Leanne Michelle Casey

Dropout from Internet‐based treatment for psychological disorders

PURPOSE The purpose of this review was to present an in-depth analysis of literature identifying the extent of dropout from Internet-based treatment programmes for psychological disorders, and literature exploring the variables associated with dropout from such programmes. METHODS A comprehensive literature search was conducted on PSYCHINFO and PUBMED with the keywords: dropouts, drop out, dropout, dropping out, attrition, premature termination, termination, non-compliance, treatment, intervention, and program, each in combination with the key words Internet and web. A total of 19 studies published between 1990 and April 2009 and focusing on dropout from Internet-based treatment programmes involving minimal therapist contact were identified and included in the review. RESULTS Dropout ranged from 2 to 83% and a weighted average of 31% of the participants dropped out of treatment. A range of variables have been examined for their association with dropout from Internet-based treatment programmes for psychological disorders. Despite the numerous variables explored, evidence on any specific variables that may make an individual more likely to drop out of Internet-based treatment is currently limited. CONCLUSIONS This review highlights the need for more rigorous and theoretically guided research exploring the variables associated with dropping out of Internet-based treatment for psychological disorders.

The use of mobile telephones as adjuncts to cognitive behavioral psychotherapy.

Despite the rapid proliferation of technological adjuncts in cognitive behavior therapy (CBT), much of this development appears to have occurred on an ad hoc basis and in many cases has resulted in applications that are beyond the resources of most practicing clinicians. The authors delineate the specific areas in which CBT can be augmented through use of technology and outline the characteristics of an ideal therapy augmentor. Mobile telephones are identified as a low-cost and accessible device whose use has been largely untapped to date. The existing literature on use of the mobile phone is reviewed, and potential areas for its application in CBT are examined. The authors conclude with clinical guidelines for its use and the recommendation that use of mobile phones in CBT is a promising avenue for both clinical practice and research.

Technological adjuncts to increase adherence to therapy: a review

This paper identified and reviewed technological adjuncts to increase client adherence to therapy. Three areas of adherence were identified, namely treatment dropout and non-attendance, engagement during and between therapy sessions, and aftercare. Database searches were conducted in each of these areas to identify relevant studies published between the years of 1990 and 2010. Adjuncts designed to replace or reduce direct therapist contact, change the medium of communication between the client and therapist, or alter the content or style of the therapy were not included in this review. Adjuncts were reviewed in light of theories of adherence, including Self Determination Theory, the Transtheoretical Model, and the Theory of Planned Behaviour. Adjuncts reviewed included appointment reminders, exercises and monitoring delivered by mobile phone, and exercises and data collection delivered by computer. Limitations and directions for future research were addressed and discussed.

Technological adjuncts to enhance current psychotherapy practices: A review

Although there are several of reviews of technology in psychology, none to date has focused on technological adjuncts for improving traditional face to face therapy. However, examination of response, adherence, and dropout rates suggests there is considerable scope for improving traditional face to face services. The purpose of this paper was to examine technological adjuncts used to enhance psychotherapy practice. This review focused only on those technologies designed to supplement or enhance traditional therapy methods. Adjuncts designed to reduce direct therapist contact or change the medium of communication were not included. Adjuncts reviewed were mobile phones, personal digital assistants, biofeedback and virtual reality. Limitations in the current literature and directions for future research were identified and discussed. This review provides a comprehensive examination of the way in which adjunctive technologies may be incorporated into face to face therapy.

The role of catastrophic misinterpretation of bodily sensations and panic self-efficacy in predicting panic severity

This study investigated the role of both negative and positive cognitions in predicting panic severity in an international sample of patients diagnosed with panic disorder (with and without agoraphobia). One hundred and fifty-nine patients were administered the Brief Bodily Sensations Interpretation Questionnaire (BBSIQ), the Self-efficacy to Control Panic Attacks Questionnaire, and the Panic and Agoraphobia Scale (PAS) prior to receiving treatment. Regression analyses indicated that both catastrophic misinterpretation of bodily sensations and panic self-efficacy independently predicted panic severity. The influence of panic self-efficacy upon panic severity remained significant even after controlling for the presence or absence of agoraphobia. There was no evidence to suggest a moderating relationship between the two cognitive factors. Results are discussed in terms of the need to consider both negative and positive cognitions in cognitive accounts of panic disorder.

Cognitive Mediation of Panic Severity: The Role of Catastrophic Misinterpretation of Bodily Sensations and Panic Self-Efficacy

This study examined the differential role of negative and positive cognitions in mediating treatment outcome in CBT for Panic Disorder through comparison of a Standard CBT (n = 36) versus a Waitlist Condition (n = 24). Regression analyses indicated that, relative to the Waitlist Condition, patients in the Standard CBT condition reported significantly greater shifts both towards higher panic self-efficacy and lower catastrophic misinterpretation of bodily sensations during treatment, as well as a significantly lower level of panic severity at posttreatment. Changes in catastrophic misinterpretation of bodily sensations and panic self-efficacy contributed significantly more to prediction of panic severity than did assignment to either Standard CBT or a Waitlist Condition. Results are discussed in terms of the importance of including both negative and positive cognitions in demonstrating cognitive mediation.

