Dissertations / Theses: 'Internet Therapy'

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Ford, Megan E. "Preference for Internet Therapy versus Traditional Therapy to Treat Postpartum Depression." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4626.

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A growing body of research has emerged about effective treatments for postpartum depression, specifically how the internet could become a pivotal and vital option for women with postpartum symptoms. With that in mind, the purpose of this quantitative study was to investigate whether women suffering from postpartum depression preferred traditional therapy treatment or internet therapy treatment. The nonexperimental survey design was used to assess differences between groups related to stigma, satisfaction with treatment, and perceived quality of treatment received. Data collected from a sample of 78 adult females, who had previously received postpartum depression therapy treatment, indicated there was no difference experienced between the treatment modalities. Results were calculated using an independent sample t-test, noninferiority design, and it was determined that participants perceived no difference in their experience of stigma, treatment satisfaction, and perception of credibility and quality between the two therapy modalities. This study adds to the growing body of literature that suggests internet therapy may be a viable option for some women. The results encourage positive social change in that psychologists may advance clinical practice through incorporating technology into their treatment plans, thereby benefiting women who suffer from this condition and who may not be able to readily access a therapist's office on a weekly basis.

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Buhrman, Monica. "Guided Internet-Based Cognitive Behaviour Therapy for Chronic Pain." Doctoral thesis, Uppsala universitet, Institutionen för psykologi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-183326.

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Chronic pain is a one of the most common causes of disability and sick leave. Psychological factors play a central role in the experience of pain and are important in the management of pain. However, for many people with chronic pain CBT is not available. There is a need to develop alternative ways to deliver treatments that reach more individuals with chronic pain. Internet-based treatments have been shown to be effective for several disorders and recent research suggests that internet-based CBT for chronic pain can be effective. The present thesis included four randomized controlled studies with the aim of evaluating whether guided internet-based treatments based on CBT can help individuals with chronic pain regarding psychological variables. Study I investigated the effects of an internet-based CBT intervention with telephone support for chronic back pain. The study showed reductions in some variables assessed. Study II investigated the effects of an internet-based CBT intervention for chronic back pain without telephone support and with a live structured interview before inclusion. It was found that the treatment can reduce some of the distress associated with chronic pain. Study III investigated the effects of a guided internet-delivered CBT as a secondary intervention. Participants were patients who had previously completed multidisciplinary treatment at a pain management unit. Results showed that the internet-based treatment can be a feasible option for persons with residual problems after completed pain rehabilitation. Effects remained at six-month follow-up. Study IV focused on the effect of a guided internet-delivered acceptance and commitment therapy (ACT) for persons with chronic pain. Results suggest that an internet-delivered ACT treatment can help persons with chronic pain. Effects remained at six-month follow-up. In conclusion, guided internet-based CBT can decrease distress associated with chronic pain.

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Mayoh, Lyndel. "Synchronous internet therapy for panic disorder how does it compare to face-to-face therapy? /." Connect to full text, 2006. http://hdl.handle.net/2123/1603.

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Thesis (D.C.P. / M. Sc.)--Faculty of Science, University of Sydney, 2006.
Submitted in fulfilment of the requirements for the degree of Doctor of Clinical Psychology/Master of Science to the Faculty of Science. Title from title screen (viewed 2 August 2007). Bibliography: leaves 95-107.

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Bergman, Nordgren Lise. "Individually tailored internet-based cognitive behavioural therapy for anxiety disorders." Doctoral thesis, Linköpings universitet, Psykologi, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-100969.

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Fear is an innate emotion and an adaptive response to provide protection from potential harm. When fear is excessive and out of proportion in relation to the confronted situation, it can lead to the development of an anxiety disorder. Many individuals feel anxious at some point, but not all experience clinical anxiety or meet the diagnostic criteria of an anxiety disorder. Still, anxiety disorders are the most prevalent form of psychiatric disorder in the general population. More often than not people suffering from one anxiety disorder also present other psychiatric conditions. As of today, cognitive and behavioural treatments have been tested and found to positively affect anxiety disorders, making them the treatment of choice. Nevertheless, many patients do not seek or receive adequate treatment. One common critique of the research trials from which the recommendations for treatments stem is the use of a single protocol targeting only one diagnosis. This is because many people suffer from comorbidities. Another problem connected to the recommendation that cognitive behavioural therapy (CBT) should be the treatment of choice for anxiety disorders is the lack of therapists with adequate training. One possible way of dealing both with the shortcoming of therapists and making CBT more accessible is the use of the Internet. Internet-based CBT (ICBT) has been tested in numerous trials during the last 15 years, showing positive outcomes for a large variety of disorders. Many ICBT trials also make use of a single protocol. Another way of dealing with comorbidities might be to tailor the treatment to let characteristics and preferences of the patient guide the design of the protocol. Little is known about possible effects of tailoring the ICBT, the effects of therapeutic relationships in ICBT, and the effectiveness and cost-effectiveness of these treatments. This thesis is based on three studies on two separate randomized controlled trials (RCTs) using the same set of modules accessible for the tailored protocol. Study I was an RCT investigating treatment effects up to two-year after completion, showing favourable outcomes of the treatment in a self-recruited sample at all measure points. Study II was a secondary analysis exploring possible relations between working alliance and treatment outcome for participants in the treatment group recruited for Study I indicating that working alliance predict outcome in this tailored treatment. The second RCT was an effectiveness trial (Study III) analysing treatment effects and cost-effectiveness of the treatment up to one year post treatment in a primary-care population. This study showed positive treatment effects both regarding symptom reduction and cost-effectiveness, and that effects were sustained at one year post treatment. Conclusions drawn from these studies are that individually tailored ICBT seems to be a feasible approach for patients with anxiety disorders regardless of comorbidities, and a responsible choice in terms of societal costs.
Rädsla är en medfödd känsla och en adaptiv respons för att skydda organismen från potentiell skada. När rädslan blir överdriven och oproportionerlig i relation till den konfronterade situationen, kan det leda till utvecklandet av ångestsyndrom. Många personer upplever någon gång ångest, men inte alla upplever klinisk ångest eller uppfyller de diagnostiska kriterierna för något ångestsyndrom. Trots detta är ångest det vanligaste psykiatriska tillståndet i befolkningen i stort och oftast uppfyller personer som lider av ett ångestsyndrom även andra psykiatriska tillstånd. Till dags dato har både kognitiva och beteendeinriktade behandlingar testats och visat sig verksamma vid ångestproblem, vilket gjort dem till de behandlingar som rekommenderas för dessa tillstånd. Trots god effekt av behandling söker många patienter ändå inte hjälp, alternativt erhåller inte adekvat behandling. En vanlig kritik mot den forskning från vilka behandlingsrekommendationerna för ångestsyndrom stammar är att många använt en manual eller ett protokoll som riktar sig mot bara en diagnos. Detta på grund av den stora komorbiditeten. Ett annat problem kopplat till rekommendationerna att kognitiv beteendeterapi (KBT) ska vara förstahandsval vid behandling av ångest är bristen på behandlare med adekvat utbildning. Ett möjligt sätt att göra KBT mer tillgängligt är att använda Internet. Internet- förmedlad KBT (IKBT) har prövats i ett stort antal studier de senaste 15 åren dessa har visat positiva resultat vid ett stort antal psykiatriska tillstånd. Flertalet av dessa studier har dock använt ett enda behandlingsprotokoll. En annan möjlighet att hantera komorbiditet kan vara att skräddarsy behandlingen för att låta patientens egenskaper och preferenser vara med och styra utformningen av behandlingsprotokollet. Möjliga effekter av att skräddarsy IKBT är relativt lite undersökt, likaså effekterna av terapeutiska relationer i IKBT samt klinisk effektivitet och kostnadseffektiviteten för dessa behandlingar. Denna avhandling bygger på tre studier från två randomiserade kontrollerade studier med samma uppsättning av moduler tillgängliga för att skräddarsy behandlingsprotokollen. I Studie I undersöktes behandlingseffekter upp till två år efter avslutad behandling i en självrekryterad grupp patienter. Studie II var en sekundäranalys av behandlingsgruppen från Studie I där eventuella samband mellan arbetsallians och behandlingsresultat undersöktes. Den andra randomiserade kontrollerade studien var en prövning av huruvida denna behandling var effektiv för en klinisk population (Studie III) rekryterad via primärvården. Förutom behandlingseffekter undersöktes även kostnadseffektiviteten upp till ett år efter behandlingsavslut. De slutsatser som dras utifrån dessa studier är att skräddarsydd IKBT verkar vara en framkomlig väg för patienter med ångest oavsett komorbiditet, att arbetsalliansen kan vara en faktor som påverkar utfallet, samt att det är ett ansvarsfullt val vad gäller samhälleliga kostnader.

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Manchaiah, Vinaya, Eldre Beukes, Elizabeth Parks Aronson, Maria Munoz, Gerhard Andersson, and Marc A. Fagelson. "Internet-based Cognitive Behavioral Therapy (ICBT) for Tinnitus in the U.S." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etsu-works/7814.

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Objectives: Although tinnitus is one of the most commonly-reported symptoms in the general population, patients with bothersome tinnitus are challenged by issues related accessibility of care, and intervention options that lack strong evidence to support their use. Therefore, creative ways of delivering evidence- based interventions are necessary. This presentation focuses on the adaptation of an Internet-based Cognitive Behavioral Therapy (ICBT) intervention, originally used in Sweden and in the UK, for individuals with tinnitus in the United States. Elements of the ICBT program requiring consideration included (a) adaptations to the platform’s features and functionalities, (b) translation into Spanish to extend the reach of the program (c) user acceptability and satisfaction of the program, (d) outcomes from a pilot trial from which it was hypothesized that patients would demonstrate a reduction in tinnitus distress and associated difficulties as measures using standardized self-reported outcome measures, and (e) discussion of the relative merits and appropriateness of the intervention. Design: The iTerapi platform developed in Sweden was adopted for use in the US. The platform required functional and security features modifications to confirm its compliance with both institutional and governmental regulations, and to ensure it was suitable for the US population. Acceptability and suitability of the materials were evaluated by both hearing healthcare professionals (n=11) andindividuals with tinnitus (n=8). A pilot study followed as adults with bothersome tinnitus completed the 8-week program (n=30). Results: Cultural adaptations included word substitutions, adapting counseling examples for a US population, and modifying the spelling of certain words. The materials were then translated into Spanish and cross-checked. Professional review ensured the suitability of the chapters. Literacy level analysis confirmed all chapters were within the guidelines to be below the 6th grade level for readability. Healthcare professionals and individuals with tinnitus reported favorable acceptance and satisfaction ratings regarding the content, suitability, presentation, usability and exercises provided in the ICBT platform. Preliminary analyses of pilot data indicated a reduction in tinnitus distress and associated difficulties (i.e., anxiety, depression, insomnia) and an improvement in quality of life. Conclusions: Ensuring that the ePlatform offers the appropriate features and functionalities for the intended population is an essential part of developing Internet-based intervention. The user evaluations and pilot trial outcomes indicated that clinical trials can be performed to assess the effectiveness of ICBT for tinnitus in the US.

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Mayoh, Lyndel Elizabeth. "Synchronous Internet Therapy for Panic Disorder: How Does it Compare to Face-to-face?" Thesis, The University of Sydney, 2006. http://hdl.handle.net/2123/1603.

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The current study aimed to test the efficacy of individual, synchronous Internet Therapy for panic disorder compared to traditional face-to-face therapy. Thirty participants diagnosed with panic disorder were randomly allocated to either Internet Therapy or face-to-face therapy, and received a manualised cognitive-behavioural treatment program. When analysed separately, results indicated that face-to-face treatment significantly reduced panic symptomatology overall, however significant gains were not shown for the Internet Therapy condition. However, a direct comparison of the two active treatments failed to show significant differences, as measured by a Multivariate Analysis of Variance (MANOVA) on pre- and post-treatment variables. Internet Therapy did, however, significantly reduce certain symptoms of panic disorder, indicating that Internet Therapy may be useful as an adjunctive treatment to face-to-face therapy. Intention-to-treat analyses suggested that face-to-face treatment may be more effective than Internet Therapy for treating panic disorder. Additionally, there were no differences between treatment conditions in levels of working alliance, indicating that among those who stay in treatment, working alliance can be established online at a similar level to that of face-to-face therapy. However a high number of dropouts in the Internet Therapy condition warranted consideration. A thorough explanation of the results is offered in addition to recommendations for the future directions of the research and clinical implementation of Internet Therapy.

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Mayoh, Lyndel Elizabeth. "Synchronous Internet Therapy for Panic Disorder: How Does it Compare to Face-to-face?" University of Sydney. Science. School of Psychology, 2006. http://hdl.handle.net/2123/1603.

