A cluster randomised trial of an internet-based intervention program for tinnitus distress in an industrial setting
- Authors: Abbott, Jo-Anne , Kaldo, Viktor , Klein, Britt , Austin, David , Hamilton, Catherine , Piterman, Leon , Williams, Ben , Andersson, Gerhard
- Date: 2009
- Type: Text , Journal article
- Relation: Cognitive Behaviour Therapy Vol. 38, no. 3 (2009), p. 162-173
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- Description: The effectiveness of a therapist-supported Internet intervention program for tinnitus distress in an industrial setting was evaluated using a cluster randomised design. Fifty-six Australian employees of two industrial organisations were randomly assigned, based on their work site (18 work sites from BP Australia and five from BHP Billiton), to either a cognitive behavioural therapy (CBT) program or an information-only control program. Participants were assessed at pre- and postprogram, measuring tinnitus distress, depression, anxiety, stress, quality of life, and occupational health. The CBT program was not found to be superior to the information program for treating tinnitus distress. A high attrition rate and small sample size limit the generalisability of the findings, and further developments of the program and assessment process are needed to enhance engagement and compliance. © 2009 Taylor & Francis.
Modification of the body sensations interpretation questionnaire (BSIQ-M) : Validity and reliability
- Authors: Austin, David , Richards, Jeffrey , Klein, Britt
- Date: 2006
- Type: Text , Journal article
- Relation: Journal of Anxiety Disorders Vol. 20, no. 2 (2006), p. 237-251
- Full Text: false
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- Description: The catastrophic misinterpretation model [Behav. Res. Ther. 24 (1986) 461-470] proposes that panic attacks result from misinterpretation of interoceptive stimuli as precursors to physical or psychological emergency. Inconclusive evidence for the model may be partly explained by limitations of the questionnaires developed to measure catastrophic misinterpretation. For example, the Body Sensations Interpretation Questionnaire (BSIQ) is unable to clarify whether anxiety-related interpretations of ambiguous interoceptive stimuli represent catastrophic misinterpretations or responses masking feared outcomes (e.g., heart failure). Additionally, it lacks items relating to several DSM-IV criteria for panic, thereby limiting content validity. Reliability is also potentially compromised due to experimenter-coding of participant-generated responses. A modified form of the BSIQ was developed to address these limitations and evaluated with non-anxious controls (n=34) and people with panic disorder (n=38). The revised questionnaire demonstrated good to excellent internal consistency, inter-rater reliability, and construct validity and is a useful development of the BSIQ.
Clinical and Cost-Effectiveness of Therapist-Guided Internet-Delivered Cognitive Behavior Therapy for Older Adults With Symptoms of Anxiety: A Randomized Controlled Trial
- Authors: Dear, Blake , Zou, Judy , Ali, Shehzad , Lorian, Carolyn , Johnston, Luke , Sheehan, Joanne , Staples, Lauren , Gandy, Milena , Fogliati, Vincent , Klein, Britt , Titov, Nickolai
- Date: 2015
- Type: Text , Journal article
- Relation: Behavior Therapy Vol. 46, no. 2 (2015), p. 206-217
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- Description: There is preliminary support for internet-delivered cognitive behaviour therapy (iCBT) as a way of improving access to treatment among older adults with anxiety. The aim of this randomized controlled trial (RCT) was to examine the efficacy, long-term outcomes, and cost-effectiveness of an iCBT program for adults over 60. years of age with anxiety. Successful applicants were randomly allocated to either the treatment group (n= 35) or the waitlist control group (n= 37). The online treatment course was delivered over 8. weeks and provided with brief weekly contact with a clinical psychologist via telephone or secure email. Eighty-four percent of participants completed the iCBT course within the 8. weeks and 90% provided data at posttreatment. Significantly lower scores on measures of anxiety (Cohen's d=. 1.43; 95% CI: 0.89 - 1.93) and depression (Cohen's d=. 1.79; 95% CI: 1.21 - 2.32) were found among the treatment group compared to the control group at posttreatment. These lower scores were maintained at 3-month and 12-month follow-up and the treatment group rated the iCBT treatment as acceptable. The treatment group had slightly higher costs ($92.2; 95% CI: $38.7 to $149.2) and Quality-Adjusted Life-Years (QALYs. =. 0.010; 95% CI: 0.003 to 0.018) than the control group at posttreatment and the intervention was found to have a greater than 95% probability of being cost-effective. The results support iCBT as an efficacious and cost-effective treatment option for older adults with symptoms of anxiety. © 2014 Association for Behavioral and Cognitive Therapies.
