = 152 participants diagnosed with SAD and/or PD were randomized to therapist-guided or unguided treatment, or a waiting-list control group. Both treatment groups used an Internet-delivered ACT-based treatment program and a smartphone application. Outcome measures were self-rated general and social anxiety and panic symptoms. Treatment groups saw reduced general (d = 0.39) and social anxiety (d = 0.70), but not panic symptoms (d = 0.05) compared to the waiting-list group, yet no differences in outcomes were observed between guided and unguided interventions. We conclude that Internet-delivered ACT is appropriate for treating SAD and potentially PD. Smartphone applications may partially compensate for lack of therapist support. (C) 2016 Published by Elsevier Ltd.

  • 5.
    Karyotaki, E.
    et al.
    Vrije University of Amsterdam, Netherlands; Vrije University of Amsterdam, Netherlands.
    Kleiboer, A.
    Vrije University of Amsterdam, Netherlands; Vrije University of Amsterdam, Netherlands.
    Smit, F.
    Vrije University of Amsterdam, Netherlands; Vrije University of Amsterdam, Netherlands; Trimbus Institute Netherlands Institute Mental Health and Addic, Netherlands.
    Turner, D. T.
    Vrije University of Amsterdam, Netherlands; Vrije University of Amsterdam, Netherlands.
    Pastor, A. M.
    Jaume University, Spain.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Karolinska Institute Disabil Research, Sweden.
    Berger, T.
    University of Bern, Switzerland.
    Botella, C.
    Jaume University, Spain; Institute Salud Carlos III, Spain.
    Breton, J. M.
    Jaume University, Spain.
    Carlbring, P.
    Stockholm University, Sweden.
    Christensen, H.
    Black Dog Institute, Australia; University of New S Wales, Australia.
    de Graaf, E.
    Maastricht University, Netherlands; Erasmus MC, Netherlands.
    Griffiths, K.
    Australian National University, Australia.
    Donker, T.
    Vrije University of Amsterdam, Netherlands; Vrije University of Amsterdam, Netherlands.
    Farrer, L.
    Australian National University, Australia.
    Huibers, M. J. H.
    Vrije University of Amsterdam, Netherlands; Vrije University of Amsterdam, Netherlands.
    Lenndin, J.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten. Not .
    Mackinnon, A.
    University of Melbourne, Australia.
    Meyer, B.
    Gaia AG, Germany; City University of London, England.
    Moritz, S.
    University of Medical Centre Hamburg Eppendorf, Germany.
    Riper, H.
    Vrije University of Amsterdam, Netherlands; Vrije University of Amsterdam, Netherlands.
    Spek, V.
    Tilburg University, Netherlands.
    Vernmark, Kristofer
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Psykologpartners, Linkoping, Sweden.
    Cuijpers, P.
    Vrije University of Amsterdam, Netherlands; Vrije University of Amsterdam, Netherlands.
    Predictors of treatment dropout in self-guided web-based interventions for depression: an individual patient data meta-analysis2015Ingår i: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 45, nr 13, s. 2717-2726Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. It is well known that web-based interventions can be effective treatments for depression. However, dropout rates in web-based interventions are typically high, especially in self-guided web-based interventions. Rigorous empirical evidence regarding factors influencing dropout in self-guided web-based interventions is lacking due to small study sample sizes. In this paper we examined predictors of dropout in an individual patient data meta-analysis to gain a better understanding of who may benefit from these interventions. Method. A comprehensive literature search for all randomized controlled trials (RCTs) of psychotherapy for adults with depression from 2006 to January 2013 was conducted. Next, we approached authors to collect the primary data of the selected studies. Predictors of dropout, such as socio-demographic, clinical, and intervention characteristics were examined. Results. Data from 2705 participants across ten RCTs of self-guided web-based interventions for depression were analysed. The multivariate analysis indicated that male gender [relative risk (RR) 1.08], lower educational level (primary education, RR 1.26) and co-morbid anxiety symptoms (RR 1.18) significantly increased the risk of dropping out, while for every additional 4 years of age, the risk of dropping out significantly decreased (RR 0.94). Conclusions. Dropout can be predicted by several variables and is not randomly distributed. This knowledge may inform tailoring of online self-help interventions to prevent dropout in identified groups at risk.

