Positive psychology and the internet: A Mental health opportunity
- Authors: Mitchell, Joanna , Vella-Brodrick, Dianne , Klein, Britt
- Date: 2010
- Type: Text , Journal article
- Relation: Sensoria Vol. 6, no. 2 (2010), p.30-41
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- Description: This paper reviews two relatively young fields of research - positive psychology and internet interventions – and discusses the combined potential of online positive psychology interventions (OPPIs) as an effective and sustainable health promotion tool. Five randomised controlled trials were identified testing the efficacy of OPPIs as a means of enhancing well-being, with three studies demonstrating increased well-being compared to a control group. Three studies also demonstrated depression symptom reduction, suggesting that well-being interventions may also have an illness treatment and prevention function. While this review is limited by the small number of studies currently available, researchers and practitioners are asked to consider the mental health promotion opportunities and benefits of delivering well-being interventions online.
Do GPs use electronic mental health resources? A qualitative study
- Authors: Austin, David , Pier, Ciaran , Mitchell, Joanna , Schattner, Peter , Wade, Victoria , Pierce, David , Klein, Britt
- Date: 2006
- Type: Text , Journal article
- Relation: Australian Family Physician Vol. 35, no. 5 (2006), p. 365-366
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- Description: BACKGROUND: The Better Outcomes in Mental Health Care (BOMHC) initiative encourages general practitioners to use electronic mental health resources (EMHRs) during consultation with patients requiring psychological assistance. However, there is little data on GPs' acceptance and use of EMHRs. METHOD: Semistructured interviews were conducted with 27 GPs to determine their attitude toward EMHRs, and their use during consultation with patients. RESULTS: Few GPs reported frequently using EMHRs in consultation. Identified barriers to use included lack of familiarity with information technology, and insufficient knowledge of available resources. Identified advantages of electronic resources included high patient acceptance, time efficiency, and improved quality of information. DISCUSSION: General practitioners recognise several advantages of utilising electronic resources for managing patients with mental illness. However, GPs are not sufficiently familiar with electronic resources to use them effectively. This could be overcome by education.
A randomised controlled trial of a self-guided internet intervention promoting well-being
- Authors: Mitchell, Joanna , Stanimirovic, Rosanna , Klein, Britt , Vella-Brodrick, Dianne
- Date: 2009
- Type: Text , Journal article
- Relation: Computers in Human Behavior Vol. 25, no. 3 (2009), p. 749-760
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- Description: Positive psychology is paving the way for interventions that enduringly enhance well-being and the internet offers the potential to disseminate these interventions to a broad audience in an accessible and sustainable manner. There is now sufficient evidence demonstrating the efficacy of internet interventions for mental illness treatment and prevention, but little is known about enhancing well-being. The current study examined the efficacy of a positive psychology internet-based intervention by adopting a randomised controlled trial design to compare a strengths intervention, a problem solving intervention and a placebo control. Participants (n = 160) completed measures of well-being (PWI-A, SWLS, PANAS, OTH) and mental illness (DASS-21) at pre-assessment, post-assessment and 3-month follow-up. Well-being increased for the strengths group at post- and follow-up assessment on the PWI-A, but not the SWLS or PANAS. Significant changes were detected on the OTH subscales of engagement and pleasure. No changes in mental illness were detected by group or time. Attrition from the study was 83% at 3-month follow-up, with significant group differences in adherence to the intervention: strengths (34%), problem solving (15.5%) and placebo control (42.6%). Although the results are mixed, it appears possible to enhance the cognitive component of well-being via a self-guided internet intervention. © 2009 Elsevier Ltd. All rights reserved.
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
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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.
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
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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
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- 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
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- 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.
The first two years of Anxiety Online, an international e-mental health service for the anxiety disorders.
- Authors: Klein, Britt , Austin, David , Nguyen, David , Smith, Andrew , Donelan, Patrick , Abbott, Jo-Anne , Kyrios, Michael , Mitchell, Joanna , Lauder, Sue , Shandley, Kerrie , Moulding, Richard , Nedeljkovic, Maja , Meyer, Denny , Ciechomski, Lisa , Shields, David , Baulch, Josephine , Williams, Ben
- Date: 2010
- Type: Text , Book chapter
- Relation: Anxiety disorders : current understandings, novel treatments 14 p. 187-203
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A controlled trial of internet-based cognitive-behavioural therapy for panic disorder with face-to-face support from a general practitioner or email support from a psychologist
- Authors: Pier, Ciaran , Austin, David , Klein, Britt , Mitchell, Joanna , Schattner, Peter , Ciechomski, Lisa , Gilson, Kathryn , Pierce, David , Shandley, Kerrie , Wade, Victoria
- Date: 2008
- Type: Text , Journal article
- Relation: Mental Health in Family Medicine Vol. 5, no. 1 (2008), p. 28-29
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- Description: Background: Panic disorder (PD) is one of the most common anxiety disorders seen in general practice, but provision of evidence-based cognitive-behavioural treatment (CBT) is rare. Many Australian GPs are now trained to deliver focused psychological strategies, but in practice this is time consuming and costly. Objective: To evaluate the efficacy of an internet-based CBT intervention (Panic Online) for the treatment of PD supported by general practitioner (GP)-delivered therapeutic assistance. Design: Panic Online supported by GP-delivered face-to-face therapy was compared to Panic Online supported by psychologist-delivered email therapy. Methods: Sixty-five people with a primary diagnosis of PD (78% of whom also had agoraphobia) completed 12 weeks of therapy using Panic Online and therapeutic assistance with his/her GP (n = 34) or a clinical psychologist (n = 31). The mean duration of PD for participants allocated to these groups was 59 months and 58 months, respectively. Participants completed a clinical diagnostic interview delivered by a psychologist via telephone and questionnaires to assess panic-related symptoms, before and after treatment. Results: The total attrition rate was 20%, with no group differences in attrition frequency. Both treatments led to significant improvements in panic attack frequency, depression, anxiety, stress, anxiety sensitivity and quality of life. There were no statistically significant differences in the two treatments on any of these measures, or in the frequency of participants with clinically significant PD at post assessment. Conclusions: When provided with accessible online treatment protocols, GPs trained to deliver focused psychological strategies can achieve patient outcomes comparable to efficacious treatments delivered by clinical psychologists. The findings of this research provide a model for how GPs may be assisted to provide evidence-based mental healthcare successfully. © 2008 Radcliffe Publishing.
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.