Therapist-assisted Internet-delivered cognitive behavior therapy for depression and anxiety: Translating evidence into clinical practice
- Authors: Hadjistavropoulos, Heather , Pugh, Nicole , Nugent, Marcie , Hesser, Hugo , Andersson, Gerhard , Ivanov, Max , Butz, Cory , Marchildon, Gregory , Asmundson, Gordon , Klein, Britt , Austin, David
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Anxiety Disorders Vol. 28, no. 8 (2015), p. 884-893
- Full Text: false
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- Description: This dissemination study examined the effectiveness of therapist-assisted Internet-delivered Cognitive Behavior Therapy (ICBT) when offered in clinical practice. A centralized unit screened and coordinated ICBT delivered by newly trained therapists working in six geographically dispersed clinical settings. Using an open trial design, 221 patients were offered 12 modules of ICBT for symptoms of generalized anxiety (. n=. 112), depression (. n=. 83), or panic (. n=. 26). At baseline, midpoint and post-treatment, patients completed self-report measures. On average, patients completed 8 of 12 modules. Latent growth curve modeling identified significant reductions in depression, anxiety, stress and impairment (. d=. .65-.78), and improvements in quality of life (. d=. .48-.66). Improvements in primary symptoms were large (. d=. .91-1.25). Overall, therapist-assisted ICBT was effective when coordinated across settings in clinical practice, but further attention should be given to strategies to improve completion of treatment modules.
Considerations in the development of a therapist-assisted internet cognitive behavior therapy service.
- Authors: Hadjistavropoulos, Heather , Thompson, Maureen , Ivanov, Max , Drost, Christina , Butz, Cory , Klein, Britt , Austin, David
- Date: 2011
- Type: Text , Journal article
- Relation: Professional Psychology: Research and Practice Vol. 42, no. 6 (2011), p. 463-471
- Full Text: false
- Description: There is mounting evidence in clinical trials that therapist-assisted Internet cognitive behavior therapy (TAICBT) is efficacious in the treatment of depression and anxiety. Nevertheless, many clinical service providers (both individuals and organizations) question whether offering this form of treatment in clinical practice is feasible. As such, having information on the factors involved in the development of this service is essential. In this article, we describe the steps taken to develop a TAICBT service that registered professionals and students (under supervision) can use with clients suffering from symptoms of depression, generalized anxiety, and panic disorder. We share salient decisions made in developing this web application and the necessary unit policies and procedures. We also offer lessons learned and practical recommendations to providers who may want to translate this promising TAICBT research into practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Dissemination of Therapist-Assisted Internet Cognitive Behaviour Therapy: Development and Open Pilot Study of a Workshop
- Authors: Hadjistavropoulos, Heather , Thompson, Maureen , Klein, Britt , Austin, David
- Date: 2012
- Type: Text , Journal article
- Relation: Cognitive Behaviour Therapy Vol. 41, no. 3 (2012), p. 230-240
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- Description: There is considerable research suggesting that therapist-assisted Internet cognitive behaviour therapy (ICBT) is efficacious in the treatment of depression and anxiety. Given this research, there is a growing interest in training students in therapist-assisted ICBT in order to assist with the dissemination of this emerging modality into routine clinical practice. In this study, we developed, delivered, and evaluated a therapist-assisted ICBT workshop for clinical psychology graduate students (n = 20). The workshop provided both research evidence and practical information related to the delivery of therapist-assisted ICBT. The workshop also incorporated an experiential component with students working on and discussing responses to client e-mails. Before and after the workshop, we measured knowledge of therapist-assisted ICBT research and professional practice issues, as well as attitudes towards and confidence in delivering therapist-assisted ICBT. Statistically significant changes were observed in all areas. Eighty-five per cent of students are now offering therapist-assisted ICBT under supervision. We conclude by discussing future research directions related to disseminating therapist-assisted ICBT. © 2012 Copyright Swedish Association for Behaviour Therapy.