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Master of Science
The current study aimed to test the efficacy of individual, synchronous Internet Therapy for panic disorder compared to traditional face-to-face therapy. Thirty participants diagnosed with panic disorder were randomly allocated to either Internet Therapy or face-to-face therapy, and received a manualised cognitive-behavioural treatment program. When analysed separately, results indicated that face-to-face treatment significantly reduced panic symptomatology overall, however significant gains were not shown for the Internet Therapy condition. However, a direct comparison of the two active treatments failed to show significant differences, as measured by a Multivariate Analysis of Variance (MANOVA) on pre- and post-treatment variables. Internet Therapy did, however, significantly reduce certain symptoms of panic disorder, indicating that Internet Therapy may be useful as an adjunctive treatment to face-to-face therapy. Intention-to-treat analyses suggested that face-to-face treatment may be more effective than Internet Therapy for treating panic disorder. Additionally, there were no differences between treatment conditions in levels of working alliance, indicating that among those who stay in treatment, working alliance can be established online at a similar level to that of face-to-face therapy. However a high number of dropouts in the Internet Therapy condition warranted consideration. A thorough explanation of the results is offered in addition to recommendations for the future directions of the research and clinical implementation of Internet Therapy.

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Hall, Tracy D. "Internet-based Family Therapy from the Perspective of the Therapist: A Qualitative Inquiry." University of Akron / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=akron1373400516.

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Mullings, Ben. "An evaluation of therapeutic alliance and outcome in an internet chat therapy service." Thesis, Curtin University, 2012. http://hdl.handle.net/20.500.11937/1264.

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Although the Internet has increasingly been the focus of research over the past decade, there have been relatively few studies about how the full variety of Internet communication tools can be used for the purpose of delivering psychological services. Much of the recent emphasis has been on web-based self-guided psychological interventions, where interactions with a psychologist are minimal (Amstadter, Broman-Fulks, Zinzow, Ruggiero, & Cercone, 2009; Spek, Cuijpers, Nyklicek, Riper, Keyzer, & Pop, 2007). A limited number of studies have investigated the processes and outcomes of psychological interventions applied over Internet chat communication (Cook & Doyle, 2002; King, Bambling, Reid, & Thomas, 2006a; Mallen, Day, & Green, 2003; Rassau & Arco, 2003); however, there has been a general tendency to avoid comparing these forms of intervention with face-to-face therapy (Anthony, 2000a). This has had the unfortunate consequence of placing the existing research beyond the reach of evidence-based practice, where various forms of intervention are compared and contrasted. The main goal of this research is to make a direct comparison of psychological processes and therapeutic outcomes when the same group of therapists deliver psychological interventions to clients over both Internet chat and face-to-face therapy.A mixed quantitative and qualitative approach was utilised to integrate findings from outcome measures with the subjective report of clients and therapists who undertook Internet chat therapy. A team of 20 therapists provided psychological services to clients who self-selected either face-to-face or Internet chat therapy. Both therapists and clients completed measures for symptom severity and the therapeutic alliance at the first and third session. Therapeutic alliance was measured using the client, therapist and observer rated versions of the CALPAS, while symptom severity was measured using the BSI and SCL-90 Analogue. The final sample consisted of 17 matched pairs of Internet and face-to-face therapy cases, with 3 additional cases where the therapist was only able to obtain an Internet case for the data. The hypotheses of this study predicted that symptom severity would decrease and that the therapeutic alliance would increase over 3 sessions in both treatment modalities. It was also hypothesised that face-to-face therapy would outperform Internet chat therapy on each measure.Results of ANOVA analyses supported all hypotheses related to improvement over the first 3 sessions of treatment, with the exception of therapist-rated symptom severity. There was a strong main effect for client-rated alliance, increasing significantly at the same rate in both treatment groups: F(1,35) = 23.021, p < .001, partial 2 = .397, Cohen’s d = 1.15. There was also a strong main effect for client-rated symptom severity across both groups over the first 3 sessions of treatment: F(1,35) = 15.191, p < .001, partial 2 = .303, Cohen’s d = .92. Results for ANOVA analyses comparing treatment modalities did not identify statistically significant differences, with the exception of significantly higher alliances rated by clients receiving Internet chat therapy: F(1,35) = 6.972, p = .012, partial 2 = .166, Cohen’s d = .76. In addition to statistically significant change, an analysis for clinically significant change was also undertaken (Jacobson & Traux, 1991). Results of this analysis showed that there were only minor differences between groups at both the first and third session. In the Internet chat therapy group 10% of cases were ‘improved’ and 5% were classed as ‘recovered’. In the face-to-face therapy group, 11.8% were categorised as ‘improved’ and 5.9% classed as being ‘recovered. In summary, there were relatively few measurable differences between these modes of service delivery.Qualitative data generated from interviews at the conclusion of Internet chat therapy showed the importance of therapeutic distance for people who select this form of treatment. Clients described how the distant way of communicating to a psychologist over Internet chat led to a more personal experience for them. Therapists described the challenge of understanding the emotions of their client when relying on the written word alone. Clients and therapists also described the formation of mental images of the other party and the role this had in terms of constructing a sense of interaction with the other person. The formation of mental images had an influence on the quality of the working alliance that developed, with both clients and therapists being generally satisfied with the therapeutic relationship overall.Despite the widespread public use of Internet chat, this popular form of communication has received very little attention from researchers. The results of this study are promising in that they demonstrate that positive clinical outcomes are associated with client interactions with psychologists offering services over this modality. With meta-analytic reviews showing that larger treatment effects are associated with web-based interventions where there is greater therapist involvement (Barak, Hen, Boniel-Nissim, & Shapira, 2008; Spek et al., 2007), the present study raises questions about whether Internet chat could be utilised more broadly as a mode of service delivery. This study provides a detailed first glimpse at how real-time written communication over the Internet could be used for psychotherapeutic purposes.

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Filgate, Eleanor Megan. "Adherence to e-therapy for adults with eating disorders : a systematic review : a retrospective case series investigation of blended internet-based cognitive-behavioural therapy (ICBT) and face-to-face cognitive-behavioural therapy (CBT) in the treatment of adults with eating disorders." Thesis, University of Edinburgh, 2018. http://hdl.handle.net/1842/31506.

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Background: Eating disorder (ED) researchers continue to explore the effectiveness of e-therapy in improving symptoms and its treatment acceptability, however issues relating to poor uptake, adherence and dropout pose a challenge. Within this portfolio, the systematic review aimed to explore adherence to e-therapy for the treatment of ED, specifically exploring rates and predictors of uptake, completion, and dropout from randomised controlled trials (RCT) of ED e-therapy. The empirical project aimed to explore in-depth symptom change for ED cases engaged in blended internet-based cognitive behavioural therapy (ICBT) and face-to-face ED input. Acceptability of blended input was also explored. Methods: For the systematic review, literature searches were undertaken in March and September 2017 across EMBASE, PsycINFO, MEDLINE, Ovid and Cochrane Central Register of Controlled Trials (CENTRAL) and ProQuest databases. Key papers were assessed against five quality criteria (random assignment to groups, blinding to treatment allocation, quality of content, level of contact, sample size with sufficient power). Using a retrospective case series design, the empirical project explored changes over time of ED, anxiety, depression, quality of life (QoL), motivation for change, overall psychological functioning and clinician-rated/patient-rated improvement. Standardised health assessment measures captured symptoms over multiple time-points, and data was analysed using t-tests, multi-level modelling (MLM) and visual analysis. Acceptability of treatment was tentatively explored using an open feedback questionnaire. Results: Systematic review results identified intervention (content, acceptability, delivery method/location), participant (nature of symptoms, BMI, education, prior therapy, personality, views on e-therapy) and therapist-related factors (therapeutic support) were indicated in predicting uptake, completion and dropout across ED e-therapy. In the empirical project, study findings were inconclusive regarding symptom change attributable to blended input. Model fit improved when severity of ED symptoms predicted overall psychological functioning and patient-rated improvement over time, however findings were non-significant - potentially due to the study being underpowered. Conclusions: Promising evidence exists for ED e-therapy as an acceptable treatment option, however understanding which content nurtures engagement best is needed. Further research is needed into the factors predicting ED blended treatment outcome.

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Reynolds, D'Arcy James. "Session Impact and Alliance in Internet Based Psychotherapy." Miami University / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=miami1248277605.

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Pescatello, Meredith S. "Treatment Engagement and Effectiveness Using an Internet-Delivered Cognitive Behavioral Therapy at a University Counseling Center." BYU ScholarsArchive, 2020. https://scholarsarchive.byu.edu/etd/9078.

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Mental health disorders are a leading cause of disability and mortality worldwide. Mental health services do not meet demand due to accessibility issues, financial burden, and increasing needs. Technology can provide affordable, accessible mental health care and some research suggests internet-delivered Cognitive Behavior Therapy (iCBT) may be an effective treatment. In iCBTs, participants typically complete Cognitive Behavior Therapy modules and videos and are supported by a therapist. Advantages of iCBT over face-to-face therapy include lower cost, no travel time, easy access, no waitlists, and trackable progress. To our knowledge there have been no naturalistic studies of iCBT programs. Therefore, this study will evaluate the usage and effectiveness of one iCBT program, SilverCloud, in a university counseling center. Participants (N=5568) were students at a large, private western university. Participants were either self-referred to the program, chose to enroll at intake as a standalone intervention, or were referred by their treating clinician as an adjunct to regular treatment. We compared the outcomes and usage of participants using SilverCloud concurrently with psychotherapy to participants using SilverCloud alone, and participants in psychotherapy alone.

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Alfonsson, Sven. "Treatment Adherence in Internet-Based CBT : The Effects of Presentation, Support and Motivation." Doctoral thesis, Uppsala universitet, Klinisk psykologi i hälso- och sjukvård, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-280804.

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Homework assignments that patient work with between sessions is a key component in both face-to-face and Internet-based Cognitive Behavior Therapy (CBT). However, adherence to assignments is often low and it is largely unclear what factors predict or affect treatment adherence, and in the end, treatment outcomes. The overall aim of this thesis was to investigate if treatment presentation and therapist support can affect adherence and treatment outcome in internet-based CBT, whether adherence can be predicted by motivation variables and to compare differences in face-to-face and online conditions in this regard. A randomized controlled trial with a brief online relaxation program for people with stress and anxiety symptoms was conducted (n = 162). Participants in the enhanced support conditions completed a larger proportion of the online treatment but adherence was not affected by enhanced treatment presentation (Study I). Participants reported reduced symptoms of stress and anxiety after the relaxation program but there were no significant additional effects of enhanced presentation or support (Study II). Participants who adhered to the prescribed assignments reported lower symptom levels at study end, regardless of treatment conditions. Adherence to the online treatment was predicted by subject factors such as treatment credibility prior to the treatment and intrinsic motivation during the treatment (Study III). To further elucidate how motivation may affect adherence, an experiment with a one-session psychotherapy model was subsequently conducted (n = 100). Participants who were randomized to the face-to-face condition reported higher motivation for the assignment and completed significantly more of the homework compared to participants in the online condition (Study IV). Self-reported intrinsic motivation could predict adherence in both conditions while new motivational variables were identified specifically for the online condition. The results from these studies confirm that adherence to assignments in Internet-based CBT is difficult to affect with treatment features but can be predicted early in treatment by subject factors such as treatment credibility and motivation. How such motivational variables can be affected to improve treatments is still unclear.

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Carlbring, Per. "Panic! Its Prevalence, Diagnosis and Treatment via the Internet." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4148.

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Andersson, Henrik, and Mikael Nilsson. "INTERNET-BASED MINDFULNESS-ACCEPTANCE-COMMITMENT IN SPORTS: A RANDOMISED CONTROLLED TRIAL." Thesis, Umeå universitet, Institutionen för psykologi, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-159893.

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The psychological aspects of sports is crucial for performance and important for sustaining good mental health. Despite this, efforts to improve those aspects are surprisingly rare and partly due to stigmatization of help-seeking together with lack of time and economic resources. However, in recent decades much research on internet-based interventions have been conducted. Also, a growing body of empirical support for the Mindfulness-Acceptance-Commitment approach (MAC) related to enhancement in performance and mental health in sports has emerged. This study was the first to explore the effects of internet-based MAC, which was conducted with the digital self-care programme ACTSPORT with or without feedback. Of 193 participants (aged 18 - 71, from 40 different sports on a variety of levels) who were randomly assigned to feedback, non-feedback and waitlist group, 125 completed the study. The results showed that participants who completed ACTSPORT with feedback experienced significantly enhanced performance, reduced performance anxiety and improved mental health, which included higher quality of life and less symptoms of depression. These improvements were predicted by significant improvements in acceptance and dispositional mindfulness. A larger effect was found for participants with feedback which indicated that some support is preferable. In conclusion, the present study indicate that internet-based interventions in sport may be effective, time-saving, cost-effective, flexible and available means for both enhancement in performance and aspects of mental health.
De psykologiska faktorerna inom idrott är avgörande för prestation och viktiga för att upprätthålla god mental hälsa. Trots detta är ansträngningar för att förbättra dessa faktorer förvånansvärt sällsynta. Det beror bland annat på att det råder ett stigma kring att söka hjälp samt brist på tid och ekonomiska resurser. De senaste decennierna har det genomförts en stor mängd forskning på internetbaserade interventioner. Dessutom har Mindfulness-Acceptance-Commitment approach (MAC) fått en ökad mängd empiriskt stöd gällande förbättring i prestation och mental hälsa inom idrott. Föreliggande studie är den första i sitt slag att undersöka effekten av internetbaserad MAC, vilken genomfördes med det digitala självhjälpsprogrammet ACTSPORT med eller utan feedback. Av 193 deltagare (ålder 18 - 71, i 40 olika sporter på alla nivåer) som randomiserades till tre grupper med feedback, utan feedback eller väntelista, fullföljde 125 deltagare studien. Resultaten visade att deltagare som fullföljde ACTSPORT med feedback upplevde signifikant förbättrad prestation, minskad prestationsångest såväl som förbättrad mental hälsa vilket inkluderade högre livskvalité och minskade depressionssymtom. Detta visade sig kunna prediceras av signifikanta förbättringar i acceptans och dispositionell mindfulness. En större effekt sågs för deltagarna i gruppen med feedback vilket indikerade att ett visst stöd är fördelaktigt. Slutsatser från studien är att internetbaserade interventioner inom idrott kan vara effektiva, tidsbesparande, kostnadseffektiva, flexibla och tillgängliga medel för att både öka prestation och aspekter av mental hälsa.