  • 6.
    Karyotaki, Eirini
    et al.
    VU, Netherlands.
    Ebert, David Daniel
    Friedrich Alexander Univ Erlangen Nurnberg, Germany.
    Donkin, Liesje
    Univ Sydney, Australia.
    Riper, Heleen
    VU, Netherlands.
    Twisk, Jos
    Vrije Univ Amsterdam, Netherlands.
    Burger, Simone
    VU, Netherlands.
    Rozental, Alexander
    UCL, England; Karolinska Inst, Sweden.
    Lange, Alfred
    Univ Amsterdam, Netherlands.
    Williams, Alishia D.
    Univ Utrecht, Netherlands.
    Zarski, Anna Carlotta
    Friedrich Alexander Univ Erlangen Nurnberg, Germany.
    Geraedts, Anna
    HumanTotalCare, Netherlands.
    van Straten, Annemieke
    VU, Netherlands.
    Kleiboer, Annet
    VU, Netherlands.
    Meyer, Bjoern
    Gaia AG, Germany; City Univ London, England.
    Ince, Burgin B. Unlu
    Middle East Tech Univ, Turkey.
    Buntrock, Claudia
    Friedrich Alexander Univ Erlangen Nurnberg, Germany.
    Lehr, Dirk
    Leuphana Univ Luneburg, Germany.
    Snoek, Frank J.
    Vrije Univ Amsterdam Med Ctr, Netherlands.
    Andrews, Gavin
    Univ New South Wales, Australia.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institute for Disability Research, Stockholm, Sweden.
    Choi, Isabella
    Univ Sydney, Australia.
    Ruwaard, Jeroen
    VU, Netherlands.
    Klein, Jan Philipp
    Luebeck Univ, Germany.
    Newby, Jill M.
    Univ New South Wales, Australia; MRC Cognit and Brain Sci Unit, England; Univ New South Wales, Australia.
    Schroder, Johanna
    Univ Med Ctr Hamburg Eppendorf, Germany; Inst Sex Res and Forens Psychiat, Germany.
    Laferton, Johannes A. C.
    Friedrich Alexander Univ Erlangen Nurnberg, Germany.
    Van Bastelaar, Kim
    Vrije Univ Amsterdam Med Ctr, Netherlands.
    Imamura, Kotaro
    Univ Tokyo, Japan.
    Vernmark, Kristofer
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Boss, Leif
    Leuphana Univ Luneburg, Germany.
    Sheeber, Lisa B.
    Oregon Res Inst, OR 97403 USA.
    Kivi, Marie
    Univ Gothenburg, Sweden.
    Berking, Matthias
    Friedrich Alexander Univ Erlangen Nurnberg, Germany.
    Tito, Nickolai
    Macquarie Univ, Australia.
    Carlbring, Per
    Stockholm Univ, Sweden; Univ Southern Denmark, Denmark.
    Johansson, Robert
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten. Karolinska Inst, Sweden.
    Kenter, Robin
    Univ Bergen, Norway.
    Perini, Sarah
    St Vincents Hosp, Australia.
    Moritz, Steffen
    VU, Netherlands.
    Nobis, Stephanie
    Leuphana Univ Luneburg, Germany.
    Berger, Thomas
    Univ Bern, Switzerland.
    Kaldo, Viktor
    Karolinska Inst, Sweden; Linnaeus Univ, Sweden.
    Forsell, Yvonne
    Karolinska Inst, Sweden.
    Lindefors, Nils
    Karolinska Inst, Sweden.
    Kraepelien, Martin
    Karolinska Inst, Sweden.
    Bjorkelund, Cecilia
    Univ Gothenburg, Sweden.
    Kawakami, Norito
    Univ Tokyo, Japan.
    Cuijpers, Pim
    VU, Netherlands.
    Do guided internet-based interventions result in clinically relevant changes for patients with depression? An individual participant data meta-analysis2018Ingår i: Clinical Psychology Review, ISSN 0272-7358, E-ISSN 1873-7811, Vol. 63, s. 80-92Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Little is known about clinically relevant changes in guided Internet-based interventions for depression. Moreover, methodological and power limitations preclude the identification of patients groups that may benefit more from these interventions. This study aimed to investigate response rates, remission rates, and their moderators in randomized controlled trials (RCTs) comparing the effect of guided Internet-based interventions for adult depression to control groups using an individual patient data meta-analysis approach. Literature searches in PubMed, Embase, PsycINFO and Cochrane Library resulted in 13,384 abstracts from database inception to January 1, 2016. Twenty-four RCTs (4889 participants) comparing a guided Internet-based intervention with a control group contributed data to the analysis. Missing data were multiply imputed. To examine treatment outcome on response and remission, mixed-effects models with participants nested within studies were used. Response and remission rates were calculated using the Reliable Change Index. The intervention group obtained significantly higher response rates (OR = 2.49, 95% CI 2.17-2.85) and remission rates compared to controls (OR = 2.41, 95% CI 2.07-2.79). The moderator analysis indicated that older participants (OR = 1.01) and native-born participants (1.66) were more likely to respond to treatment compared to younger participants and ethnic minorities respectively. Age (OR = 1.01) and ethnicity (1.73) also moderated the effects of treatment on remission.Moreover, adults with more severe depressive symptoms at baseline were more likely to remit after receiving intemet-based treatment (OR = 1.19). Guided Internet-based interventions lead to substantial positive treatment effects on treatment response and remission at post-treatment. Thus, such interventions may complement existing services for depression and potentially reduce the gap between the need and provision of evidence-based treatments.