Time dilation and acceleration in depression
- Authors: Kent, Lachlan , Van Doorn, George , Klein, Britt
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Acta Psychologica Vol. 194, no. (2019), p. 77-86
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- Description: Background: A recent meta-analysis left open a significant question regarding altered time perception in depression: Why do depressed people overproduce short durations and under-produce longer durations if their present experience is that time flows slowly? Experience and judgement of time do not seem to accord with one another. Analysis: By excluding two of the six studies on methodological grounds from a previous meta-analysis of medium-length interval productions, and re-analysing the remaining four studies, the present paper finds that subjective time accelerates from initial dilation within present experience (approximately 1 s duration) to subsequent acceleration within working memory (approximately 30 s duration) when depressed. Proposals: It is proposed that depressive time dilation and acceleration refer to the default mode and central executive networks, respectively. The acceleration effect is suggested to occur due to mood congruency between long intervals, boredom, and depression. This mood congruency leads to the automatic recall of intrusive, negative, and non-specific autobiographical long-term memories used to judge intervals from previous experience. Acceleration in working memory then occurs according to the contextual change model of duration estimation. Limitations: The meta-analysis is limited to four studies only, but provides a potential link between time experience and judgement within the same explanatory model. Conclusions: Similarities between psychological time dilation/acceleration and physical time dilation/acceleration are discussed.
Bayes, time perception, and relativity : The central role of hopelessness
- Authors: Kent, Lachlan , Van Doorn, George , Hohwy, Jakob , Klein, Britt
- Date: 2019
- Type: Text , Journal article
- Relation: Consciousness and Cognition Vol. 69, no. (2019), p. 70-80
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- Description: Time judgement and time experience are distinct elements of time perception. It is known that time experience tends to be slow, or dilated, when depressed, but there is less certainty or clarity concerning how depression affects time judgement. Here, we use a Bayesian Prediction Error Minimisation (PEM) framework called 'distrusting the present' as an explanatory and predictive model of both aspects of time perception. An interval production task was designed to probe and modulate the relationship between time perception and depression. Results showed that hopelessness, a symptom of severe depression, was associated with the ordering of interval lengths, reduced overall error, and dilated time experience. We propose that 'distrusting the future' is accompanied by 'trusting the present', leading to the experiences of time dilation when depressed or hopeless. Evidence was also found to support a relative difference model of how hopelessness dilates, and arousal accelerates, the rate of experienced time.
Systema Temporis : a time-based dimensional framework for consciousness and cognition
- Authors: Kent, Lachlan , Van Doorn, George , Klein, Britt
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Consciousness and Cognition Vol. 73, no. (2019), p. 1-12
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- Description: This study uses a combined categorical-dimensional approach to depict a hierarchical framework for consciousness similar to, and contiguous with, factorial models of cognition (cf., intelligence). On the basis of the longstanding definition of time consciousness, the analysis employs a dimension of temporal extension, in the same manner that psychology has temporally organised memory (i.e., short-term, long-term, and long-lasting memories). By defining temporal extension in terms of the structure of time perception at short timescales (<100 s), memory and time consciousness are proposed to fit along the same logarithmic dimension. This suggests that different forms of time consciousness (e.g., experience, wakefulness, and self-consciousness) are embedded within, or supported by, the ascending timescales of different modes of memory (i.e., short-term, long-term, etc.). A secondary dimension is also proposed to integrate higher-order forms of consciousness/emotion and memory/cognition. The resulting two-dimensional structure accords with existing theories of cognitive and emotional intelligence.
Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT?