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Manchaiah, Vinaya, George Vlaescu, Srinivas Varadaraj, Elizabeth Parks Aronson, Marc A. Fagelson, Maria Munoz F, Gerhard Andersson, and Eldre W. Beukes. "Features, Functionality, and Acceptability of Internet-Based Cognitive Behavioral Therapy for Tinnitus in the United States." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etsu-works/7811.

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Objective: Although tinnitus is one of the most commonly reported symptoms in the general population, patients with bothersome tinnitus are challenged by issues related to accessibility of care and intervention options that lack strong evidence to support their use. Therefore, creative ways of delivering evidence-based interventions are necessary. Internet-based cognitive behavioral therapy (ICBT) demonstrates potential as a means of delivering this support but is not currently available in the United States. This article discusses the adaptation of an ICBT intervention, originally used in Sweden, Germany, and the United Kingdom, for delivery in the United States. The aim of this study was to (a) modify the web platform's features to suit a U.S. population, (b) adapt its functionality to comply with regulatory aspects, and (c) evaluate the credibility and acceptability of the ICBT intervention from the perspective of health care professionals and patients with bothersome tinnitus. Materials/Method:Initially, the iTerapi ePlatform developed in Sweden was adopted for use in the United States. Functional adaptations followed to ensure that the platform's functional and security features complied with both institutional and governmental regulations and that it was suitable for a U.S. population. Following these adaptations, credibility and acceptance of the materials were evaluated by both health care professionals (n = 11) and patients with bothersome tinnitus (n = 8). Results:Software safety and compliance regulatory assessments were met. Health care professionals and patients reported favorable acceptance and satisfaction ratings regarding the content, suitability, presentation, usability, and exercises provided in the ICBT platform. Modifications to the features and functionality of the platform were made according to user feedback. Conclusions:Ensuring that the ePlatform employed the appropriate features and functionalities for the intended population was essential to developing the Internet-based interventions. The favorable user evaluations indicated that the intervention materials were appropriate for the tinnitus population in the United States.

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Silfvernagel, Kristin. "Individually tailored internet-based cognitive behavioural therapy for adolescents, young adults and older adults with anxiety." Doctoral thesis, Linköpings universitet, Psykologi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-135823.

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Anxiety disorders share the feature of excessive fear, anxiety and related behavioural disturbances. Fear is defined as the emotional response to a real or a perceived imminent threat and anxiety is the anticipation of a future threat. The anxiety disorders covered in this thesis are panic disorder with or without agoraphobia, social phobia, post-traumatic stress disorder, generalized anxiety disorder and anxiety disorder not otherwise specified. Cognitive behavioural treatment protocols are typically designed to target one specific disorder and falls under the definition of disorder-specific cognitive behavioural therapy. It is however unclear if this is the most optimal approach in regards to the high comorbidity between anxiety disorders and depressive disorders. Internet-based cognitive behavioural therapy has in the past generally been disorder-specific and from above mentioned predicament two alternative treatment approaches emerged, the tailored and the transdiagnostic approach that aims to simultaneously treat both principal and comorbid disorders. Previous trials on internet-based cognitive behavioural therapy have targeted adults in general and relatively few target adolescents, young adults and older adults. The aims of this thesis were to further develop and test the effects of tailored internet-based cognitive behavioural therapy on the basis of age, for adolescents, young adults and older adults. Specifically by developing and testing the effects of individually tailored internet-based cognitive behavioural therapy for adolescents with anxiety and comorbid depressive symptoms and by adapting and testing the effects of individually tailored internet-based cognitive behavioural therapy for young adults and older adults with anxiety and comorbid depressive symptoms. These aims were tested in two pilot effectiveness studies (Paper I and III) and two efficacy randomised controlled trials (Paper II and IV). The results from these four trials showed significant results across all outcome measures with overall moderate to large effect sizes. The tentative conclusion based on these results is that tailoring internet-based cognitive behavioural therapy can be a feasible approach in the treatment of anxiety symptoms and comorbid depressive symptoms for adolescents, young adults and older adults. Despite the positive findings of the studies in this thesis, there is a need for more research examining the acceptability and effectiveness of internet-based cognitive behavioural therapy for adolescents, young adults and older adults with anxiety and depression before implementation on a larger scale.

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Vernmark, Kristofer. "Therapeutic alliance and different treatment formats when delivering internet-based CBT for depression." Doctoral thesis, Linköpings universitet, Psykologi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-142389.

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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.
Depression is a debilitating disorder that affects a large part of the adult population every year. Yet there is still a lack of access to effective care for people in need. Cognitive Behaviour therapy (CBT) is an evidence-based method for treating depression that together with the increased availability of Internet services provides an opportunity to increase access to effective treatment. Internet-based interventions can be effective in the treatment of depression, but there is a lack of knowledge concerning which formats of delivery that can be used and if therapeutic alliance is of equal importance when providing treatment over the Internet. The overall aim of this thesis was to examine the effects of different treatment formats (email therapy, guided self-help, and blended treatment) in internet-based CBT for depression and to further examine the role of alliance in these treatment modalities. Findings from this thesis show that email therapy and internetbased treatment programs were effective methods for treating depression. Alliance ratings were high, showing that a positive therapeutic alliance can be achieved in internet-based treatments. Patient-rated alliance could not predict outcome in any of the different treatment formats. However, therapist-rated alliance predicted change in depression during blended treatment. This thesis includes the first randomized controlled study on CBTbased email therapy, and the first internet-based behavioral activation program with ACT-components, for adult depression.

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Johansson, Robert. "Treating depression and its comorbidity : From individualized Internet-delivered cognitive behavior therapy to affect-focused psychodynamic psychotherapy." Doctoral thesis, Linköpings universitet, Psykologi, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-100385.

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The overarching goal of this thesis has been to enhance Internet-delivered psychological treatments for depression and its comorbidity. To this end, three randomized controlled trials (Study II, III and IV) with a total of 313 participants were conducted. A prevalence study (Study I) was also conducted to provide an up-to-date estimate of the prevalence of depression, anxiety disorders, and their comorbidity in the Swedish general population. Study I showed that more than every sixth individual in Sweden suffers from symptoms of depression and/or anxiety. Comorbidity between depression and anxiety was substantial and associated with higher symptom burden and lower health-related quality of life. Study II showed that a tailored Internet-based CBT protocol (ICBT) was effective in reducing symptoms of depression when compared to a control group. Among individuals with more severe depression and comorbidities, the tailored ICBT treatment worked better than standardized ICBT. Study III showed that a psychodynamic Internet-based psychotherapy was highly effective in the treatment of depression, when compared to a group who received psychoeducation and online support. In Study IV, an Internet-delivered affect-focused psychodynamic psychotherapy proved to have a large effect on depression and a moderately large effect on anxiety disorders. In conclusion, this thesis shows that in the context of treating depression and its comorbidity, Internet-delivered psychological treatments can be potentially enhanced by psychodynamic psychotherapy and by individualization.
Det övergripande syftet med denna avhandling har varit att vidareutveckla internetbaserad psykologisk behandling för depression och dess komorbiditet. Tre randomiserade kontrollerade studier (Studie II, III och IV) med totalt 313 deltagare genomfördes i linje med detta syfte. En prevalensstudie (Studie I) genomfördes också för att tillhandahålla ett uppdaterat estimat av prevalensen av depression, ångest och deras komorbiditet i Sverige. Studie I visade att mer än var sjätte individ i Sverige lider av symptom på depression och/eller ångest. Det fanns påtaglig komorbiditet mellan depression och ångest, vilket var associerat med högre symptombörda och lägre livskvalitét. Studie II visade att en skräddarsydd internetbaserad KBT-behandling var effektiv för att reducera symptom på depression, i jämförelse med en kontrollgrupp. Bland individer med svårare depression och komorbiditet, fungerade den skräddarsydda interventionen bättre än en standardiserad. Studie III visade att psykodynamisk internetbehandling var effektiv vid behandling av depression, i jämförelse med en grupp som fick psykoedukation och stödsamtal online. I Studie IV visades att en affektfokuserad psykodynamisk internetbehandling hade stor effekt vad gällde att reducera symptom på depression, och medelstor effekt vad gällde att reducera symptom på ångest. Sammanfattningsvis visar denna avhandling att internetbaserad psykologisk behandling kan potentiellt vidareutvecklas av psykodynamisk psykoterapi och individanpassning, vid behandling av depression och dess komorbiditet.

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Berni, Luiz Eduardo Valiengo. "Self-empowerment - jornada de transformação: um método transpessoal de personal coaching via internet." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/47/47131/tde-16122008-122302/.

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Utilizando como referência teórica a Abordagem Transdisciplinar e os conhecimentos produzidos pelos movimentos New Age, particularmente pelas Psicologias Transpessoais de enfoque humanista, entre as quais a Abordagem Centrada na Pessoa, este estudo tem por objetivo geral participar dos debates sobre essas abordagens e sobre as relações entre Psicologia e Informática, novo campo de ação para psicólogos, aqui particularizados os novos métodos de auto-conhecimento mediados por computador, via Internet, a distância. Define como objetivo específico verificar as potencialidades e contribuições do Processo Self-Empowerment, método de Personal Coaching, basicamente mediado a distância, via Internet, e desenvolvido ao longo de três etapas ou módulos: (1) Etapa da reflexão biográfica, (2) Etapa da consulta oracular ao Eu Interior por meio do Jogo da Transformação e (3) Etapa de estruturação de um Plano de Ação. A pesquisa descritiva aqui apresentada considerou os fundamentos teóricos do processo e sua metodologia. Seus resultados possibilitara constituir um conjunto articulado, teórico-metodológico, que contribui expressivamente para a condução de processos de autoconhecimento, auto-realização e auto-transcendência, em geral e, de modo particular, para os processos de personal coaching via Internet. Os resultados da pesquisa mostram que o Processo Self-Empowerment possibilita aos participantes um melhor conhecimento de si mesmos, atualização de suas potencialidades e maior possibilidade de uma participação social mais efetiva e consciente.
The general aim of this study is to participate in the debate between Transdisciplinarity, Transpersonal and Humanistic Psychology, including the Person-Centered Approach, with E-learning and Information Technology in Internet, as new branch of psychology with new methods to counseling, self-knowledge mediated by computer, through e-learning. The research intended to verify the specific capabilities and contributions of the Case Self-Empowerment Journey of Transformation as an E-learning Counseling or as a Personal Coaching Method developed over three phases or modules: (1) Phase of autobiographical reflection, (2) Phase of oracular consultation of the Self through the Transformation Game (3) Phase of Action Planning. This descriptive research aims in additional for the theoretical and methodological approach of Self-Empowerment Process. The results indicate that Self- Empowerment Process contributes significantly to the Internet counseling and to self-development, self-knowledge, self-realization and self-transcendence, and contributes to participants have more effective in social participation.

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Singulane, Bianca Aparecida Ribeiro. "Aliança terapêutica e satisfação com o tratamento na psicoterapia por internet para dependentes de álcool." Universidade Federal de Juiz de Fora, 2016. https://repositorio.ufjf.br/jspui/handle/ufjf/1286.