  • 7.
    van Breda, Ward
    et al.
    Vrije University of Amsterdam, Netherlands.
    Hoogendoorn, Mark
    Vrije University of Amsterdam, Netherlands.
    Eiben, A. E.
    Vrije University of Amsterdam, Netherlands.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Riper, Heleen
    Vrije University of Amsterdam, Netherlands.
    Ruwaard, Jeroen
    Vrije University of Amsterdam, Netherlands.
    Vernmark, Kristofer
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Psykologpartners Linkoping, St T Larsgatan 30, S-58224 Linkoping, Sweden.
    A feature representation learning method for temporal datasets2016Ingår i: PROCEEDINGS OF 2016 IEEE SYMPOSIUM SERIES ON COMPUTATIONAL INTELLIGENCE (SSCI), IEEE , 2016Konferensbidrag (Refereegranskat)
    Abstract [en]

    Predictive modeling of future health states can greatly contribute to more effective health care. Healthcare professionals can for example act in a more proactive way or predictions can drive more automated ways of therapy. However, the task is very challenging. Future developments likely depend on observations in the (recent) past, but how can we capture this history in features to generate accurate predictive models? And what length of history should we consider? We propose a framework that is able to generate patient tailored features from observations of the recent history that maximize predictive performance. For a case study in the domain of depression we find that using this method new data representations can be generated that increase the predictive performance significantly.

  • 8.
    Vernmark, Kristofer
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Therapeutic alliance and different treatment formats when delivering internet-based CBT for depression2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Depression är en funktionsnedsättande problematik som påverkar en stor del av den vuxna populationen varje år. Trots ett omfattande behov av hjälp så råder det brist på tillgång till effektiv behandling. Kognitiv Beteendeterapi (KBT) är en evidensbaserad metod som har stöd vid behandling av depression och förmedlad via internet skulle metoden kunna tillgängliggöras för fler. Dock är det i dagsläget oklart vilka format och vilket innehåll som kan användas när behandlingen förmedlas via internet, samt vilken betydelse den terapeutiska alliansen har för en behandling som till största del sker på distans. Syftet med denna avhandling var att undersöka effekterna för olika format av internetbehandling (epostterapi, guidad självhjälp och blended treatment) vid depression, samt alliansens roll i dessa format.

    Studiernas resultat visar på att epostterapi och internetförmedlade självhjälpsprogram med behandlarstöd var effektiva metoder för att behandla depression. Alliansskattningar var höga, vilket visar att en positiv terapeutisk allians kan uppnås i internetbehandling. Patientskattningar av allians kunde inte predicera utfallet i någon av behandlingarna, men behandlarskattad allians predicerade förbättring på depressionsskattningar i blended treatment. Den här avhandlingen innehåller den första randomiserade kontrollerade studien på KBT-baserad epostterapi vid depression, samt det första internet-förmedlade självhjälpsprogrammet baserat på beteendeaktivering och ACT.