- Authors: Kiropoulos, Litza , Klein, Britt , Austin, David , Gilson, Kathryn , Pier, Ciaran , Mitchell, Joanna , Ciechomski, Lisa
- Date: 2008
- Type: Text , Journal article
- Relation: Journal of Anxiety Disorders Vol. 22, no. 8 (2008), p. 1273-1284
- Full Text: false
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- Description: This study compared Panic Online (PO), an internet-based CBT intervention, to best-practice face-to-face CBT for people with panic disorder with or without agoraphobia. Eighty-six people with a primary diagnosis of panic disorder were recruited from Victoria, Australia. Participants were randomly assigned to either PO (n=46) or best practice face-to-face CBT (n=40). Effects of the internet-based CBT program were found to be comparable to those of face-to-face CBT. Both interventions produced significant reductions in panic disorder and agoraphobia clinician severity ratings, self reported panic disorder severity and panic attack frequency, measures of depression, anxiety, stress and panic related cognitions, and displayed improvements in quality of life. Participants rated both treatment conditions as equally credible and satisfying. Participants in the face-to-face CBT treatment group cited higher enjoyment with communicating with their therapist. Consistent with this, therapists' ratings for compliance to treatment and understanding of the CBT material was higher in the face-to-face CBT treatment group. PO required significantly less therapist time than the face-to-face CBT condition.
Internet-based treatment for panic disorder: does frequency of therapist contact make a difference?
- Authors: Kiropoulos, Litza , Klein, Britt , Austin, David , Gilson, Kathryn , Pier, Ciaran , Mitchell, Joanna , Ciechomski, Lisa
- Date: 2008
- Type: Text , Journal article
- Relation: Cognitive behaviour therapy Vol. 22, no. 8 (2008), p. 1273-1284
- Full Text: false
- Reviewed:
- Description: rInternet-based interventions with therapist support have proven effective for treating a range of mental health conditions. This study examined whether frequency of therapist contact affected treatment outcomes. Fifty-seven people with panic disorder (including 32 with agoraphobia) were randomly allocated to an 8-week Internet-based cognitive behavioural treatment intervention (Panic Online) with either frequent (three e-mails per week) or infrequent (one e-mail per week) support from a psychologist. Posttreatment, intention-to-treat analyses revealed that both treatments were effective at improving panic disorder and agoraphobia severity ratings, panic-related cognitions, negative affect, and psychological and physical quality of life domains, with no differences between conditions. High end-state functioning was achieved by 28.6% of the frequent and infrequent participants, respectively. Therapist alliance, treatment credibility, and satisfaction also did not differ between groups, despite significantly greater therapist time invested in the frequent contact condition. The results provide evidence that the effectiveness of Internet-based mental health interventions may be independent of the frequency of therapist support and may, therefore, be more cost-effective than previously reported.
Efficacy of internet therapy for panic disorder
- Authors: Klein, Britt , Richards, Jeffrey , Austin, David
- Date: 2006
- Type: Text , Journal article
- Relation: Journal of Behavior Therapy and Experimental Psychiatry Vol. 37, no. 3 (2006), p. 213-238
- Full Text: false
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- Description: Fifty-five people with panic disorder (PD) were randomised to internet-based cognitive behavioural panic treatment (CBT) (with email contact), therapist-assisted CBT manual or information-only control (both with telephone contact). Both CBT treatments were more effective in reducing PD symptomatology, panic-related cognition, negative affect, and number of GP visits and improving physical health ratings. Internet treatment was more effective than CBT manual in reducing clinician-rated agoraphobia and number of GP visits at post-assessment. At follow-up, these effects were maintained for both CBT groups, with internet CBT better at improving physical health ratings and reducing GP visits. This study provides support for the efficacy of internet-based CBT. © 2005 Elsevier Ltd. All rights reserved.