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CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico
Introdução: O consumo de álcool salienta-se como um grave problema de saúde pública no Brasil e no mundo. Porém, o número de usuários que procuram ajuda ou que conseguem tratamento ainda é reduzido. As terapias por computador (e-terapias) têm sido apontadas como alternativas de tratamento para diversos transtornos mentais, dentre eles o uso problemático de álcool e outras drogas. Uma preocupação importante relacionada a esta modalidade de atendimento refere-se à aliança terapêutica e a satisfação com o tratamento, condições básicas para que haja um atendimento psicoterapêutico de qualidade. Objetivo: O presente trabalho contempla objetivos de dois estudos: o primeiro pretendeu avaliar a literatura sobre aliança terapêutica nas Terapias cognitivo-comportamentais realizadas por videoconferência para diferentes transtornos mentais; e o segundo almejou avaliar a aliança terapêutica e a satisfação com o tratamento em uma psicoterapia por videoconferência para dependentes de álcool. Metodologia: No primeiro estudo foi realizada uma revisão sistemática de literatura, incluindo artigos empíricos dos últimos 11 anos, escritos nas línguas inglesa, portuguesa ou espanhola, que avaliavam a aliança terapêutica na TCC realizada por videoconferência. No segundo estudo, foi realizado um estudo de casos múltiplos, retirados de uma amostra que participou da TCC por videoconferência para dependentes de álcool. Os resultados foram analisados por meio de uma triangulação de dados, trabalhados de forma qualitativa e quantitativa. Resultados: No artigo 1 observou-se que a maioria dos estudos indicou que a aliança foi alta no decorrer das sessões de TCC por videoconferência, podendo ser comparada com a formada na psicoterapia presencial. Já os resultados do estudo 2 mostraram que, na TCC por videoconferência, houve formação de uma aliança terapêutica de qualidade e que os clientes ficaram satisfeitos com tratamento. Discussão: Apesar das limitações destes estudos, podemos inferir que há indícios tanto na revisão de literatura, quanto no estudo empírico, de que a aliança terapêutica e a satisfação com o tratamento na TCC por videoconferência pode ser comparável com os resultados encontrados na psicoterapia presencial. Assim, ela pode ser uma alternativa viável de tratamento para indivíduos com dependência de álcool.
Introduction: Alcohol consumption stands out as a serious public health problem in Brazil and worldwide. However, the number of users seeking help or who fail treatment is still low. The computer therapies (e-therapies) have been identified as alternative treatment for various mental disorders, including the abuse of alcohol and other drugs. A major concern related to this type of service refers to the therapeutic alliance and treatment satisfaction, basic conditions so that there is a psychotherapeutic care quality. Objective: This study includes two study objectives: the first aimed to evaluate the literature on therapeutic alliance in cognitive-behavioral therapies conducted by videoconference for different mental disorders; and the second craved evaluate the therapeutic alliance and treatment satisfaction in psychotherapy by videoconference to alcoholics. Methodology: In the first study was carried out a systematic review of the literature, including empirical articles from the past 11 years, written in English, Portuguese or Spanish that evaluated the therapeutic alliance in CBT held by videoconference. In the second study, we conducted a study of multiple cases, drawn from a sample of CBT participated by videoconference for alcoholics. The results were analyzed by means of a data triangulation worked qualitative and quantitative manner. Results: In Article 1 it was observed that most studies indicated that the alliance was high during the CBT sessions by videoconference and can be compared to that formed in the presence psychotherapy. Already the second study results showed that, in CBT by video conference, there is formation of a therapeutic alliance of quality and that clients were satisfied with treatment. Discussion: Despite the limitations of these studies, we can infer that there is evidence of the therapeutic alliance and treatment satisfaction in CBT by videoconference can be comparable with the results found in face psychotherapy. Thus, it can be a viable alternative treatment for patients with alcohol dependence.

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Gumier, Andressa Bianchi. "Terapia por internet para dependentes de álcool: desenvolvimento de um protocolo de pesquisa e intervenção." Universidade Federal de Juiz de Fora, 2015. https://repositorio.ufjf.br/jspui/handle/ufjf/305.

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CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Diante do crescente envolvimento dos indivíduos com álcool e da falta de ofertas de tratamento em relação à demanda, tem aumentado na literatura estudos avaliando a eficácia e a efetividade de intervenções realizadas por internet. A partir de uma revisão de literatura sobre o tema, verificou-se que, no país, ainda não foi realizado nenhum estudo com esses propósitos. Porém, anterior à realização de um ensaio clínico randomizado desta natureza, faz-se primordial o estabelecimento de um protocolo de intervenção terapêutica padronizado que possa auxiliar e orientar os clínicos e pesquisadores no desenvolvimento de uma terapia realizada por internet. A criação de um protocolo de pesquisa clínica contribui para uma melhor compreensão do estudo e possibilita um melhor julgamento da confiabilidade, da repetibilidade e da reproducibilidade dos seus resultados. O presente trabalho tem como objetivo geral desenvolver um protocolo de pesquisa e intervenção para a realização de um ensaio clínico randomizado para avaliar a efetividade de uma terapia realizada por internet com a presença de um terapeuta para dependentes de álcool baseada na Terapia Cognitivo-Comportamental, na Prevenção de Recaída e em princípios da Entrevista Motivacional.
Given the increasing involvement of individuals with alcohol and the lack of treatment offers over demand, studies to evaluate the efficacy and effectiveness of interventions through the internet have increased in the literature. From a literature review on the topic, it was found that, in Brazil, no studies for these purposes were done. However, prior to carrying out a randomized clinical trial of this nature, it is essential to establish a standard therapeutic intervention protocol that can assist and guide clinicians and researchers in the development of a therapy performed through the internet. The creation of a clinical research protocol contributes to a better understanding of the study and provides a better judgment of the reliability, repeatability and reproducibility of their results. The main objective of this essay is develop a protocol for research and intervention for conducting a randomized clinical trial to evaluate the effectiveness of a therapy performed through the internet with the presence of a therapist for alcoholics based on Cognitive-Behavioral Therapy, in Relapse Prevention and principles of Motivational Interviewing.

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Lundgren, Johan. "Behind the Screen : -Internet-Based Cognitive Behavioural Therapy to Treat Depressive Symptoms in Persons with Heart Failure." Doctoral thesis, Linköpings universitet, Avdelningen för omvårdnad, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-143312.

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Introduction The prevalence of depressive symptoms in persons with heart failure is higher than in age- and gender-matched populations not suffering from heart failure. Heart failure in itself is associated with an unpredictable trajectory of symptoms, a poor prognosis, high mortality and morbidity, and low health-related quality of life (HrQoL). With the addition of depressive symptoms to heart failure the negative health effects increase further. Though the negative consequences of depressive symptoms in heart failure are well known, there is a knowledge gap about the course of depressive symptoms in heart failure and about how to effectively manage these symptoms. Pharmacological treatment with serotonin reuptake inhibitors has not been able to demonstrate efficacy in persons with heart failure. In a few studies, cognitive behavioural therapy (CBT) delivered face-to-face, has demonstrated effects on depressive symptoms in persons with heart failure. However, currently there are barriers in delivering face-to-face CBT as there is a lack of therapists with the required training. As a solution to this, the use of Internet-based CBT (ICBT) has been proposed. ICBT has been shown to be effective in treatment of mild and moderate depression but has not been evaluated in persons with heart failure. Aim The overall aim of this thesis was to describe depressive symptoms over time and to develop and evaluate an ICBT intervention to treat depressive symptoms in persons with heart failure. Design and Methods The studies in this thesis employ both quantitative (Studies I, II and III) and qualitative (Studies II and IV) research methods. The sample in Study I (n=611) were recruited in the Netherlands. The participants (n=7) in Study II were recruited via advertisements in Swedish newspapers. Studies III and IV used the same cohort of participants (Study III n=50, Study IV n=13). These participants were recruited via an invitation letter sent to all persons who had made contact with healthcare services in relation to heart failure during the previous year, at the clinics of cardiology or medicine in four hospitals in southeast Sweden. Study I had a quantitative longitudinal design. Data on depressive symptoms was collected at baseline (discharge from hospital) and after 18 months. Data on mortality and hospitalisation was collected at 18 and 36 months after discharge from hospital. Study II employed three differentBehind the Screen2patterns of design, as follows: I) The development and context adaptation of the ICBT program was based on research, literature and clinical experience and performed within a multi-professional team. II) The feasibility of the program from the perspective of limited efficacy and function was investigated with a quantitative pre-post design. III) Participants’ experience of the ICBT program was investigated with a qualitative content analysis. Data on depressive symptoms was collected pre and post intervention. The time used for support and feedback was logged during the intervention, and qualitative interviews were performed with the participants after the end of the intervention. Study III was designed as a randomised controlled trial. A nine-week ICBT program adapted to persons with heart failure and depressive symptoms was tested against an online moderated discussion forum. Data on depressive symptoms, HrQoL and cardiac anxiety was collected at baseline (before the intervention started) and after the end of the intervention (approximately 10 weeks after the start of the intervention). Study IV had a qualitative design to explore and describe participants’ experiences of ICBT. The participants were recruited from within the sample in Study III and all had experience of ICBT. Data collection occurred after the ICBT program ended and was carried out using qualitative interviews by telephone. Results The mean age of the samples used in this thesis varied between 62 and 69 years of age. Concerning the symptom severity of heart failure, most persons reported New York Heart Association (NYHA) class II (40-57%) followed by NYHA class III (36-41%). Ischaemic heart disease was the most common comorbidity (36-43%). The vast majority had pharmacological treatment for their heart failure. Six percent of the persons in Study I used pharmacological antidepressants. In Studies II and III, the corresponding numbers were 43% and 18% respectively. Among persons hospitalised due to heart failure symptoms, 38% reported depressive symptoms. After 18 months, 26% reported depressive symptoms. Four different courses of depressive symptoms were identified: 1) Non-depressed 2) Remitted depressive symptoms. 3) Ongoing depressive symptoms. 4) New depressive symptoms. The highest risk for readmission to hospital and mortality was found among persons in the groups with ongoing and new depressive symptoms. A nine-week ICBT program consisting of seven modules including homework assignments on depressive symptoms for persons with heart failure was developed and tested. The RCT study (Study III) showed no significant difference in depressive symptoms between ICBT and a moderated discussion forum. Within-group analysis of depressive symptoms demonstrated a significant decrease of depressive symptoms in the ICBT group but not in the discussion forum group. The participants’ experience of ICBT was described in one theme: ICBT- an effective, but also challenging tool for self-management of health problems. This theme was constructed based on six categories: Something other than usual healthcare; Relevance and recognition; Flexible, understandable and safe; Technical problems; Improvements by live contact; Managing my life better. Conclusion After discharge from hospital, depressive symptoms decrease spontaneously among a large proportion of persons with heart failure, though depressive symptoms are still common in persons with heart failure that are community dwelling. Depressive symptoms in persons with heart failure are associated with increased risk of death and hospitalisation. The highest risks are found among persons with long-term ongoing depressive symptoms and those developing depressive symptoms while not hospitalised. ICBT for depressive symptoms in heart failure is feasible. An intervention with a nine-week guided self-help program with emphasis on behavioural activation and problem-solving skills appears to contribute to a decrease in depressive symptoms and improvement of HrQoL. When ICBT is delivered to persons with heart failure and depressive symptoms the participants requests that the ICBT is contextually adapted to health problems related to both heart failure and depressive symptoms. ICBT is experienced as a useful tool for self-care and something other than usual healthcare. ICBT also requires active participation by the persons receiving the intervention, something that was sometimes experienced as challenging.

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Larsson, Ellinor. "Promoting social activities and participation among seniors : exploring and evaluating social and Internet-based occupational therapy interventions." Doctoral thesis, Umeå universitet, Arbetsterapi, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-114436.

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Introduction The use of technology and Internet-based activities (IBAs) is increasing in society. However, seniors with limited experiences with the Internet can experience restricted participation in meaningful activities that are dependent on the Internet. Also, social transitions during aging might lead to reduced social activities and social contacts and to increased experiences of loneliness, all of which might have negative health implications. Therefore, there is a need to advance the knowledge of how occupational therapists can support seniors’ use of IBAs and create opportunities for social contacts and social activities during aging. Aim The overall aim of this thesis is to increase the knowledge of how Internet-based activities influence seniors’ participation in society, how seniors experience and are influenced by support from a social Internet-based occupational therapy intervention, and how different aspects of this intervention can contribute to healthy ageing. Methods In study I, seniors’ experiences of IBAs were explored and described through interviews with 10 seniors (66–82 years old) that were analyzed with the constant comparative method. In study II, a multiple case study with five seniors (65–85 years old) was used to explore the design of an Internet-based occupational therapy social intervention program and how it influenced social activities and social contacts among the participants. The qualitative and quantitative data from multiple sources were analyzed by pattern matching. In study III, an explorative randomized crossover study with an AB/BA design was conducted with 30 seniors (61–89 years old) who were vulnerable to loneliness and who participated in the intervention program. The quantitative data were analyzed with parametric and non-parametric statistics. In study IV, a qualitative interview study was conducted to collect the experiences of 15 seniors (66–87 years old) from the previous intervention process in study III. The interviews were analyzed with the constant comparative method. All participants in studies I–IV were community-dwelling, retired seniors without home-care services. Results Complex interactions of different aspects influence seniors’ possibilities and preferences for taking part in IBAs. The performance of IBAs yielded different experiences of participation in society (study I). The initial explorative results indicated that the client-centered and individually adapted intervention program supports participation in social IBAs (SIBAs) and other social contexts (study II). After participation in the intervention program, the experiences of loneliness significantly decreased, and satisfaction with social contacts on the Internet increased for one group (study III). If an individual’s requirements are met during the intervention process, experiences of habitual SIBA usage, increased self-reliance, and enriched social contacts and social activities both on and off the Internet might be facilitated (study IV). Conclusion This thesis provides knowledge of how social support, experiences of and accessibility to technology, life-changing events, and identified meaningfulness with online activities influence the motivation to participate in social and Internet-based activities. The occupational therapist should address the individual’s perspective in the intervention program so as to adapt the intervention and to support experiences of satisfactory participation and enhanced social activities and social contacts for seniors. In addition, healthy aging might be supported by the intervention program due to the reduction in loneliness and increased participation in social activities and society. Further evaluation of the framework and content of the intervention program for seniors with restricted participation in IBAs and SIBAs and high levels of loneliness is suggested.