    Delarbeten
    1. Internet administered guided self-help versus individualized e-mail therapy: A randomized trial of two versions of CBT for major depression
    Öppna denna publikation i ny flik eller fönster >>Internet administered guided self-help versus individualized e-mail therapy: A randomized trial of two versions of CBT for major depression
    Visa övriga...
    2010 (Engelska)Ingår i: BEHAVIOUR RESEARCH AND THERAPY, ISSN 0005-7967, Vol. 48, nr 5, s. 368-376Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Internet-delivered psychological treatment of major depression has been investigated in several trials, but the role of personalized treatment is less investigated. Studies suggest that guidance is important and that automated computerized programmes without therapist support are less effective. Individualized e-mail therapy for depression has not been studied in a controlled trial. Eighty-eight individuals with major depression were randomized to two different forms of Internet-delivered cognitive behaviour therapy (CBT), or to a waiting-list control group. One form of Internet treatment consisted of guided self-help, with weekly modules and homework assignments. Standard CBT components were presented and brief support was provided during the treatment. The other group received e-mail therapy, which was tailored and did not use the self-help texts i.e., all e-mails were written for the unique patient. Both treatments lasted for 8 weeks. In the guided self-help 93% completed (27/29) and in the e-mail therapy 96% (29/30) completed the posttreatment assessment. Results showed significant symptom reductions in both treatment groups with moderate to large effect sizes. At posttreatment 34.5% of the guided self-help group and 30% of the e-mail therapy group reached the criteria of high-end-state functioning (Beck Depression Inventory score below 9). At six-month follow-up the corresponding figures were 47.4% and 43.3%. Overall, the difference between guided self-help and e-mail therapy was small, but in favour of the latter. These findings indicate that both guided self-help and individualized e-mail therapy can be effective.

    Ort, förlag, år, upplaga, sidor
    Elsevier Science B.V., Amsterdam., 2010
    Nyckelord
    Internet treatment, Major depression, E-mail therapy, Guided self-help
    Nationell ämneskategori
    Samhällsvetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-57417 (URN)10.1016/j.brat.2010.01.005 (DOI)000278168000003 ()
    Tillgänglig från: 2010-06-18 Skapad: 2010-06-18 Senast uppdaterad: 2017-10-30
    2. Therapeutic alliance in guided internet-delivered cognitive behavioural treatment of depression, generalized anxiety disorder and social anxiety disorder
    Öppna denna publikation i ny flik eller fönster >>Therapeutic alliance in guided internet-delivered cognitive behavioural treatment of depression, generalized anxiety disorder and social anxiety disorder
    Visa övriga...
    2012 (Engelska)Ingår i: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 50, nr 9, s. 544-550Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in several controlled trials, but the mechanisms of change are largely unknown. Therapeutic alliance is a factor that has been studied in many psychotherapy trials, but the role of therapeutic alliance in ICBT is less well known. The present study investigated early alliance ratings in three separate samples. Participants from one sample of depressed individuals (N = 49), one sample of individuals with generalized anxiety disorder (N = 35), and one sample with social anxiety disorder (N = 90) completed the Working Alliance Inventory (WAI) modified for ICBT early in the treatment (weeks 3-4) when they took part in guided ICBT for their conditions. Results showed that alliance ratings were high in all three samples and that the WAI including the subscales of Task, Goal and Bond had high internal consistencies. Overall, correlations between the WAI and residualized change scores on the primary outcome measures were small and not statistically significant. We conclude that even if alliance ratings are in line with face-to-face studies, therapeutic alliance as measured by the WAI is probably less important in ICBT than in regular face-to-face psychotherapy.

    Ort, förlag, år, upplaga, sidor
    Elsevier, 2012
    Nationell ämneskategori
    Samhällsvetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-79399 (URN)10.1016/j.brat.2012.05.003 (DOI)000307909100003 ()22728647 (PubMedID)
    Tillgänglig från: 2012-07-16 Skapad: 2012-07-16 Senast uppdaterad: 2018-12-12Bibliografiskt granskad
    3. Internet-based behavioral activation and acceptance-based treatment for depression: A randomized controlled trial
    Öppna denna publikation i ny flik eller fönster >>Internet-based behavioral activation and acceptance-based treatment for depression: A randomized controlled trial
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    2013 (Engelska)Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 148, nr 2-3, s. 331-337Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background: Internet-based cognitive behavior therapy for depression has been tested in several trials but there are no internet studies on behavioral activation (BA), and no studies on BA over the internet including components of acceptance and commitment therapy (ACT). The aim of this study was to develop and test the effects of internet-delivered BA combined with ACT against a waiting list control condition as a first test of the effects of treatment. less thanbrgreater than less thanbrgreater thanMethods: Selection took place with a computerized screening interview and a subsequent semi-structured telephone interview. A total of 80 individuals from the general public were randomized to one of two conditions. The treatment lasted for 8 weeks after which both groups were assessed. We also included a 3 month follow-up. The treatment included interactive elements online and a CD-ROM for mindfulness and acceptance exercises. In addition, written support and feedback was given by a therapist every week. less thanbrgreater than less thanbrgreater thanResults: Results at posttreatment showed a large between group effect size on the Beck Depression inventory II d = 0.98 (95%CI = 0.51-1.44). In the treated group 25% (10/40) reached remission defined as a BDI score andlt;= 10 vs. 5% (2/40) in the control group. Results on secondary measures were smaller. While few dropped out from the study (N = 2) at posttreatment, the average number of completed modules was M = 5.1 out of the seven modules. less thanbrgreater than less thanbrgreater thanLimitations: The study only included a waiting-list comparison and it is not possible to determine which treatment components were the most effective. less thanbrgreater than less thanbrgreater thanConclusions: We conclude that there is initial evidence that BA with components of ACT can be effective in reducing symptoms of depression.