- Description: C1
A brief internet-based treatment for panic disorder
- Authors: Klein, Britt , Richards, Jeffrey
- Date: 2001
- Type: Text , Journal article
- Relation: Behavioural and Cognitive Psychotherapy Vol. 29, no. 1 (2001), p. 113-117
- Full Text:
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- Description: This study investigated the effectiveness of an Internet-based intervention for people with panic disorder. Twenty-two participants met criteria for panic disorder and were randomly assigned to either the treatment or a self-monitoring control condition. The study took place over 3 weeks and consisted of one week of self-monitoring prior to the intervention group accessing the program for one week, followed by one week of post-intervention assessment. Participants were assessed on measures pertaining to panic, negative affect, body vigilance, anxiety sensitivity and self-efficacy in managing panic. The treatment condition was associated with significant reductions in all variables except anxiety sensitivity and depressive affect. This type of intervention for people with fearful panic attacks holds promise as an efficacious and economical method for treating spontaneous panic.
Preferences for e-mental health services amongst an online Australian sample?
- Authors: Klein, Britt , Cook, Suellen
- Date: 2010
- Type: Text , Journal article
- Relation: E-Journal of Applied Psychology Vol. 6, no. 1 (2010), p. 39
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- Description: This study explored whether differences exist between those who prefer using internet-based mental health services (e-preferers) in comparison to those who prefer traditional face-to-face mental health services (non e-preferers). Gender, age, level of education, relationship status, location of residence, country of birth, previous use of mental health services, specific e-mental health service concerns, perceptions of helpfulness and future use of mental health services were investigated. Two-hundred and eighteen Australians (female=165, male=53) with ages ranging from 18 to 80 (M=36.6, SD=14.5) accessed the online survey. Results indicated that although 77.1% of respondents preferred face-to-face services only 9.6% indicated they would not use e-mental health services. No differences were found between e-preferers and non e-preferers on any demographic variable and on previous mental health service usage, however, several differences regarding perceptions of helpfulness and future use of services and concerns about e-mental health services were observed. In addition, several individual difference variables (stigma, locus of control, learning styles and personality traits) were explored and found to differ between the two groups (stigma, locus of control and personality traits). These results may help inform the future direction of mental health services, including the need to increase public awareness regarding e-mental health services.
A therapist-assisted Internet-based CBT intervention for posttraumatic stress disorder : Preliminary results
- Authors: Klein, Britt , Mitchell, Joanna , Gilson, Kathryn , Shandley, Kerrie , Austin, David , Kiropoulos, Litza , Abbott, Jo-Anne , Cannard, Gwenda
- Date: 2009
- Type: Text , Journal article
- Relation: Cognitive Behaviour Therapy Vol. 38, no. 2 (2009), p. 121-131
- Full Text: false
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- Description: Posttraumatic stress disorder (PTSD) is a debilitating mental health condition frequently associated with psychiatric comorbidity and diminished quality of life, and it typically follows a chronic, often lifelong, course. Previous research has shown that trauma-related psychopathology (but not necessarily clinical PTSD) can be effectively treated via the Internet. This study is the first of its kind to report on the online treatment of patients with a Diagnostic and Statistical Manual of Mental Disorders (fourth edition) clinical diagnosis of PTSD with therapist support by e-mail only. Preliminary findings are presented of an open trial involving a 10-week Internet-based therapist-assisted cognitive behavioural treatment for PTSD (PTSD Online). Pre and posttreatment measures of PTSD and related symptomatology were compared for 16 participants with a variety of trauma experiences. Participants showed clinically significant reductions in PTSD severity and symptomatology, moderate tolerance of the program content, and high therapeutic alliance ratings. No significant change was found on measures of more general psychological symptoms. The results suggest that PTSD Online appears to be an effective and accessible clinical treatment for people with a confirmed PTSD diagnosis.
Internet-based treatment for panic disorder: Does frequency of therapist contact make a difference?