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Rozental, Alexander. "Negative effects of Internet-based cognitive behavior therapy : Monitoring and reporting deterioration and adverse and unwanted events." Doctoral thesis, Stockholms universitet, Klinisk psykologi, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-135382.

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Internet-based cognitive behavior therapy (ICBT) has the potential of providing many patients with an effective form of psychological treatment. However, despite helping to improve mental health and well-being, far from everyone seem to benefit. In some cases, negative effects may also emerge. The overall aim of the present thesis was to establish the occurrence and characteristics of such incidents in ICBT using a combination of quantitative and qualitative methods. Study I determined deterioration, non-response, and adverse and unwanted events in a sample of 133 patients undergoing ICBT for social anxiety disorder. The results indicated that up to 6.8% fared worse during the treatment period, depending on the self-report measure and time point, as determined using the Reliable Change Index (RCI), while the non-response rate was between 29.3 to 86.5% at post treatment assessment, and 12.9% experienced other negative effects. Study II investigated the responses to open-ended questions on adverse and unwanted events among 556 patients in four separate clinical trials of ICBT; social anxiety disorder, panic disorder, major depressive disorder, and procrastination. In total, 9.3% reported negative effects, with a qualitative content analysis revealing two categories and four subcategories; patient-related, i.e., gaining insight and experiencing new symptoms, and treatment-related, i.e., difficulties applying the treatment interventions and problems related to the treatment format. Study III explored the number of patients achieving reliable deterioration, as determined using the RCI on the individual raw scores of 2866 patients from 29 clinical trials of ICBT. The results showed that the deterioration rate was higher among patients in a control condition, 17.4%, in comparison to treatment, 5.8%. Predictors were related to decreased odds of deterioration for patients receiving treatment; clinical severity at pre treatment assessment, being in a relationship, having a university degree, and being older. As for the control condition, only clinical severity at pre treatment assessment was associated with decreased odds of deterioration. Study IV examined a newly developed self-report measure for monitoring and reporting adverse and unwanted events, the Negative Effects Questionnaire. The results suggested a six-factor solution with 32 items; symptoms, quality, dependency, stigma, hopelessness, and failure. One-third of the patients reported experiencing unpleasant memories, stress, and anxiety, with novel symptoms and a lack of quality in the treatment and therapeutic relationship having the greatest negative impact. The general finding of the present thesis is that negative effects do occur in ICBT and that they are characterized by deterioration, non-response, and adverse and unwanted events, similar to psychological treatments delivered face-to-face. Researchers and clinicians in ICBT are recommended to monitor and report negative effects to prevent a negative treatment trend and further the understanding of what might contribute to their incidents. Future research should investigate the relationship between negative effects and treatment outcome, especially at follow-up, to examine if they are transient or enduring. Also, interviews could be conducted with those achieving reliable deterioration to explore if and how it is experienced by the patients and to see if it is attributed to the treatment interventions or other circumstances.
Internetbaserad kognitiv beteendeterapi (IKBT) har goda förutsättningar att kunna bli en form av psykologisk behandling som på ett effektivt sätt hjälper patienter med att hantera sin psykiska ohälsa och förbättra sitt välmående. Trots detta är det dock långtifrån alla som tycks bli bättre. För en del kan det till och med resultera i negativa effekter. Det övergripande syftet med denna avhandling har således varit att undersöka förekomsten av sådana fall och hur dessa uttrycks, såväl med kvantitativa som kvalitativa metoder. Studie I fastställde andelen försämrade, oförändrade samt andra ogynnsamma eller oönskade händelser bland 133 personer som behandlades med IKBT för social ångest. Resultatet visade att uppemot 6,8 % försämrades under sin behandlingsperiod beroende på vilket självskattningsformulär respektive tidpunkt som studerades, beräknat enligt metoden Reliable Change Index (RCI). Likaså var 29,3 % till 86,5 % oförändrade vid eftermätningen samt att 12,9 % rapporterade andra former av negativa effekter. Studie II undersökte svaren på öppna frågor som gällde ogynnsamma eller oönskade händelser bland 556 patienter i fyra olika kliniska studier med IKBT; social ångest, paniksyndrom, egentlig depressionsepisod och prokrastinering. Totalt sett rapporterade 9,3 % att de hade erfarit negativa effekter, vilka analyserades med hjälp av kvalitativ innehållsanalys. Två övergripande kategorier och fyra subkategorier framkom; patientrelaterade, som ökad insikt respektive nya symptom, samt behandlingsrelaterade, som svårigheter att implementera behandlingsinterventionerna respektive problem med behandlingsformatet. Studie III utrönte andelen patienter som försämrades i enlighet med RCI, baserat på insamlad rådata från 2866 personer i 29 olika kliniska studier med IKBT. Resultatet visade att försämring var mer förekommande hos de som var i en kontrollgrupp, 17,4 %, jämfört med de som fick behandling, 5,8 %. Bland de som genomgick behandling existerade det även ett par prediktorer som innebar lägre odds för försämring; större svårigheter vid förmätningen, att befinna sig i en relation, att ha en universitetsutbildning respektive att vara äldre. För de som var i en kontrollgrupp var enbart större svårigheter vid förmätningen relaterat till lägre odds för försämring. Studie IV testade ett nykonstruerat självskattningsformulär; Negative Effects Questionnaire. Resultatet visade på en faktorlösning med sex faktorer och 32 påståenden; symptom, kvalitet, beroende, stigma, hopplöshet respektive misslyckande. En tredjedel av personerna svarade att de hade upplevt obehagliga minnen, stress och ångest, samtidigt som nya symptom och bristande kvalitet i både behandlingen respektive den terapeutiska relationen hade haft störst negativ inverkan på dem. Den generella slutsatsen av denna avhandling är således att negativa effekter förekommer i IKBT och att de kännetecknas av försämring, ett oförändrat tillstånd samt andra ogynnsamma eller oönskade händelser, något som liknar tidigare forskning av psykologisk behandling som bedrivs ansikte-mot-ansikte. Forskare och behandlare i IKBT rekommenderas att övervaka och rapportera negativa effekter i syfte att förhindra en negativ utveckling i behandlingen samt för att öka kunskapen om vad som kan bidra till deras förekomst. Framtida forskning bör undersöka relationen mellan negativa effekter och behandlingsutfall utifrån längre tidsperspektiv för att se om dess påverkan är övergående eller ihållande. Vidare kan till exempel intervjuer utföras med de patienter som har försämrats för att ta reda på om och hur det uppfattas samt huruvida det har förorsakats av behandlingen eller andra omständigheter.

At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 4: In press.

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Xin, Ren. "Machine Learning Classification of Response to Internet-based Cognitive-Behavioural Therapy using Genome-Wide Association Study Data." Thesis, KTH, Skolan för elektroteknik och datavetenskap (EECS), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-280354.

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Genome-Wide Association Study (GWAS) data is used to predict clinical outcome of Internet-based Cognitive-Behavioural Therapy for patients suffering from depression. The original data has a very small sample size, but a huge number of features. We reduce the number of Single Nucleotide Polymorphisms (SNPs) by selecting the ones associated with unipolar depression. We define and train a Convolutional Neural Network model with the new data containing only the selected SNPs. For comparison, we also train a logistic regression model with the new data and train both models with a same size data set containing SNPs randomly chosen from the total set. The results show that the selected SNPs have stronger prediction power than the random SNPs, the trained models with the selected SNPs have better performance than a nondiscriminating classifier; however, the CNN model does not perform better than the logistic regression model. These results are discussed, with suggestions for future improvements, such as means to increase the sample size and to reduce the feature size.
Data från Genome-Wide Association (GWAS) används för att förutsäga kliniskt resultat av internetbaserad kognitiv beteendeterapi för patienter som lider av depression. Originaluppgifterna har en mycket liten provstorlek, men ett stort antal funktioner. Vi minskar antalet funktioner, som är enkla nukleotidpolymorfismer (SNP), genom att välja de som är associerade med unipolär depression. Vi definierar och tränar en Convolutional Neural Network-modell med den nya informationen som endast innehåller de valda SNP:erna. Som jämförelse tränar vi också en logistisk regressionsmodell med den nya datan och tränar båda modellerna med samma storlek som innehåller SNP:er som slumpmässigt valt från den totala uppsättningen. Resultaten visar att de valda SNP:erna har starkare förutsägelseskraft än de slumpmässiga SNP:erna, de tränade modellerna med de valda SNP:erna har bättre prestanda än en icke-diskriminerande klassificerare; CNN-modellen presterar emellertid inte bättre än den logistiska regressionsmodellen. Dessa resultat diskuteras med förslag på framtida förbättringar, till exempel medel för att öka provstorleken och minska funktionsstorleken.

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Holländare, Fredrik. "Managing depression via the Internet : self-report measures, treatment & relapse prevention." Doctoral thesis, Örebro universitet, Hälsoakademin, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-15734.

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Cognitive behaviour therapy (CBT) is an effective treatment for depression but access is limited. One way of increasing access is to offer CBT via the Internet. In Study I, guided Internet-based CBT was found to have a large effect on depressive symptoms compared to taking part in an online discussion group. Approximately two hours were spent on guiding each patient and the large effect found differs from previous studies that showed smaller effects, probably due to lack of guidance. The intervention had no effect on the participants’ quality of life but significantly decreased their level of anxiety. Internet-based versions of self-report measures can be more practical and efficient than paper versions. However, before implementation, evidence of psychometrical equivalence to the paper versions should be available. This was tested in Studies II and III for the Montgomery-Åsberg Depression Rating Scale – Self-rated (MADRS-S) and the Beck Depression Inventory – Second Edition (BDI-II). When the full scales were investigated, equivalent psychometric properties were found in the two versions of the MADRS-S and BDI-II. However, in the Internet-version of the BDI-II, a lower score was found for the question about suicidality and the difference was statistically significant. Although the difference was small, this indicates that suicidality might be underestimated when using the Internet-based BDI-II. As the long-term prognosis after treatment for depression is poor, in Study IV we investigated the possibility of delivering CBT-based relapse prevention via the Internet. The results revealed that fewer participants in the intervention group experienced a relapse compared to the control group and that the time spent on guiding each participant was approximately 2.5 hours. A trend towards a higher remission rate was found in the CBT group at the six-month follow-up and a reduction of depressive symptoms was associated with a lowered risk of relapse. CBT-based relapse prevention via the Internet can potentially be made available to large numbers of patients, thus improving their prognosis. The Internet increases the possibilities for health care providers in the management of depression.

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Kaldo, Viktor. "Cognitive Behavioural Therapy as Guided Self-help to Reduce Tinnitus Distress." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis Acta Universitatis Upsaliensis, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8927.

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Petrozzi, Marco John. "Management of Chronic Low Back Pain in Manual Therapy Practice." Thesis, University of Sydney, 2020. https://hdl.handle.net/2123/24264.

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Guidelines recommend a biopsychosocial approach in managing chronic LBP in primary care chiropractic and physiotherapy practice. The broad aims of this thesis were to trial a novel psychologically informed manual therapy treatment approach to improve the effectiveness of patient-centred care for people with chronic LBP at medium risk of ongoing disability; to explore any prognostic factors related to ongoing disability; and to explore the experiences of trial participants living with chronic LBP and their responses to treatment interventions experienced in the trial. The thesis comprised three studies. Study one: determined in a randomised controlled trial (Mind Your Back) that psychologically informed manual therapy (internet-delivered MoodGYM program added to physical treatments) was not more effective than standard physical treatments on disability (SMD −0.06, 95% CI: −0.45 to 0.31) or self-efficacy (SMD 0.06, 95% CI: −0.31 to 0.45) in adults (n=108) at medium risk of chronic LBP related disability. Study two: examined a range of putative clinical and socio-demographic factors at baseline and found lower work ability (β = −1.05, 95% CI: −1.40 to −0.70; p < 0.0001) and prior consultation with a medical practitioner within 3-months of seeking treatment (β = 3.35, 95% CI: 1.14 to 5.55; p < 0.003) predicted greater disability in trial participants at 6-months follow-up (unadjusted R2 = 0.31). Study Three: found chronic LBP profoundly disrupted physical, psychological and social aspects of trial participants’ lives and that they preferred interventions which were personalised and tailored to their individual needs. This thesis provides new knowledge and insights for clinicians to better understand and manage patients with chronic LBP at medium risk of ongoing disability, and expands research on psychologically informed manual therapy in chronic LBP in primary care chiropractic and physiotherapy practice.

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La, Lima Christopher N. "Therapist-Guided, Internet-Based Cognitive Behavioral Therapy for Body Dysmorphic Disorder - English Version (BDD-NET)| A Feasibility Study." Thesis, Hofstra University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10624263.