    Ort, förlag, år, upplaga, sidor
    Elsevier, 2013
    Nyckelord
    Depression, Internet-based treatment, Acceptance and commitment therapy, Randomized controlled trial
    Nationell ämneskategori
    Samhällsvetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-94601 (URN)10.1016/j.jad.2012.12.020 (DOI)000318909700024 ()
    Anmärkning

    Funding Agencies|Swedish Science Foundation||Swedish Council for Social Research||Swedish Council for Work Life Research||

    Tillgänglig från: 2013-06-27 Skapad: 2013-06-27 Senast uppdaterad: 2017-12-06
    4. Working alliance as a predictor of change in depression during blended cognitive behaviour therapy
    Öppna denna publikation i ny flik eller fönster >>Working alliance as a predictor of change in depression during blended cognitive behaviour therapy
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    2019 (Engelska)Ingår i: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 48, nr 4, s. 285-299Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Blended Cognitive Behaviour Therapy (bCBT) is a new form of treatment, mixing internet-based modules and face-to-face therapist sessions. How participants rate the therapeutic alliance in bCBT has not yet been thoroughly explored, and neither is it clear whether therapist- and patient-rated alliances are predictors of change in depression during treatment. Depression and alliance ratings from 73 participants in a treatment study on bCBT (part of the E-COMPARED project) were analysed using growth curve models. Alliance, as rated by both patients and therapists, was high. The therapist-rated working alliance was predictive of subsequent changes in depression scores during treatment, whereas the patient-rated alliance was not. A therapeutic alliance can be established in bCBT. The role of the therapist-rated alliance seems to be of particular importance and should be carefully considered when collecting data in future studies on bCBT.

    Ort, förlag, år, upplaga, sidor
    Routledge, 2019
    Nyckelord
    Therapeutic alliance; depression; blended treatment; internet-based treatment; growth models
    Nationell ämneskategori
    Tillämpad psykologi
    Identifikatorer
    urn:nbn:se:liu:diva-153321 (URN)10.1080/16506073.2018.1533577 (DOI)000470850800002 ()30372653 (PubMedID)
    Forskningsfinansiär
    EU, FP7, Sjunde ramprogrammet, 603098
    Anmärkning

    We thank the E-COMPARED consortium forfinancialsupport.

    Tillgänglig från: 2018-12-12 Skapad: 2018-12-12 Senast uppdaterad: 2019-07-15Bibliografiskt granskad
  • 9.
    Vernmark, Kristofer
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Hesser, Hugo
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Topooco, Naira
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Berger, Thomas
    Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland.
    Riper, Heleen
    Department of Clinical, Neuro-, & Developmental Psychology, Faculty of Behavioural and Movement Sciences, VU Amsterdam, Amsterdam, The Netherlands.
    Luuk, Liisa
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Backlund, Lisa
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Carlbring, Per
    Department of Psychology, Stockholm University, Stockholm, Sweden; Department of Psychology, University of Southern Denmark, Denmark.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Working alliance as a predictor of change in depression during blended cognitive behaviour therapy2019Ingår i: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 48, nr 4, s. 285-299Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Blended Cognitive Behaviour Therapy (bCBT) is a new form of treatment, mixing internet-based modules and face-to-face therapist sessions. How participants rate the therapeutic alliance in bCBT has not yet been thoroughly explored, and neither is it clear whether therapist- and patient-rated alliances are predictors of change in depression during treatment. Depression and alliance ratings from 73 participants in a treatment study on bCBT (part of the E-COMPARED project) were analysed using growth curve models. Alliance, as rated by both patients and therapists, was high. The therapist-rated working alliance was predictive of subsequent changes in depression scores during treatment, whereas the patient-rated alliance was not. A therapeutic alliance can be established in bCBT. The role of the therapist-rated alliance seems to be of particular importance and should be carefully considered when collecting data in future studies on bCBT.

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