- Authors: Klein, Britt , Austin, David , Pier, Ciaran , Kiropoulos, Litza , Shandley, Kerrie , Mitchell, Joanna , Gilson, Kathryn , Ciechomski, Lisa
- Date: 2009
- Type: Text , Journal article
- Relation: Cognitive Behaviour Therapy Vol. 38, no. 2 (2009), p. 100-113
- Full Text: false
- Reviewed:
- Description: Internet-based interventions with therapist support have proven effective for treating a range of mental health conditions. This study examined whether frequency of therapist contact affected treatment outcomes. Fifty-seven people with panic disorder (including 32 with agoraphobia) were randomly allocated to an 8-week Internet-based cognitive behavioural treatment intervention (Panic Online) with either frequent (three e-mails per week) or infrequent (one e-mail per week) support from a psychologist. Posttreatment, intention-to-treat analyses revealed that both treatments were effective at improving panic disorder and agoraphobia severity ratings, panic-related cognitions, negative affect, and psychological and physical quality of life domains, with no differences between conditions. High end-state functioning was achieved by 28.6% of the frequent and infrequent participants, respectively. Therapist alliance, treatment credibility, and satisfaction also did not differ between groups, despite significantly greater therapist time invested in the frequent contact condition. The results provide evidence that the effectiveness of Internet-based mental health interventions may be independent of the frequency of therapist support and may, therefore, be more cost-effective than previously reported. © 2009 Taylor & Francis.
A therapist-assisted cognitive behavior therapy internet intervention for posttraumatic stress disorder: Pre-, post- and 3-month follow-up results from an open trial
- Authors: Klein, Britt , Mitchell, Joanna , Abbott, Jo-Anne , Shandley, Kerrie , Austin, David , Gilson, Kathryn , Kiropoulos, Litza , Cannard, Gwenda , Redman, Tomi
- Date: 2010
- Type: Text , Journal article
- Relation: Journal of Anxiety Disorders Vol. 24, no. 6 (2010), p. 635-644
- Full Text: false
- Reviewed:
- Description: This study was an open trial evaluation of a 10-week therapist-assisted cognitive behavior therapy (CBT) internet intervention (PTSD Online) undertaken with people with a primary clinical diagnosis of posttraumatic stress disorder (PTSD) (n= 22) at pre-assessment. Participants were re-assessed at post-assessment and 3-month follow-up. Significant improvements on PTSD severity ratings and related PTSD symptomatology were observed at post-assessment and maintained at 3-month follow-up. At post-assessment, 69.2% of the sample showed clinically significant improvement and 77% of the sample at follow-up assessment. Non-significant, yet improved, change was observed on all other general psychological measures. Overall, treatment satisfaction was good (69%), participant therapeutic alliance ratings were high (87.5%), and the average total therapist time required was 194.5. min. PTSD Online appears to be an efficacious treatment option for people with PTSD that can be provided entirely remotely, with far less therapist time than traditional face-to-face treatment, and without compromising therapeutic alliance. © 2010 Elsevier Ltd.
Anxiety online-A virtual clinic: Preliminary outcomes following completion of five fully automated treatment programs for anxiety disorders and symptoms
- Authors: Klein, Britt , Meyer, Denny , Austin, David , Kyrios, Michael
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 13, no. 4 (2011), p.
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- Description: Background: The development of e-mental health interventions to treat or prevent mental illness and to enhance wellbeing has risen rapidly over the past decade. This development assists the public in sidestepping some of the obstacles that are often encountered when trying to access traditional face-to-face mental health care services. Objective: The objective of our study was to investigate the posttreatment effectiveness of five fully automated self-help cognitive behavior e-therapy programs for generalized anxiety disorder (GAD), panic disorder with or without agoraphobia (PD/A), obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and social anxiety disorder (SAD) offered to the international public via Anxiety Online, an open-access full-service virtual psychology clinic for anxiety disorders. Methods: We used a naturalistic participant choice, quasi-experimental design to evaluate each of the five Anxiety Online fully automated self-help e-therapy programs. Participants were required to have at least subclinical levels of one of the anxiety disorders to be offered the associated disorder-specific fully automated self-help e-therapy program. These programs are offered free of charge via Anxiety Online. Results: A total of 225 people self-selected one of the five e-therapy programs (GAD, n = 88; SAD, n = 50; PD/A, n = 40; PTSD, n = 30; OCD, n = 17) and completed their 12-week posttreatment assessment. Significant improvements were found on 21/25 measures across the five fully automated self-help programs. At postassessment we observed significant reductions on all five anxiety disorder clinical disorder severity ratings (Cohen d range 0.72-1.22), increased confidence in managing one's own mental health care (Cohen d range 0.70-1.17), and decreases in the total number of clinical diagnoses (except for the PD/A program, where a positive trend was found) (Cohen d range 0.45-1.08). In addition, we found significant improvements in quality of life for the GAD, OCD, PTSD, and SAD e-therapy programs (Cohen d range 0.11-0.96) and significant reductions relating to general psychological distress levels for the GAD, PD/A, and PTSD e-therapy programs (Cohen d range 0.23-1.16). Overall, treatment satisfaction was good across all five e-therapy programs, and posttreatment assessment completers reported using their e-therapy program an average of 395.60 (SD 272.2) minutes over the 12-week treatment period. Conclusions: Overall, all five fully automated self-help e-therapy programs appear to be delivering promising high-quality outcomes; however, the results require replication. © Britt Klein, Denny Meyer, David William Austin, Michael Kyrios.