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Background: Body Dysmorphic Disorder (BDD) is a debilitating mental illness that leads to significant functional impairment. Cognitive-behavioral therapy (CBT) is an empirically supported treatment shown to reduce BDD and associated symptoms, but most people suffering from BDD do not have access to it. To address limited access to evidence-based treatments, internet-based CBT (ICBT) was created. It is a growing CBT platform that has demonstrated efficacy with a number of disorders, including BDD. ICBT for BDD (BDD-NET) has been developed to treat BDD, and has been tested in one pilot study and one randomized controlled trial (RCT) against an active comparison group, showing promising results. Currently, BDD-NET only exists in a Swedish platform and is only available to patients in Sweden. Objectives: The current study aimed to test an English-language version of BDD-NET, utilizing global inclusion, in order to begin to establish a more accessible BDD treatment option for English-speakers across national borders and geographic locations. It was hypothesized that subjects would improve in BDD and associated symptoms, be satisfied with treatment, and be willing and able to complete the BDD-NET core treatment modules. Treatment: BDD-NET contains core CBT strategies such as exposure with response prevention (EX/RP) and cognitive restructuring, and is conducted through the internet on a confidential platform. Patients complete psychoeducational readings, written work, and home practice of CBT strategies with therapist guidance through a confidential messaging system. Design: The current study is an uncontrolled clinical trial with within-subjects repeated measures design. Participants included 21 self-referred adults diagnosed with BDD. The primary outcome measure was the Yale-Brown Obsessive Compulsive Scale for BDD (BDD-YBOCS), administered at baseline, mid-treatment, and post-treatment. Secondary outcomes were depression, global functioning, client satisfaction with BDD-NET, treatment credibility, therapeutic alliance, and treatment engagement and completion. Outcomes were analyzed using a multivariate approach to repeated measures, as well as paired-sample t-tests. Proportions of patients completing core modules (1-5) of BDD-NET and discontinuing treatment early were calculated. Clinical assessments of treatment effects and feedback from participants were utilized to aid in development on the BDD-NET treatment protocol. Results: Participants deemed BDD-NET as acceptable and reported that they were able to utilize BDD-NET treatment resources. BDD-NET was associated with significant improvements in BDD-YBOCS scores (p<.001), with a large within-group effect size ( d = 1.71). Fifty-seven percent of participants who completed post-assessments were responders (≥ 30% reduction on the BDD-YBOCS), and 36% were in remission from BDD. Depression and global functioning improved from pre- to post-treatment, with large effect sizes. Conclusions: BDD-NET has great potential to largely increase access to evidence-based psychiatric treatment for English-speaking patients with BDD across national borders and from a variety of cultural backgrounds. BDD-NET may be particularly helpful in targeting patients with barriers to care. A randomized controlled trial of an English-language version of BDD-NET is warranted.

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Berto, Cibele Cristine de Oliveira. "Criação, implementação e avaliação de um recurso didático multimídia como suporte para o ensino presencial de fisioterapia respiratória." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/5/5163/tde-22112006-145508/.

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As novas tecnologias da informação têm sido amplamente utilizadas no ensino em saúde. No entanto, não há relatos do uso desses recursos no ensino em fisioterapia respiratória. Os objetivos foram: criar um material didático para o ensino de manobras de higiene brônquica (MHB), manobras de reexpansão pulmonar (MRP) e oxigenioterapia (OT), disponibilizá-lo na Web e avaliar o aprendizado dos alunos que o utilizaram. O material elaborado foi dividido em três partes: 1) princípios fisiológicos, 2) fisiopatologia e 3) MHB, MRP ou OT. Cada parte foi composta de conteúdo teórico e/ou recursos audiovisuais desenvolvidos especificamente para o ensino dos temas MHB, MRP e OT. O material foi desenvolvido e implementado didaticamente em páginas eletrônicas utilizando-se vídeos, fotos e uma apostila resumindo as evidências da literatura sobre os temas selecionados. Para testar o material foram convidados 50 alunos de duas instituições de ensino superior de fisioterapia (IES-A e IES-B), dos quais 38 aceitaram participar (22 da IES-A; 16 da IES-B). Os alunos realizaram um teste e depois foram, aleatoriamente, divididos em dois grupos (controle, CL e on-line, OL). O grupo OL teve 15 dias de acesso ao material e os dois grupos repetiram o teste 15 dias após o término do período de acesso. O teste foi composto por questões elaboradas por fisioterapeutas chefes de grandes hospitais de São Paulo que não tiveram acesso ao material. Os alunos da IES-A obtiveram melhor nota no 1o teste em relação aos alunos da IES-B. O grupo OL da IES-B obteve maior nota no 2o teste, quando comparado ao seu grupo CL (respectivamente, 7,75 ± 1,28 e 5,93 ± 0,72; p < 0,05). Portanto, o grupo OL da IES-A e os grupos CL da IES-A e IES-B não apresentaram alteração da nota no 2o teste. Nossos resultados sugerem que o material desenvolvido melhorou o conhecimento para alguns alunos e que o uso de tecnologias da informação pode facilitar o aprendizado fisioterapia respiratória.
Advances in information technology have been widely used in teaching health care professionals; however, we are not aware of any previous study reporting its use in the instruction of respiratory therapists. The objectives of the present study were to develop materials for teaching bronchial hygiene techniques (BHT), lung expansion techniques (LET) and oxygen therapy (OT) using Web based technology and to evaluate the learning among undergraduate physical therapist students. Each material was divided in physiological principles; physiopathology; and the physical therapy technique itself (BHT, LET and OT). Each division was composed by a theoretical component and audiovisual resources aimed the instruction of BHT, LET and OT. Fifty students from two distinct universities (UA and UB) were invited to participate in the study and 38 accepted (UA: 22 and UB: 16). After taking the first on-line test, students from each university were divided into two groups: control (without on-line access) and online (with on-line access). All of the students performed a second test 15 days after the period of access. The test was developed by five senior physical therapists from large hospitals that did not have access to the material. Our results show that, in the first test, students from the UA had better performance than students of the UB. The online group of the UB had better performance than the control group on the second test (7.75 ± 1.28 and 5.93 ± 0.72 score; p < 0.05). On contrary, the performance of the online group of the UA and both controls groups of the UA and UB in the second test was similar to the first test. Our results suggest that respiratory therapy teaching using Web based technology can improve students\' learning.

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Ram, Molly, and Louise Sjögren. "Användning, erfarenheter och betydelser av internet hos män och kvinnor över 65 år : - ur ett aktivitets- och delaktighetsperspektiv." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för rehabilitering, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-40384.

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Syftet var att beskriva användning, erfarenheter och betydelser av internet hos män och kvinnor över 65 år, ur ett aktivitets- och delaktighetsperspektiv. Metoden som användes var en kvantitativ tvärsnittsstudie och urvalet bestod av ett bekvämlighetsurval samt ett snöbollsurval. Enkäten utformades av författarna till examensarbetet med stöd av begrepp från Model Of Human Occupation. Totalt 50 enkäter delades ut och 38 enkäter besvarades. Datamaterialet bearbetades deskriptivt och analytiskt. Resultatet visade att 17 av 19 respondenter i åldersgruppen 67-76 år använde internet jämfört med 10 av 18 respondenter i åldersgruppen 77-94 år. Tre fjärdedelar i målgruppen var användare av internet och de flesta använde dessutom internet varje dag. Vad internet användes till överensstämde inte alltid med vad respondenterna upplevde som betydelsefullt. Alla respondenter förutom två, som var internetanvändare, kände sig delaktiga i samhället. Majoriteten av respondenterna upplevde tillfredsställelse med sina vardagsaktiviteter. Slutsatsen är att både användare och icke-användare av internet kände sig delaktiga i samhället och upplevde tillfredsställelse med sina vardagsaktiviteter. Internetanvändning behöver inte betyda känsla av delaktighet. Att söka efter information var den internettjänst som användes mest bland respondenterna. Vad internet användes till överensstämde inte alltid med vad respondenterna upplevde som betydelsefullt.

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Daynes, Lu. "wtf? : the role of netspeak on levels of distress in internet based therapies and subsequent impact on therapist understanding." Thesis, University of Wolverhampton, 2012. http://hdl.handle.net/2436/297681.

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Internet-based therapies are growing in number and popularity and cover a diverse range of practices for both individuals and groups. In concordance with the hyperpersonal theory and online disinhibition effect, people more readily disclose personal information when conducted via the internet. Due to technological constraints and social interactions, a non-standard language developed and has widely been termed “netspeak” (Crystal, 2006). Emotional words are processed differently to non-emotional words. Further, people do not connect with abbreviations on the same emotional level as they do when the words are written in full. Three studies were conducted: the first focused on assessing if a short emotionally evocative mini-biography had an emotional impact on participants. This material was then used in a second study which was a mass-testing of 62 young people on whether netspeak can change the impact on mood. The study used 3 conditions whereby participants re-wrote the mini-biography into either full English, using Netspeak or in their own words. A new vignette was created from the Netspeak condition to use as material for a third study. This final study was conducted via email into how much a psychological therapist understood what had been written in the Netspeak vignette. No differences were seen from re-writing an emotional biography in netspeak to English. Although psychological therapists demonstrated some understanding of the netspeak vignette, there was evidence of misinterpretation, presumption and misunderstanding suggesting that there may be some barrier to communication in internet therapy. The clinical implications of this research suggest that psychological therapists need to reflect on their practice in order to be aware of the level of assumption that can be made during therapy.

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Rödén, Elin, and Elin Sehlin. "Arbetsterapeutiska interventioner med digital teknik : En litteraturöversikt." Thesis, Umeå universitet, Avdelningen för arbetsterapi, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-159002.

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Utbudet av digital teknik som vi använder i det dagliga livet har ökat och utvecklats de senaste åren. Utveckling innebär möjligheter men också utmaningar för personer med svårigheter eller begränsad tillgång att hantera digital teknik. Arbetsterapeutiska insatser i form av stöd och anpassning av och med teknik kan göra skillnad för att tillgodose personers aktivitetsbehov. Syftet med studien var att beskriva arbetsterapeutiska interventioner som gjorts med stöd av digital teknik. En litteraturöversikt valdes och sökningar gjordes i databaserna Cinahl, MedLine, PsycINFO och PubMed. Tolv artiklar varav elva kvantitativa samt en kvalitativ kvalitetsgranskades, analyserades och sammanställdes. Resultatet presenteras i fyra kategorier utifrån Occupational Therapy Intervention Process Model (OTIPM). Resultatet visar att arbetsterapeuter bidragit med sin kompetens och tillämpat digital teknik i interventioner för personer med och utan funktionsvariation. Då digital teknik kan modifieras att tillgodose klienters aktivitetsbehov har fortsatt implementering av insatser med digital teknik stor potential i arbetsterapeuters arbete att främja aktivitet och delaktighet.

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Hopps, Sandra. "The efficacy of cognitive-behavioural group therapy for loneliness via inter-relay-chat among people with physical disabilities." Doctoral thesis, Université Laval, 2002. http://proquest.umi.com/pqdweb?did=766080811&sid=2&Fmt=2&clientId=9268&RQT=309&VName=PQD.

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Thiel, Lindsey. "Applying therapies and technologies to the treatment of dysgraphia : combining neuropsychological techniques and compensatory devices to enhance use of writing via the internet." Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/applying-therapies-and-technologies-to-the-treatment-of-dysgraphia-combining-neuropsychological-techniques-and-compensatory-devices-to-enhance-use-of-writing-via-the-internet(e794c4bb-22a9-43be-b4ce-077ba008b8bc).html.

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Effective writing rehabilitation for people with acquired dysgraphia following a stroke could lead to more opportunities to communicate, reduce isolation and improve quality of life. Previous research has suggested that both impairment-focused spelling therapies and assistive technologies can support writing rehabilitation, although the strength of the evidence is limited. The central aim of this PhD study was to investigate whether a combined approach to writing therapy, including impairment-based therapies and assistive technologies, could improve the email writing of participants with varying severity of acquired dysgraphia. An email writing assessment was developed for outcome measurement and data from 42 control participants were collated to determine the neuro-typical range of email writing performance on this task. A within-participants, multiple case design was used to evaluate the effects of two different approaches to therapy with participants with dysgraphia. In the first study, two impairment-based therapies (uni-modal and multi-modal) were compared with eight participants with dysgraphia and the effects of these on spelling accuracy of treated and untreated words were measured. The functional outcomes (email writing, written picture description, writing frequency and perception of disability) of these therapies were also investigated in a second study. The third study evaluated the effects of training eight participants with dysgraphia (six of whom had participated in the first two studies) to use an assistive writing technology for functional writing. There was a wide range of performance in neuro-typical participants on email writing, with both age and education emerging as determinants of performance. Within the clinical studies, there were no significant differences between uni-modal and multi-modal therapies with respect to spelling accuracy, but these lexical therapies led to significant improvements to accuracy of treated and untreated words, written picture description and word length within emails. Training and use of assistive writing software resulted in significant improvements in spelling accuracy and word length within emails. All participants with dysgraphia showed some responsiveness to intervention. Both impairment-based and compensatory approaches to writing rehabilitation were found to have benefit, although the effects varied across participants and outcome measures. This study has highlighted the need for further research into assessments and therapies for writing in aphasia, specifically focusing on candidacy for specific approaches to writing rehabilitation.