Measuring self-efficacy in gambling: the Gambling Refusal Self-Efficacy Questionnaire.

This paper reports on the development and psychometric properties of a Gambling Refusal Self-Efficacy Questionnaire (GRSEQ). Two hundred and ninety-seven gamblers from both normal and clinical populations completed an initial set of 31-items of which 26 were selected for inclusion in the final version of the GRSEQ. A series of factor analyses showed four clear factors accounting for 84% of the variance. These factors can be summarised as situations and thoughts associated with gambling, the influence of drugs on gambling, positive emotions associated with gambling and negative emotions associated with gambling. The GRSEQ total score and factors scores showed high internal consistency (Cronbach’s alpha ranging from 0.92 to 0.98). Participants experiencing problems with gambling scored significantly lower on the GRSEQ, and discriminant analyses showed that the scale is able to correctly classify the non-problem (i.e., community and student samples) and problem gamblers (i.e., clinical sample). Furthermore, the GRSEQ showed significant negative relationships with other gambling-related variables (gambling urge and gambling-related cognitions) and negative mood states (depression, anxiety and stress) and was shown to be sensitive to change in treatment of pathological gambling. The results suggest that the GRSEQ is a useful measure of gambling refusal self-efficacy that is suitable for assessment of gamblers from both normal and clinical populations.

Effectiveness of Group and Individual Formats of a Combined Motivational Interviewing and Cognitive Behavioral Treatment Program for Problem Gambling: A Randomized Controlled Trial

BACKGROUND The study aimed to assess the effectiveness of group and individual formats of a combined motivational interviewing and cognitive behavioral treatment (CBT) program for problem gamblers (PGs) using a randomized controlled design. METHOD One hundred and two PGs were randomly assigned to individual or group CBT conditions. Twenty-eight of these participants were randomly allocated to a 6-week waitlist control condition prior to receiving the designated treatment. RESULTS At post-treatment, there were significant improvements in all dependent variables (frequency and amount gambled, gambling urges, gambling cognitions, negative psychological states, and life satisfaction) for both the treatment conditions but not for the waitlist condition. Individuals that completed the individual (compared to group) treatment condition generally had higher effect sizes for gambling correlates. Therapeutic gains for gambling correlates were generally maintained at 6-month follow-up. CONCLUSIONS A combined motivational interviewing and CBT program applied in group or individual format can improve PG behaviors, as well as gambling correlates.

Outcomes associated with virtual reality in psychological interventions: where are we now?

The impending commercial release of affordable VR systems is likely to accelerate both the opportunity and demand for VR applications that specifically target psychological conditions. The aim of this study was to conduct a meta-analysis of outcomes associated with VR psychological interventions and to examine the methodological rigour used in these interventions. Literature search was conducted via Ovid, ProQuest Psychology Journals and ScienceDirect (Psychology) databases. Interventions were required to: be published between 1980 to 2014; use a randomised controlled trial design; be published in a scholarly journal; focused primarily on psychological/behavioural intervention; include validated measures; include reported means and standard deviations of outcome measures; and include one group with clinical/subclinical disorders, syndromes or distressing behaviours. Thirty eligible studies were identified. Random effects meta-analysis found an overall moderate effect size for VR interventions. Individual meta-analyses found an overall large effect size against non-intervention wait-lists and an overall moderate effect size against active interventions. No correlation was found between treatment outcomes and methodological rigour. Limitations may include limited study numbers, the use of a single coder, a need for more in-depth analyses of variation in form VR intervention, and omission of presence as a moderating factor. The current review supports VR interventions as efficacious, promising forms of psychological treatment. Use of reporting guidelines such as the CONSORT and CONSORT-EHEALTH statements should promote greater emphasis on methodological rigour, providing a firm foundation for the further development of clinical VR applications.

Measuring mental health literacy – a review of scale-based measures

Abstract Background: Mental Health Literacy (MHL) has become an important concept in the literature; however, quantitative research on MHL methodology has been limited. Aims: This review identified peer-reviewed papers investigating MHL, assessed psychometric attributes of scale-based measures of MHL, and the extent that studies assessed the attributes that define MHL. Method: A comprehensive review of the literature was conducted to identify measures which generate a total MHL or subscale score was also conducted. A total of 13 studies were identified and their psychometric attributes determined using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN). The extent to which each measure assessed the attributes of MHL was also determined. Results: Results showed that included studies failed to report detailed information about the sample, measure development and testing to demonstrate the psychometric properties of their tool. Conclusion: There are substantial limitations in current ability to measure MHL and there is significant scope for the development and evaluation of psychometrically robust measures that assess the relevant attributes of MHL. Further research could also focus on the adequacy of the current definition of MHL.