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Blending Internet-based and tele group treatment: Acceptability, effects, and mechanisms of change of cognitive behavioral treatment for depression

The current COV-19 pandemic increases the need for remote treatment. Among several provision strategies, tele groups have been tested as an efficient option. Still, the number of studies is comparably low, with a clear lack of studies investigating supposed treatment mechanisms. Sixty-one mildly to...

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Autores principales: Schuster, Raphael, Fischer, Elena, Jansen, Chiara, Napravnik, Nathalie, Rockinger, Susanne, Steger, Nadine, Laireiter, Anton-Rupert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9204733/
https://www.ncbi.nlm.nih.gov/pubmed/35722084
http://dx.doi.org/10.1016/j.invent.2022.100551
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author Schuster, Raphael
Fischer, Elena
Jansen, Chiara
Napravnik, Nathalie
Rockinger, Susanne
Steger, Nadine
Laireiter, Anton-Rupert
author_facet Schuster, Raphael
Fischer, Elena
Jansen, Chiara
Napravnik, Nathalie
Rockinger, Susanne
Steger, Nadine
Laireiter, Anton-Rupert
author_sort Schuster, Raphael
collection PubMed
description The current COV-19 pandemic increases the need for remote treatment. Among several provision strategies, tele groups have been tested as an efficient option. Still, the number of studies is comparably low, with a clear lack of studies investigating supposed treatment mechanisms. Sixty-one mildly to moderately depressed participants from Salzburg, Bavaria, and Upper Austria were randomized to the intervention or a waiting list control group (RCT). The seven-week treatment comprised preparatory online modules, followed by personalized feedback and a subsequent tele group session. Large treatment effects were observed for depression (CES-D: d = 0.99, p < .001; PHQ-9: d = 0.87, p = .002), together with large effects for cognitive behavioral skills (cognitive style, and behavioral activation, d = 0.88–0.97). Changes in skills mediated treatment outcomes for CES-D and PHQ-9, suggesting comparable mechanisms as in face-to-face therapy. Two typical moderators, therapeutic alliance, and group cohesion, however, failed to predict outcome (p = .289), or only exhibited statistical tendencies (p = .049 to .071). Client satisfaction, system usability, and treatment adherence were high. Blending Internet-based and tele group interventions offers additional options for low-threshold care that is less dependent on population density, commuting distances, or constraints due to the current COV-19 crisis. Results indicate that the blended intervention is clinically effective by fostering core CBT skills. While findings suggest the notion that working alliance and group cohesion can be established online, their relevancy for outcomes of blended treatment needs to be further investigated.
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spelling pubmed-92047332022-06-18 Blending Internet-based and tele group treatment: Acceptability, effects, and mechanisms of change of cognitive behavioral treatment for depression Schuster, Raphael Fischer, Elena Jansen, Chiara Napravnik, Nathalie Rockinger, Susanne Steger, Nadine Laireiter, Anton-Rupert Internet Interv Full length Article The current COV-19 pandemic increases the need for remote treatment. Among several provision strategies, tele groups have been tested as an efficient option. Still, the number of studies is comparably low, with a clear lack of studies investigating supposed treatment mechanisms. Sixty-one mildly to moderately depressed participants from Salzburg, Bavaria, and Upper Austria were randomized to the intervention or a waiting list control group (RCT). The seven-week treatment comprised preparatory online modules, followed by personalized feedback and a subsequent tele group session. Large treatment effects were observed for depression (CES-D: d = 0.99, p < .001; PHQ-9: d = 0.87, p = .002), together with large effects for cognitive behavioral skills (cognitive style, and behavioral activation, d = 0.88–0.97). Changes in skills mediated treatment outcomes for CES-D and PHQ-9, suggesting comparable mechanisms as in face-to-face therapy. Two typical moderators, therapeutic alliance, and group cohesion, however, failed to predict outcome (p = .289), or only exhibited statistical tendencies (p = .049 to .071). Client satisfaction, system usability, and treatment adherence were high. Blending Internet-based and tele group interventions offers additional options for low-threshold care that is less dependent on population density, commuting distances, or constraints due to the current COV-19 crisis. Results indicate that the blended intervention is clinically effective by fostering core CBT skills. While findings suggest the notion that working alliance and group cohesion can be established online, their relevancy for outcomes of blended treatment needs to be further investigated. Elsevier 2022-06-01 /pmc/articles/PMC9204733/ /pubmed/35722084 http://dx.doi.org/10.1016/j.invent.2022.100551 Text en © 2022 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Full length Article
Schuster, Raphael
Fischer, Elena
Jansen, Chiara
Napravnik, Nathalie
Rockinger, Susanne
Steger, Nadine
Laireiter, Anton-Rupert
Blending Internet-based and tele group treatment: Acceptability, effects, and mechanisms of change of cognitive behavioral treatment for depression
title Blending Internet-based and tele group treatment: Acceptability, effects, and mechanisms of change of cognitive behavioral treatment for depression
title_full Blending Internet-based and tele group treatment: Acceptability, effects, and mechanisms of change of cognitive behavioral treatment for depression
title_fullStr Blending Internet-based and tele group treatment: Acceptability, effects, and mechanisms of change of cognitive behavioral treatment for depression
title_full_unstemmed Blending Internet-based and tele group treatment: Acceptability, effects, and mechanisms of change of cognitive behavioral treatment for depression
title_short Blending Internet-based and tele group treatment: Acceptability, effects, and mechanisms of change of cognitive behavioral treatment for depression
title_sort blending internet-based and tele group treatment: acceptability, effects, and mechanisms of change of cognitive behavioral treatment for depression
topic Full length Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9204733/
https://www.ncbi.nlm.nih.gov/pubmed/35722084
http://dx.doi.org/10.1016/j.invent.2022.100551
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