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Kofmehl, Joel Joseph. "Online Versus In-Person Therapy: Effect of Client Demographics and Personality Characteristics." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3108.

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Traditionally, mental health professionals have provided psychotherapeutic services through face-to-face sessions. As the Internet has become an increasingly important part of individuals' personal and professional lives, psychologists and clients have used this medium to expand access to psychotherapy. The purpose of this quantitative correlational design was to investigate whether demographic variables and the personality traits of extroversion/introversion (E/I), as assessed by the Big Five Inventory, predicted clients' preferences for a specific method of administered psychotherapy. The theoretical framework for this study was social information processing through computer-mediated communication. An online survey site was used to assist in survey design and data collection, and 301 individuals participated in the study. Results of the Pearson correlation indicated that age was negatively correlated with use of online therapy (p = .038). The variables of region, race, and E/I had no statistically significant effect on the use of online versus in-person therapy (all p values > .05). Findings reflected larger social trends that decisions to seek online therapy fall along lines of diversity related to age and technological knowledge. Recommendations include engaging older patients in opportunities for participating in online therapeutic services, as well as further research on the relationship between cultural diversity and online therapy. These results can inform practitioners and the community about the importance of expanding access to psychotherapeutic services for individuals who need them, which will in turn be an important component of positive social change.

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Andersson, Sara, and Malin Berglund. "Rumineringsfokuserad kognitiv beteendeterapi via internet: En indikerad preventiv insats för ungdomar." Thesis, Örebro universitet, Institutionen för juridik, psykologi och socialt arbete, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-45357.

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Amaro, Tisljarec Deise. "Adverse effects of psychotherapy : Outcomes of a combined Internet treatment for Social Anxiety Disorder." Thesis, Stockholms universitet, Psykologiska institutionen, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-100440.

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Social Anxiety Disorder (SAD) is a mental disorder with high prevalence but low treatment accessibility. A way to facilitate care to these patients is through Internet based treatment. As is the case of most psychological treatments, much has been studied about positive effects but there is a gap regarding adverse effects. This study seeks to fill this gap in the case of an Internet delivered treatment. From a total of 127 participants who took part in a treatment that combined attention biased modification (ABM) and Internet based cognitive behavior therapy (iCBT), 21 (16.5%) presented adverse effects. Most of the adverse effects were detected after participants had received iCBT (13.4%), and these were mostly related to deterioration of symptoms (5.5%), negative wellbeing (3.9%) and emergence of new symptoms (1.6%). Perceived side effects after attention training were less common (4.7%). A thematic analysis showed also that the techniques used in treatment, the lack of time to complete treatment and becoming aware with the impairments of the disorder and its consequences could influence the emergence of adverse effects.

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Costa, Noel José Dias da. "A supervisão pela internet para o tratamento comportamental da enurese com aparelho nacional de alarme." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/47/47133/tde-19102010-112908/.

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Objetivou-se verificar a viabilidade de uma proposta de aperfeiçoamento a distância para a prática psicológica no atendimento à Enurese (EN) em Serviços-escola, Unidades Básicas de Saúde e consultórios particulares, situados em diferentes regiões do país e se o tempo de experiência dos psicólogos participantes da proposta estava relacionado com algumas variáveis como: o número de contatos de supervisão, o tempo para alta dos clientes, as variações nos escores de problemas de comportamento dos clientes e da intolerância dos pais deles. Foram participantes (N=40) psicólogos de diferentes regiões do país, de ambos os sexos, divididos em dois grupos conforme sua experiência, sendo G1: menos de 10 anos (n=27) e G2: mais de 10 anos (n=13). Os participantes receberam treinamento e supervisão num programa de Educação a Distância (EAD) e atenderam crianças ou adolescentes com queixa de EN. As informações e as questões relativas ao atendimento foram comunicadas ao participante, através da internet, pela qual ele também ofereceu respostas e subsídios para sua prática. Os participantes tiveram total liberdade de consultar o supervisor quantas vezes desejassem para solucionar questões ou buscar orientação. O atendimento que desenvolveram se deu através de intervenção comportamental com uso de aparelho nacional de alarme. A Escala de Intolerância foi utilizada para avaliação dos pais, e para avaliar os filhos utilizou-se o Inventário de Comportamentos da Infância e Adolescência CBCL e o Registro simples de \"molhadas\" (descontrole enurético) ao longo do atendimento. Os resultados foram de dois tipos: dos participantes psicólogos e de seus clientes e pais. Foram comparados os números médios de contatos entre os psicólogos e o supervisor, dos dois diferentes grupos de experiência, e os escores obtidos nos instrumentos de avaliação dos clientes aplicados antes e após a intervenção, a fim de verificar a efetividade do tratamento, além do decréscimo do número de molhadas durante este. Do total de participantes, 15 concluíram o tratamento de seus clientes tendo eles atingido os critérios de sucesso e alta, dois tiveram clientes que concluíram sem sucesso, 13 descontinuaram o tratamento, quatro não conseguiram clientes e seis permanecem atendendo seus clientes que não finalizaram o tratamento ao final da coleta dessa pesquisa. O G1 atingiu alta no tratamento com uma média de 20,1 (dp=9,96) contatos para supervisão ix em 20,4 semanas(dp=5,27). O G2 alcançou alta com média de 10,0 contatos (dp=5,30) em 20,4 semanas (dp=7,13). Observou-se, nos clientes, significativa redução nos escores na escala total de problemas de comportamento dos clientes e de intolerância de seus pais em ambos os grupos de participantes após o tratamento. Os resultados deste estudo são inferiores aos obtidos no atendimento com supervisão presencial realizados no país, mas aproximam-se deles, justificando portanto o seu uso. Esses dados demonstram a viabilidade dessa modalidade de atendimento
The objective was to examine feasibility of a distance improvement program of psychological practice in treating Enuresis (EN) in School-services, Basic Health Units, and private offices, located in different areas of the country and if the amount of experience time of the participating psychologists was in any way related to variables such as: the number of supervision contacts, time for client discharge, and intolerance of their parents. Participants were (N=40) psychologists from different regions of the country, from both genders, divided into two groups according to their experience, where G1: under 10 years (N=27), and G2: over 10 years (N=13). Participants received training and supervision in a Distance Learning program (EAD) and treated children or adolescents complaining about EN. Treatment information and related questions were made known to the participant through the internet, where answers and practice aid were also offered. Participants were totally free to consult with supervisor as many times as desired to solve issues or seek guidance. Developed treatment was performed by behavioral intervention with the use of national alarm device. Throughout treatment, the Intolerance Scale was used for parent evaluation, and the Child Behavior Checklist CBCL, as well as bedwetting Record for evaluating the children. Results were of two kinds: of participating psychologists and their clients and parents. The average number of contacts between participating psychologists and their supervisors, of the two experience groups, and pre and post treatment scores obtained in client evaluation instruments were compared in order to check treatment effectiveness, as well as the decrease in bedwetting throughout it. Of the total number of participants, 15 concluded treatment with client achieving success criteria and discharge, two had clients concluding without success, 13 discontinued treatment, four did not obtain clients, and six remained treating clients who had not finish treatment at the end of data collection for this research. G1 obtained treatment discharge with an average of 20.1 (SD=9.96) contacts for supervision in 20.4 weeks (SD=5.27). G2 obtained treatment discharge with an average of 10.0 contacts (SD=5.30) in 20.4 weeks (SD=7.13). Clients were observed to have a significant decrease in total behavior problems scale scores and parent intolerance in both groups of participants xi after treatment. Results of this study are inferior to the ones obtained in treatment with face to face supervision performed in the country, but are close, therefore justifying their use. Such data demonstrates feasibility for this treatment modality

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Agustsson, Hilmir. "Diagnostic Musculoskeletal Imaging: How Physical Therapists Utilize Imaging in Clinical Decision-Making." Diss., NSUWorks, 2018. https://nsuworks.nova.edu/hpd_pt_stuetd/72.

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This qualitative study describes how physical therapist experts in musculoskeletal disorders evaluate and interpret imaging studies and how they employ imaging in clinical decision-making. The informants are physical therapists who are certified orthopedic clinical specialists (OCS) and/or fellows of the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT). The study employed web conferencing to display patient cases, record screen-capture videos, and to conduct interviews. Informants were observed and their activity video-captured as they evaluated imaging studies and, afterwards, interviews were employed to explore the processes they utilized to evaluate and interpret the images and to discuss imaging-related clinical decision-making, including possible functional consequences of changes seen in the images, contraindications to treatment, and indications for referral. The interviews were transcribed and analyzed in the tradition of grounded theory. This study found that the informants’ evaluation of imaging studies was contextual and non-systematic, guided by the clinical presentation. The informants used imaging studies to provide a deeper understanding of clinical findings and widen perspectives, arriving at clinical decisions through the synthesis of imaging, clinical findings, and didactic knowledge. They tended to look for imaging evidence of interference with normal motion, rather than evidence of pathology. Overall, the informants expressed conservative views on the use of imaging, noting they would rather use clinical findings and treatment response than imaging findings as a basis for referral to other health care professionals. Using imaging studies to support clinical decision-making can provide physical therapists a wider perspective when planning treatment interventions. By showing physical therapists’ approach to interpreting imaging studies and how this relates to their clinical decision-making, the findings of this study could contribute to discussions of the place of imaging in physical therapist practice, as well as help set objectives for imaging curricula in professional-level and continuing education.

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Almlöv, Jonas. "Origo: A randomized Controlled Study : – the Efficacy of a Guided Self-help Treatment for Generalized Anxiety Disorder via the Internet." Thesis, Linköping University, Department of Behavioural Sciences, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-8215.

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The aim of this study was to evaluate if a population suffering from generalized anxiety disorder could benefit from an Internet based self-help treatment guided via email contact with a therapist. The treatment was based on established cognitive behavioral principles. It was hypothesized that significant improvements would be found as measured by eight self report questionnaires, absence of a clinical diagnoses and global clinical improvement. A total of 89 participants were included and 44 were randomized to a treatment condition and 45 were assigned to a waitlist control. The controls received similar treatment after the first post treatment assessment, conducted eight weeks after the beginning or treatment of the first group. The results showed statistically significant improvements for the treatment group. No changes were observed in the waiting-list control group, with the exception of a minor decrease in depression scores. Large effect sizes were found both within the treatment group and between the two groups in favor of the treatment. In conclusion, Internet treatment can be an efficacious format for treating generalized anxiety disorder.

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Axelsson, Katarina. "Uppföljning av nationell interaktiv webbplats - en mötesplats för barn till föräldrar med psykisk sjukdom." Thesis, Örebro University, Department of Health Sciences, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-1418.

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En nationell interaktiv webbplats- www.kuling.nu arbetades 2003 fram på Psykosvårdens utrednings-och behandlingsenhet, Karlakliniken. Webbplatsen riktar sig till barn och ungdomar som har en förälder med psykisk sjukdom och är en del av det anhörigstöd som erbjuds på enheten. Denna studie görs som en uppföljning av kuling.nu där syftet är att beskriva den interaktiva webbplatsen kuling.nu med avseende på innehållet i besökarnas inlägg på diskussionsforumet samt användningen av webbplatsen. Huvudinläggen på kuling.nus diskussionsforum har analyserats med hjälp av kvalitativ innehållsanalys. Analysen gav sex teman som speglar innehållet i inläggen: ensamhet; att bära ansvar; känsloupplevelsen; betydelsen för den egna personen; sökande efter svar och förmedling av stöd. En mörk bild av situationen för barn till en förälder med psykisk sjukdom förmedlas i inläggen och en stor ensamhet med förälderns sjukdom. Den tillskrivs ansenlig betydelse för den egna personen och ger svårigheter som behöver bearbetas. Uppföljningen visar att kuling.nus syfte att ge stöd till barnen uppfylls genom det stöd skribenterna ger varandra i sina inlägg på diskussionsforumet och den informationen om psykisk sjukdom som finns på webbplatsen.

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Donnamaria, Carla Pontes. "Experi?ncias de atendimento psicol?gico grupal via internet: uma perspectiva psicanal?tica." Pontif?cia Universidade Cat?lica de Campinas, 2013. http://tede.bibliotecadigital.puc-campinas.edu.br:8080/jspui/handle/tede/451.

