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.
Development and usability evaluation of an online self-management intervention for fear of cancer recurrence (iConquerFear)
- Authors: Smith, Allan. , Bamgboje-Ayodele, Adeola , Butow, Phyllis , Klein, Britt , Turner, Jane , Sharpe, Louise , Fardell, Joanna , Beatty, Lisa , Pearce, Alison , Thewes, Belinda , Beith, Jane , Girgis, Afaf , iConquerFear Community Advisory, Group
- Date: 2019
- Type: Text , Journal article
- Relation: Psycho-Oncology Vol. , no. (2019), p.
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- Description: Objective: To develop and evaluate the usability of iConquerFear, an online self-management adaptation of an efficacious face-to-face therapist-delivered treatment for fear of cancer recurrence (FCR). Methods: iConquerFear development was theory based and person based. Development was guided by Ritterband et al's behaviour change model for internet interventions. iConquerFear end users (cancer survivors) provided iterative feedback in accordance with Yardley et al's person-based approach to maximise engagement and usability. Online focus groups and cognitive interviews were conducted to evaluate the usability of iConquerFear. Discussions were recorded, transcribed verbatim, and thematically analysed. Results: Five online FCR modules were developed. Twenty-three cancer survivors (47% of those eligible) participated; 11/23 (58%) were breast cancer survivors, and average age was 53 years (SD = 10.8). Thematic saturation was reached after six focus groups (n = 16) and seven individual think-aloud interviews. Thematic analysis produced five overarching themes: easy navigation essential; satisfaction and engagement with content; flexible access is key; normalising and empowering; and a useful first step. Conclusions: Online self-management interventions like iConquerFear have the potential to address the unmet supportive care needs reported by burgeoning numbers of cancer survivors. However, that potential may not be realised unless interventions are rigorously developed and user tested, as benefits are constrained by limited engagement. Themes from the usability testing of iConquerFear highlight the importance of developing flexible, tailored, interactive, and contextual online self-management interventions for people with cancer. © 2019 John Wiley & Sons, Ltd.
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
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- 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.
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.
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.
Advancing cognitive behaviour therapy for older adults with comorbid insomnia and depression
- Authors: Sadler, Paul , McLaren, Suzanne , Klein, Britt , Jenkins, Megan
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Cognitive Behaviour Therapy Vol. 47, no. 2 (2018), p. 139-154
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- Description: Insomnia and depression are two of the most common mental health problems that negatively impact older adults. The burden associated with these highly comorbid conditions requires an innovative approach to treatment. There have been significant advancements in the field of cognitive behaviour therapy for insomnia (CBT-I) over recent years. CBT-I has evolved from targeting homogenous insomnia samples to now showing promising results for comorbid insomnia. CBT-I is not only effective at treating comorbid insomnia, but can also have a positive impact on depression severity. Despite these important clinical developments, limited research has explored whether modifying CBT-I programmes to specifically target comorbid depression could improve outcomes for older populations. This paper reviews recent literature and provides therapeutic recommendations to advance CBT-I for older adults with comorbid insomnia and depression. © 2017 Swedish Association for Behaviour Therapy.
An online psychological intervention can improve the sexual satisfaction of men following treatment for localized prostate cancer : Outcomes of a randomised controlled trial evaluating my road ahead
- Authors: Wootten, Addie C , Meyer, Denny , Abbott, Jo-Anne , Chisholm, Katherine , Austin, David , Klein, Britt , McCabe, Marita , Murphy, Declan G , Costello, Anthony
- Date: 2016
- Type: Text , Journal article
- Relation: Psycho-Oncology Vol. 26, no. 7 (2016), p. 975-981
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- Description: BACKGROUND: Prostate cancer treatment often results in significant psycho-sexual challenges for men following treatment; however, many men report difficulty in accessing appropriate care. METHODS: A randomized controlled trial was undertaken to assess the efficacy of a 10-week self-guided online psychological intervention called My Road Ahead (MRA) for men with localized prostate cancer in improving sexual satisfaction. Participants were randomized to 1 of 3 conditions MRA alone or MRA plus online forum, or forum access alone. Pre, post, and follow-up assessments of overall sexual satisfaction were conducted. Mixed models and structural equation modeling were used to analyze the data. RESULTS: One hundred forty-two men (mean age 61 y; SD = 7) participated. The majority of participants had undergone radical prostatectomy (88%) and all men had received treatment for localized prostate cancer. Significant differences were obtained for the 3 groups (P = .026) and a significant improvement in total sexual satisfaction was observed only for participants who were allocated to MRA + forum with a large effect size (P = .004, partial eta2 = 0.256). Structural equation modeling indicated that increases in sexual function, masculine self-esteem, and sexual confidence contributed significantly to overall sexual satisfaction for the MRA + forum plus forum condition. CONCLUSIONS: This study is the first, to our knowledge, that has evaluated a self-guided online psychological intervention tailored to the specific needs of men with prostate cancer. The findings indicate the potential for MRA to deliver support that men may not otherwise receive and also highlight the importance of psychological intervention to facilitate improved sexual outcomes.
