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Therapist-assisted Internet-delivered cognitive behavior therapy for depression and anxiety: Translating evidence into clinical practice

- Hadjistavropoulos, Heather, Pugh, Nicole, Nugent, Marcie, Hesser, Hugo, Andersson, Gerhard, Ivanov, Max, Butz, Cory, Marchildon, Gregory, Asmundson, Gordon, Klein, Britt, Austin, David

  • 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.

Considerations in the development of a therapist-assisted internet cognitive behavior therapy service.

- Hadjistavropoulos, Heather, Thompson, Maureen, Ivanov, Max, Drost, Christina, Butz, Cory, Klein, Britt, Austin, David

  • 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)

Dissemination of Therapist-Assisted Internet Cognitive Behaviour Therapy: Development and Open Pilot Study of a Workshop

- Hadjistavropoulos, Heather, Thompson, Maureen, Klein, Britt, Austin, David

  • 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.

A Case study illustrating therapist-assisted internet cognitive behavior therapy for depression

- Pugh, Nicole, Hadjistavropoulos, Heather, Klein, Britt, Austin, David

  • 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.
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