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Made available in DSpace on 2016-04-04T18:29:58Z (GMT). No. of bitstreams: 1 Carla Pontes Donnamaria.pdf: 1446889 bytes, checksum: 17cfa3f992b4834efcd27d9cab756d9d (MD5) Previous issue date: 2013-02-20
The use of new technologies, especially the Internet, in the provision of psychological service at a distance has expanded rapidly in recent years. Since there is not a similar expansion of studies related to this subject, the practice is recognized with restrictions in Brazil. The aim of the present study was to investigate and analyze, under a psychoanalytic perspective, experiences in online psychological service in group modality via Internet in real-time using voice and video. The specific objectives are: to describe from the application of the fundamental psychoanalytic rule (free association), the effect of setting group at a distance over the associations and their psychic processes, and achieve an understanding of the potential of the online group to constitute an effective therapeutic device to sensitize them of their unconscious psychic processes. Two groups were formed, each group brought together up to five participants to conduct twenty four weekly sessions of one hour and thirty minutes, which took place between the months of April to October 2011. The results show that the online group dynamics reproduces many of the vicissitudes of presential group dynamics, including the mobilization of its members for the search for an initially undifferentiated identity, for reinvestment in this state every time the group suffered with changes on its configuration, the nuisances with more constant silences, by transforming personal problems into group problems, establishing and reinforcing bond feelings, and by opening up a space to reframe the problems experienced. It was concluded that the online group can be an effective therapeutic space, despite some limitations and differences, also discussed in this work.
O emprego das novas tecnologias, sobretudo da Internet, na oferta de atendimento psicol?gico ? dist?ncia tem se expandido aceleradamente nos ?ltimos anos. N?o havendo uma expans?o correlata de estudos sobre o assunto, a pr?tica ? regulamentada no pa?s com restri??es. A presente pesquisa teve por objetivo investigar e analisar, sob uma perspectiva psicanal?tica, experi?ncias de atendimento psicol?gico ? dist?ncia na modalidade de grupo, em comunica??o via Internet, em tempo real, por v?deo e voz. Dentre os objetivos espec?ficos: descrever, a partir do enunciado da regra psicanal?tica fundamental (associa??o livre), as incid?ncias da configura??o de grupo ? dist?ncia sobre as associa??es e os seus processos ps?quicos, e alcan?ar uma compreens?o acerca das potencialidades do grupo online de se constituir em um dispositivo terap?utico efetivo para sensibiliz?-lo de seus processos ps?quicos inconscientes. Foram compostos dois grupos, reunindo at? cinco participantes cada um, para a realiza??o de vinte e quatro sess?es, em frequ?ncia semanal de uma hora e trinta minutos, que aconteceram entre os meses de abril a outubro de 2011. O quadro geral evidencia que a din?mica grupal online reproduz muitas das vicissitudes da din?mica grupal presencial, incluindo a mobiliza??o de seus participantes pela busca de uma identidade inicialmente indiferenciada, pelo reinvestimento nesse estado cada vez que o grupo lidava com altera??es em sua configura??o, pelos inc?modos diante dos sil?ncios mais constantes, pela transforma??o de problemas pessoais em problemas de grupo, instaurando e fortalecendo sentimentos de v?nculo, e pela abertura de um espa?o para a ressignifica??o dos problemas vividos. Concluiu-se que o grupo online pode constituir um espa?o terap?utico efetivo, n?o obstante algumas limita??es e diferencia??es, igualmente discutidas neste trabalho.

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Kothari, Radha. "Guided Internet-based cognitive behavioural therapy for perfectionism, and its impact on self-esteem and intolerance of uncertainty : a randomised controlled trial." Thesis, University College London (University of London), 2017. http://discovery.ucl.ac.uk/10024577/.

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Perfectionism, low self-esteem, and intolerance of uncertainty are transdiagnostic processes, elevated across, and implicated in the aetiology and maintenance of, a number of mental health disorders. The present research explores the relationship between these transdiagnostic processes, and whether a change in one (perfectionism), can effect a change in the others (self-esteem and intolerance of uncertainty). Part one is a meta-analytic review of 21 studies investigating the relationship between perfectionism and self-esteem. A negative association was found between self-esteem and perfectionism, particularly the unhelpful or maladaptive aspects of perfectionism known as perfectionistic concerns. Part two presents the findings of a randomised controlled trial (RCT) of a guided internet-based cognitive behaviour therapy (ICBT) for perfectionism, which was conducted jointly with Professor Roz Shafran and her research team. A total of 120 participants took part (experimental = 62, control = 58). Negative associations were observed between perfectionism and self-esteem, and self-esteem and intolerance of uncertainty. A positive association was observed between perfectionism and intolerance of uncertainty. ICBT for perfectionism significantly reduced levels of perfectionism and intolerance of uncertainty, and increased self-esteem, post-intervention (12 weeks). Changes in perfectionism and intolerance of uncertainty, but not self-esteem, were maintained at follow-up (24 weeks). Part three considers the broader challenges of internet-based interventions, treating perfectionism, conducting RCTs, and the advantages and disadvantages of being a clinician-researcher.

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Englund, Ida. "“Recruitment of research participants into randomized controlled trials of internet-based cognitive behavioural therapy (iCBT) for depression: a systematic review and meta-analysis”." Thesis, Uppsala universitet, Internationell mödra- och barnhälsovård (IMCH), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-415871.

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Introduction Research about health has become a very important part of the world today. Theres a constant need for new treatment methods and evidence. Recruitment is one of the most challenging parts of conducting a trial, especially in trials regarding mental health. The result of this is often a waste of money and resources in research. Method This study is a systematic review and meta-analysis investigating the recruitment in randomized controlled trials on internet-based CBT interventions for depression. Results The recruitment rates were calculated as number of participants screened divided by number of participants randomized into the trial. The overall recruitment rates of all the trials was 54.3%. The analysis of the recruitment moderators shown that a clinical recruitment setting together with referral as recruitment personnel.

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Cernvall, Martin. "Symptoms of Posttraumatic Stress in Parents of Children on Cancer Treatment : Factor Structure, Experiential Avoidance, and Internet-based Guided Self-help." Doctoral thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-234518.

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Having a child diagnosed with cancer is stressful and many parents of children on treatment for cancer report symptoms of posttraumatic stress (PTSS). The overall purpose was to, among parents of children on treatment for cancer, investigate the factor structure of PTSS; investigate the relationships between experiential avoidance (EA), rumination, PTSS and depression; and to develop, test, and evaluate a guided self-help intervention provided via the internet. In a longitudinal study with three assessments (n = 249-203) results indicated that a four-factor solution of PTSS including the factors re-experiencing, avoidance, dysphoria, and hyper-arousal provided best fit and that the pattern and size of factor loadings were equivalent across the three assessments (Study I). In a case study with pre-, post-, and follow-up assessments a guided self-intervention was well received with clinical significant and reliable improvements in PTSS, depression, and quality of life (Study II). Furthermore, in cross-sectional analyses (n = 79) EA and rumination were positively associated with PTSS and depression and provided incremental explanation in depression while controlling for demographic characteristics, anxiety, and PTSS. In longitudinal analyses (n = 20), EA but not rumination predicted PTSS and depression while controlling for initial levels (Study III). Finally, in a randomized controlled trial with parents fulfilling the modified symptom criteria on the PTSD-Checklist allocated to guided self-help via the internet (n = 31) or to a wait-list control condition (n = 27) there was a significant intervention effect with a large effect size for the primary outcome PTSS. Similar results were observed for the secondary outcomes depression and anxiety, but not for EA and rumination. Exploratory analyses suggested that the relationships between EA and PTSS and between EA and depression were weakened in the intervention group (Study IV). The studies included in the current thesis suggest that a four-factor solution should be used when assessing PTSS in parents of children on cancer treatment. Furthermore, rumination and EA in particular seem to be important constructs to consider when understanding PTSS and depression in this population. Finally, guided self-help via the internet shows promise in reducing PTSS and depression among parents of children on cancer treatment who report a high level of PTSS.

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Choi, Isabella. "Reducing cultural and structural barriers to treatment: feasibility, efficacy, and acceptability of an Internet-delivered cognitive behavioural therapy program for Chinese Australians with depression." Thesis, The University of Sydney, 2014. http://hdl.handle.net/2123/12297.

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iCBT has the potential to overcome barriers and improve access to depression treatment among Chinese migrants. The aim of this thesis was to examine the feasibility, efficacy, and acceptability of culturally adapted Internet-delivered cognitive behavioural therapy (iCBT) depression treatment for Chinese Australians. The first study described the process of modifying an existing iCBT depression treatment for use by Chinese migrants based on cultural adaptation guidelines. Results suggest the adaptations to the iCBT program were relevant to the Chinese participants regardless of acculturation level, but further modifications may improve cultural relevance. Chinese Australian participants with depression were then randomly allocated to receiving the iCBT depression program (n=25) or deferred-treatment waitlist control (n=30) in a CONSORT compliant RCT design. Treatment group participants reported significantly reduced symptoms of depression compared to controls, with moderate to large between-group effect sizes, and gains were maintained at three-month follow-up. A matched samples study comparing Chinese- (n=55) and English- speaking iCBT depression program participants (n=55) found that iCBT reduced structural barriers, and encouraged Chinese participants who had not sought treatment to seek help early, while it was an additional source of help for English-speaking participants. A survey found that Chinese (n=289) and Caucasian Australian primary-care patients (n=106) perceived Internet treatment to reduce treatment barriers, but face-to-face treatment was preferred across symptom severity. However, only 12% of the entire sample refused to try Internet treatment for depression. The overall findings support the feasibility of modifying iCBT for a cultural group and show that guided iCBT treatments for Chinese migrants is efficacious and acceptable. This research supports iCBT reduces treatment barriers and can improve access among Chinese and other cultural groups.

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Makarushka, Marta Maria 1969. "Efficacy of an Internet-based Intervention Targeted to Adolescents with Subthreshold Depression." Thesis, University of Oregon, 2011. http://hdl.handle.net/1794/12091.

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xiv, 105 p. ill. (some col.)
Depression during adolescence is highly prevalent with as many as 20% experiencing a major depressive episode by the age of 18. Adolescent depression causes significant impairment across life areas including school functioning, such as poor academic performance and decreased academic achievement. Despite the existence of many evidence-based treatment options, merely 25% of depressed adolescents receive treatment. For this reason, it is essential that easily accessible preventive interventions for adolescent depression be developed and made available. Computerized interventions could broaden the reach of prevention efforts and preliminary results indicate that they have the potential to successfully prevent adolescent depression. The Coping with Depression course is an empirically validated cognitive-behavioral depression treatment and prevention program that is well-suited for computerized delivery. This dissertation reports on the development and evaluation of a web-based interactive multimedia version of the adolescent Coping with Depression course with students experiencing subclinical levels of depression. The Blues Blaster program includes the following six modules, with five mini-sessions in each: (a) defining depression, (b) mood monitoring, (c) increasing fun activities, (d) increasing positive thinking, (e) recognizing negative thinking, and (f) decreasing negative thinking. Key concepts are presented and reinforced in a variety of engaging ways within each session, including video, animation, comic strips, graphics, interactive exercises, and games. The Blues Blaster program was evaluated in a randomized controlled trial with 161 adolescents who were randomly assigned to either the Blues Blaster or informationonly control conditions. Participants were assessed at baseline, post-treatment (six weeks after baseline), and six-month follow-up. Results demonstrated greater improvement for the Blues Blaster condition in depression levels, negative thoughts, behavioral activation, knowledge, self-efficacy, and school functioning compared to the information-only control condition. These findings suggest that this targeted prevention program is appropriate for use with middle school students to decrease depression levels and therefore the risk that they will develop major depression in the future.
Committee in charge: Christopher Murray， Chairperson； Deanne Unruh， Member； Jeffrey Sprague， Member； John R. Seeley， Member； Sara Hodges， Outside Member

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Weineland, Sandra. "A Contextual Behavioral Approach for Obesity Surgery Patients." Doctoral thesis, Uppsala universitet, Institutionen för psykologi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-183622.

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This thesis investigates a contextual behavioral approach for obesity surgery patients. In a contextual approach a behavior is interpreted as inseparable from its current and historical context. Candidates for bariatric surgery often have a history of self-stigma, body dissatisfaction and eating for emotional relief. Despite losing a large amount of weight post surgery, psychological problems may still be present for some patients. One possible common underlying process observed in body concerns and eating patterns is experiential avoidance. Experiential avoidance is defined as; any attempt to avoid, change, or control unwanted thoughts and feelings when so doing causes harm. Though a multidisciplinary team is recommended for post-surgical care, there are few studies evaluating the psychological treatment of patients undergoing bariatric surgery. In this thesis a protocol based on Acceptance and Commitment Therapy (ACT), was developed and implemented, partly via the Internet, in a clinical setting. In an acceptance-based approach to obesity, psychological well-being is the main outcome. ACT was significantly more effective than ‘treatment as usual’ in terms of body dissatisfaction and quality of life after surgery. Both groups improved in eating disordered attitudes and behaviors. Predictions based on the underlying treatment model were also investigated. Positive treatment outcomes were found to be associated with increased psychological flexibility. Despite some methodological limitations, the results are promising and future studies should further evaluate ACT in the context of bariatric surgery. This thesis also acknowledges the need for clinical assessment tools appropriate for the bariatric surgery context. The Acceptance and Action Questionnaire for Weight (AAQ-W) is a measure of experiential avoidance, and was evaluated in the present thesis. The AAQ-W was found to be a reliable and valid measure for people undergoing bariatric surgery. Another measure, Disordered Eating in Bariatric Surgery (DEBS) was developed and evaluated. The DEBS was found to posses satisfactory psychometric properties in terms of reliability and validity. The AAQ-W and the DEBS may facilitate both systematic clinical evaluation and future research within the area of bariatric surgery.

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Dissertations / Theses on the topic 'Internet Therapy'

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