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.
Clinical and Cost-Effectiveness of Therapist-Guided Internet-Delivered Cognitive Behavior Therapy for Older Adults With Symptoms of Depression: A Randomized Controlled Trial
- Authors: Titov, Nickolai , Dear, Blake , Ali, Shehzad , Zou, Judy , Lorian, Carolyn , Johnston, Luke , Terides, Matthew , Kayrouz, Rony , Klein, Britt , Gandy, Milena , Fogliati, Vincent
- Date: 2015
- Type: Text , Journal article
- Relation: Behavior Therapy Vol. 46, no. 2 (2015), p. 193-205
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- Description: Depression is a common and significant health problem among older adults. Unfortunately, while effective psychological treatments exist, few older adults access treatment. The aim of the present randomized controlled trial (RCT) was to examine the efficacy, long-term outcomes, and cost-effectiveness of a therapist-guided internet-delivered cognitive behavior therapy (iCBT) intervention for Australian adults over 60. years of age with symptoms of depression. Participants were randomly allocated to either a treatment group (n= 29) or a delayed-treatment waitlist control group (n=. 25). Twenty-seven treatment group participants started the iCBT treatment and 70% completed the treatment within the 8-week course, with 85% of participants providing data at posttreatment. Treatment comprised an online 5-lesson iCBT course with brief weekly contact with a clinical psychologist, delivered over 8. weeks. The primary outcome measure was the Patient Health Questionnaire-9 Item (PHQ-9), a measure of symptoms and severity of depression. Significantly lower scores on the PHQ-9 (Cohen's d=. 2.08; 95% CI: 1.38 - 2.72) and on a measure of anxiety (Generalized Anxiety Disorder-7 Item) (Cohen's d=. 1.22; 95% CI: 0.61 - 1.79) were observed in the treatment group compared to the control group at posttreatment. The treatment group maintained these lower scores at the 3-month and 12-month follow-up time points and the iCBT treatment was rated as acceptable by participants. The treatment group had slightly higher Quality-Adjusted Life-Years (QALYs) than the control group at posttreatment (estimate: 0.012; 95% CI: 0.004 to 0.020) and, while being a higher cost (estimate $52.9. l 95% CI: -. 23.8 to 128.2), the intervention was cost-effective according to commonly used willingness-to-pay thresholds in Australia. The results support the potential efficacy and cost-effectiveness of therapist-guided iCBT as a treatment for older adults with symptoms of depression. © 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
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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.
A Case study illustrating therapist-assisted internet cognitive behavior therapy for depression
- Authors: Pugh, Nicole , Hadjistavropoulos, Heather , Klein, Britt , Austin, David
- Date: 2014
- Type: Text , Journal article
- Relation: Cognitive and Behavioral Practice Vol. 21, no. 1 (2014), p. 64-77
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- Description: Randomized controlled trials show that therapist-assisted Internet cognitive behavior therapy (ICBT) is efficacious in the treatment of depression. Given that this is a novel way of delivering cognitive behavior therapy, however, clinical service providers may have questions about how to provide therapist-assisted ICBT in clinical practice, particularly with respect to therapist assistance. To exemplify this approach, we present a case study of an older adult male who received 12 modules of therapist-assisted ICBT for depression over the course of 5. months. Highlights of the therapeutic exchanges that occurred over email are provided to illustrate the type of information clients may share with therapists and the nature of therapist assistance. Treatment progress was assessed via self-report questionnaires measuring depression, anxiety, and adjustment. Consistent with the research evidence, significant improvement was observed on all symptom measures at posttreatment. Satisfaction with the therapist-assisted ICBT program and a strong therapeutic alliance was also reported. The case will expand clinician understanding of therapist-assisted ICBT and may serve to stimulate clinician interest in the provision of therapist-assisted ICBT. Future research directions stemming from this case are presented. © 2013.