Development of an online intervention for bipolar disorder. www.moodswings.net.au
- Authors: Lauder, Sue , Chester, Andrea , Castle, David , Dodd, Seetal , Berk, Lesley , Klein, Britt , Austin, David , Gilbert, Monica , Chamberlain, James , Murray, Greg , White, Carolynne , Piterman, Leon , Berk, Michael
- Date: 2013
- Type: Text , Journal article
- Relation: Psychology, Health and Medicine Vol. 18, no. 2 (2013), p. 155-165
- Full Text: false
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- Description: We describe the development process and completed structure, of a self-help online intervention for bipolar disorder, known as MoodSwings (www.moodswings.net.au). The MoodSwings program was adapted as an Internet intervention from an efficacious and validated face-to-face, group-based psychosocial intervention. The adaptation was created by a psychologist, who had previously been involved with the validation of the face-to-face program, in collaboration with website designers. The project was conducted under the supervision of a team of clinician researchers. The website is available at no cost to registered participants. Self-help modules are accessed sequentially. Other features include a mood diary and a moderated discussion board. There has been an average of 1,475,135 hits on the site annually (2008 and 2009), with some 7400 unique visitors each year. A randomised controlled trial based on this program has been completed. Many people with bipolar disorder are accepting of the Internet as a source of treatment and, once engaged, show acceptable retention rates. The Internet appears to be a viable means of delivering psychosocial self-help strategies. © 2013 Copyright Taylor and Francis Group, LLC.
Lessons learned from delivering an internet intervention for insomnia in an Australian public hospital outpatient setting
- Authors: Meaklim, Hailey , Abbott, Jo-Anne , Kennedy, Gerard , Murray, Greg , Klein, Britt , Rehm, Imogen
- Date: 2019
- Type: Text , Journal article
- Relation: Australian Psychologist Vol. 54, no. 3 (2019), p. 225-234
- Full Text: false
- Reviewed:
- Description: Objectives: This study examined the feasibility of delivering an online cognitive behavioural therapy for insomnia intervention (Sleep-e) within an Australian public hospital outpatient insomnia clinic. Method: This study was conducted as an open trial pilot study. Fifty-two patients waiting for clinic treatment were invited to participate, with ten commencing and six completing the 7-week internet intervention. Participants completed a battery of questionnaires regarding their demographic information, sleep and insomnia symptoms, and provided feedback about the program. Exclusion criteria were minimal, and the study allowed for participants to have other health, psychiatric, and sleep disorder co-morbidities. Results: Post-program satisfaction results suggested that Sleep-e was easy to use; participants were satisfied with it; and found it beneficial in improving sleep. Paired samples t tests for the intention-to-treat sample indicated reductions in participants' insomnia severity (p = 0.02) and sleep onset latency (p = 0.04) from pre- to post-program. However, a larger sample is needed to generalise the results to the wider population. Conclusion: The findings support Sleep-e as a helpful treatment for insomnia in a public hospital outpatient population for at least a subgroup of patients. However, significant lessons were learned regarding the importance of educating health care providers and patients about novel models of internet service delivery. Potential models of adaptive or blended stepped-care are discussed to facilitate program implementation. Future research should identify how to implement internet interventions more effectively in public health settings to take advantage of their potential to improve clinical efficiency.