The impact of prostate cancer on partners: A qualitative exploration
- Authors: Wootten, Addie , Abbott, Jo-Anne , Osborne, Dawn , Austin, David , Klein, Britt , Costello, Anthony , Murphy, Declan
- Date: 2014
- Type: Text , Journal article
- Relation: Psycho-Oncology Vol. 23, no. 11 (2014), p. 1252-1258
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- Description: Objective: Prostate cancer and its treatment can result in numerous physical and psychological morbidities for the patient as well as his partner. This qualitative study aimed to explore the experiences of intimate spouses or partners of men diagnosed and/or treated for prostate cancer to better understand the personal impact of prostate cancer on the partner. Methods: Twenty-seven partners participated in this study. Six focus groups were convened, and one in-depth interview was undertaken to explore the practical impact of prostate cancer on the intimate spouse/partner. All discussions were audio-recorded and transcribed and then coded using a thematic approach. Results: Six themes emerged: (a) The influence of the man's response to prostate cancer on the partner, (b) The need to be involved in treatment and medical decision making, (c) Supporting a man who is experiencing a loss of masculinity, (d) Degree of congruence between each partner's coping responses, (e) Constrained communication, and (f) Changed roles and increased practical management. Conclusions: It is clear that prostate cancer impacts substantially on many areas of partner well-being. An effective intervention provided to this population seems warranted and may lead to improvements in partner well-being, assist the couple in lessening the impact of prostate cancer and its treatment on their relationship, and assist in the man's recovery. © 2014 John Wiley & Sons, Ltd.
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
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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.
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.
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.
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
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- 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)
Establishing guidelines for executing and reporting internet research
- Authors: Proudfoot, Judith , Klein, Britt , Barak, Azy , Calbring, Per , Cuijpers, Pim , Lange, Alfred , Ritterband, Lee , Andersson, Gerhard
- Date: 2011
- Type: Text , Journal article
- Relation: Cognitive behaviour therapy Vol. 40, no. 2 (2011), p. 82-97
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- Description: The field of Internet interventions is growing rapidly. New programs are continually being developed to facilitate health and mental health promotion, disease and emotional distress prevention, risk factor management, treatment, and relapse prevention. However, a clear definition of Internet interventions, guidelines for research, and evidence of effectiveness have been slower to follow. This article focuses on the quality standardization of research on Internet-delivered psychological and behavioural interventions. Although the science underpinning Internet interventions is just starting to be established, across research studies there are often conceptual and methodological difficulties. The authors argue that this situation is due to the lack of universally accepted operational guidelines and evaluation methods. Following a critical appraisal of existing codes of conduct and guidelines for Internet-assisted psychological and health interventions, the authors developed a framework of guidelines for Internet intervention research utilizing aspects of facet theory (Guttman & Greenbaum, 1998). The framework of facets, elements, and guidelines of best practice in reporting Internet intervention research was then sent to several leading researchers in the field for their comment and input, so that a consensus framework could be agreed on. The authors outline 12 key facets to be considered when evaluating and reporting Internet intervention studies. Each facet consists of a range of recommended elements, designed as the minimum features for reporting Internet intervention studies. The authors propose that this framework be utilized when designing and reporting Internet intervention research, so results across studies can be replicated, extended, compared, and contrasted with greater ease and clarity.
Training postgraduate psychology students to deliver psychological services online
- Authors: Shandley, Kerrie , Klein, Britt , Kyrios, Michael , Austin, David , Ciechomski, Lisa , Murray, Greg
- Date: 2011
- Type: Text , Journal article
- Relation: Australian psychologist Vol. 46, no. 2 (2011), p. 120-125
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- Description: Information and communication technologies are increasingly being used to remotely deliver psychological services. This delivery method confers clear advantages to both client and therapist, including the accessibility of services by otherwise unserved populations and cost-effective treatment. Remote services can be delivered in a real-time or delayed manner, providing clients with a wealth of therapy options not previously available. The proliferation of these services has outstripped the development and implementation of all but the most rudimentary of regulatory frameworks, potentially exposing clients to substandard psychological services. Integrating mandatory training on the delivery of online psychological services into accredited postgraduate psychology courses would aid in addressing this issue. The purpose of this article is to outline issues of consideration in the development and implementation of such a training programme. An online etherapy training programme developed by Swinburne University's National eTherapy Centre will be used as an example throughout.
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.
Online alcohol interventions: A systematic review
- Authors: White, Angela , Kavanagh, David , Stallman, Helen , Klein, Britt , Kay-Lambkin, Frances , Proudfoot, Judith , Drennan, Judy , Connor, Jason , Baker, Amanda , Hines, Emily , Young, Ross
- Date: 2010
- Type: Text , Journal article , Review
- Relation: Journal of Medical Internet Research Vol. 12, no. 5 (2010), p. e62p.1-e62p.12
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- Description: Background: There has been a significant increase in the availability of online programs for alcohol problems. A systematic review of the research evidence underpinning these programs is timely. Objectives: Our objective was to review the efficacy of online interventions for alcohol misuse. Systematic searches of Medline, PsycINFO, Web of Science, and Scopus were conducted for English abstracts (excluding dissertations) published from 1998 onward. Search terms were: (1) Internet, Web*; (2) online, computer *; (3) alcohol*; and (4) Eeffect *, trial*, random* (where * denotes a wildcard). Forward and backward searches from identified papers were also conducted. Articles were included if (1) the primary intervention was delivered and accessed via the Internet, (2) the intervention focused on moderating or stopping alcohol consumption, and (3) the study was a randomized controlled trial of an alcohol-related screen, assessment, or intervention. Results: The literature search initially yielded 31 randomized controlled trials (RCTs), 17 of which met inclusion criteria. Of these 17 studies, 12 (70.6%) were conducted with university students, and 11 (64.7%) specifically focused on at-risk, heavy, or binge drinkers. Sample sizes ranged from 40 to 3216 (median 261), with 12 (70.6%) studies predominantly involving brief personalized feedback interventions. Using published data, effect sizes could be extracted from 8 of the 17 studies. In relation to alcohol units per week or month and based on 5 RCTs where a measure of alcohol units per week or month could be extracted, differential effect sizes to posttreatment ranged from 0.02 to 0.81 (mean 0.42, median 0.54). Pre-post effect sizes for brief personalized feedback interventions ranged from 0.02 to 0.81, and in 2 multi-session modularized interventions, a pre-post effect size of 0.56 was obtained in both. Pre-post differential effect sizes for peak blood alcohol concentrations (BAC) ranged from 0.22 to 0.88, with a mean effect size of 0.66. Conclusions: The available evidence suggests that users can benefit from online alcohol interventions and that this approach could be particularly useful for groups less likely to access traditional alcohol-related services, such as women, young people, and at-risk users. However, caution should be exercised given the limited number of studies allowing extraction of effect sizes, the heterogeneity of outcome measures and follow-up periods, and the large proportion of student-based studies. More extensive RCTs in community samples are required to better understand the efficacy of specific online alcohol approaches, program dosage, the additive effect of telephone or face-to-face interventions, and effective strategies for their dissemination and marketing.
- Description: Background: There has been a significant increase in the availability of online programs for alcohol problems. A systematic review of the research evidence underpinning these programs is timely. Objectives: Our objective was to review the efficacy of online interventions for alcohol misuse. Systematic searches of Medline, PsycINFO, Web of Science, and Scopus were conducted for English abstracts (excluding dissertations) published from 1998 onward. Search terms were: (1) Internet, Web*; (2) online, computer *; (3) alcohol*; and (4) E\effect *, trial*, random* (where * denotes a wildcard). Forward and backward searches from identified papers were also conducted. Articles were included if (1) the primary intervention was delivered and accessed via the Internet, (2) the intervention focused on moderating or stopping alcohol consumption, and (3) the study was a randomized controlled trial of an alcohol-related screen, assessment, or intervention. Results: The literature search initially yielded 31 randomized controlled trials (RCTs), 17 of which met inclusion criteria. Of these 17 studies, 12 (70.6%) were conducted with university students, and 11 (64.7%) specifically focused on at-risk, heavy, or binge drinkers. Sample sizes ranged from 40 to 3216 (median 261), with 12 (70.6%) studies predominantly involving brief personalized feedback interventions. Using published data, effect sizes could be extracted from 8 of the 17 studies. In relation to alcohol units per week or month and based on 5 RCTs where a measure of alcohol units per week or month could be extracted, differential effect sizes to posttreatment ranged from 0.02 to 0.81 (mean 0.42, median 0.54). Pre-post effect sizes for brief personalized feedback interventions ranged from 0.02 to 0.81, and in 2 multi-session modularized interventions, a pre-post effect size of 0.56 was obtained in both. Pre-post differential effect sizes for peak blood alcohol concentrations (BAC) ranged from 0.22 to 0.88, with a mean effect size of 0.66. Conclusions: The available evidence suggests that users can benefit from online alcohol interventions and that this approach could be particularly useful for groups less likely to access traditional alcohol-related services, such as women, young people, and at-risk users. However, caution should be exercised given the limited number of studies allowing extraction of effect sizes, the heterogeneity of outcome measures and follow-up periods, and the large proportion of student-based studies. More extensive RCTs in community samples are required to better understand the efficacy of specific online alcohol approaches, program dosage, the additive effect of telephone or face-to-face interventions, and effective strategies for their dissemination and marketing.